More young in their 20s dying, Coronavirus mutating?

[lonely_john]

https://tribune.com.pk/story/2181846/1-young-doctor-screening-coronavirus-patients-passes-away-gilgit-baltistan/

 

https://www.huffingtonpost.co.uk/entry/coronavirus-deaths-22-march-2020_uk_5e77544dc5b6f5b7c545fc9c

 

https://www.newsweek.com/olympic-champion-swimmer-diagnosed-coronavirus-calls-it-worse-virus-i-have-ever-endured-1493664

 

https://www.bbc.com/sport/football/51995137

 

https://news.sky.com/story/coronavirus-healthy-nhs-nurse-36-in-intensive-care-after-contracting-covid-19-11962025

 

https://www.cbc.ca/news/canada/toronto/coronavirus-patient-1.5502501

 

I’ve been reading more of these cases in the last 2 days. Athletes, doctors, university students, even young teenagers dying, with no pre-existent conditions or travel history to China, Iran, or Italy. I hope this virus is not mutating and learning how to kill everyone and not only the elders. Please stay safe, self-isolate, and ask your closest providers to do the same and spread the word.

Edited March 23, 2020 by lonely_john

[+ azdr0710]

Can you link a few articles that discuss this? Thanks.

[+ Keith30309]

This is probably a stupid question but how difficult is it to extract the DNA map of an infected person to compare it to that which is infecting others ?

[BSR]

I’ve been reading more of these cases in the last 2 days. Athletes, doctors, university students, even young teenagers dying, with no pre-existent conditions or travel history to China, Iran, or Italy. I hope this virus is not mutating and learning how to kill everyone and not only the elders. Please stay safe, self-isolate, and ask your closest providers to spread the word.

 

I've read the same thing. One theory is that because vaping causes lung damage, albeit usually undetected because vapers are often young and otherwise healthy, vapers are far more likely to die if they catch the coronavirus. Since vaping is a relatively new phenomenon, we lack medical studies on its long-term effects. I'm convinced that vaping is not the safe alternative to cigarettes that people thought/hoped it would be.

[+ stevenkesslar]

Can you link a few articles that discuss this? Thanks.

 

I'm going to cut and paste part of what I just posted in the Politics Forum. This is the part of the post that is apolitical and relates to this question:

 

I'll keep repeating certain points. I think Newsom's strategy is that a lot of young people are going to get sick, anyway. No Governor can say, "Hey, go on Spring break and get a virus, kids." But in some ways, that's good policy. Their risks are about the same as the whole population faces every Winter, anyway. Clearly, many of them feel young and invulnerable.

 

The massive workforce problem is that whether this peaks in May or July, my experience with my parents is that young people, like college students, are the ones who do most the front-line and entry-level jobs in nursing homes. They serve the food to seniors, clean the tables, provide personal care, etc. We know from Washington state's experience that the last thing you want is this virus ripping through a nursing home full of seniors.

 

One way or the other, a lot of these young people want to go to work and simply have to go to work now - at Albertsons, or Dominos, or a Kaiser pharmacy, or a construction job. Their risk of getting seriously ill or dying is low - or at least much lower than the risks for seniors.

 

If we didn't have a "hospital-demic", arguably it would make sense to tell everyone under 30 or 40, or even 50 or 60 if they have no serious health problems already, to just keep living their lives normally. You're going to get a bad flu, but you'll be fine. No Governor can say that, because it is horrible politics. And even if they did, the problem is that unless you can put all the higher risk groups in a bubble, you're going to have a hospital crisis, anyway.

 

As an aside, this may end up being nature's most effective commercial against smoking and vaping, ever.

 

I've been trying to figure out why it is that 20 % of young adults end up in hospitals, as reported by the CDC. At least based on this data, I think the answer is clear. Of a group of 2449 COVID-19 cases, 705 were aged 20-44. Of that group, 15 - 20 % were hospitalized. 2 - 4 % of the total group (so maybe 15 or so people) were admitted to the ICU. Of all 705 people with COVID-19 aged 20-44, one died.

 

All this is going to change. Under normal policy, the 100 or so 20-44 year olds would be kept in a hospital for observation, and also for isolation. That's probably not going to happen now. In NYC, every one of those beds is urgently needed for people who may need life saving care. I'm no doctor, but I think the health care problem is that you can't tell in advance, necessarily, which 15 of those 100 patients aged 20-44 will need to be admitted to the ICU.

 

Rep. Ben McAdam, 45, is at home, but he says this: “I got really labored breathing. I feel like I have a belt around my chest, really tight. When I cough, my muscles are so sore so I just feel pain every time I cough, which is frequently. I feel short of breath, and I have a fever of about 102. So, it’s pretty bad.” So he should be fine. But if there are a lot of healthy 45 year olds out there, and this is how sick they get, it goes back to the basic "hospital-demic" problem.

 

No one knows why a small group of young people need to be in an ICU. But one theory is that they smoke or vape. Since this is an illness that screws up your lungs, that at least makes sense as a theory. So one benefit of COVID-19 is it could scare young people out of smoking, or vaping.

 

 

 

To me knowledge, that CDC study is the best one in the US. And it is being used to document the headlines that a significant percentage of the people in hospitals are young. That is true. But they are not a significant part of the people who are dying. The real health care problem is that if some of them (about 15 % of those hospitalized) had not been admitted to an ICU, they may have died.

 

Here's a story about workers at Amazon who are rightfully scared. The massive workforce issue is that even young and healthy people like Ben McAdam don't particularly want to get the nastiest flu ever - even if they know they will be fine. They certainly deserve sick pay, because they are the front line soldiers, in effect, in a global war against a virus. And some of these industries are critical now. We can't just close grocery stores and pharmacies and Amazon down. And part of the reason why is that no matter what the federal government sends out as a cushion, a lot of people want to work, and need the money.

 

We were not prepared. But sooner rather than later this has to get sorted out, and will get sorted out. In California, I think the implicit message is that if you are a 40 year old construction worker, we desperately need your labor now. You're in a union, so if you get sick you will get sick pay. And if you are one of the unlucky ones who need an ICU, we have your back - just like you have our's. And if you are 70 and have lung and heart conditions, please stay home and avoid this mess.

 

I don't think anybody in office can say it as bluntly as I just did. But, in effect, and right or wrong, that is what is being said through policy.

 

What would help a lot if the goal is to suppress this once we get it under control is to get everybody tested ASAP. The FDA is already approving fast track do-it-yourself test kits, I think. Everybody should get one in the mail, for free, just like everybody gets one in the mail. we should have drive through tests stations everywhere, like South Korea does. So Patriotism 2020 means you test yourself, and isolate yourself if you test positive. It may save lives or a stay in the hospital - even if you are 20 and very unfortunate. Whatever this would cost, it is a small fraction of what we are all going to pay because we were totally unprepared.

Edited March 23, 2020 by stevenkesslar

[lonely_john]

This is probably a stupid question but how difficult is it to extract the DNA map of an infected person to compare it to that which is infecting others ?

I see where you are coming from. You mean the severely ill, right?

[lonely_john]

I've read the same thing. One theory is that because vaping causes lung damage, albeit usually undetected because vapers are often young and otherwise healthy, vapers are far more likely to die if they catch the coronavirus. Since vaping is a relatively new phenomenon, we lack medical studies on its long-term effects. I'm convinced that vaping is not the safe alternative to cigarettes that people thought/hoped it would be.

Legitimate valid theory. I do think that young vapers have unknowingly put themselves at a higher risk. But this does not explain the cases of sports people getting severely ill.

[mike carey]

I have no evidence, but I suspect that a proportion of younger people was always going to have severe disease, and that as the total number of cases increases, the number of seriously ill young people is becoming clear.

[+ stevenkesslar]

I have no evidence, but I suspect that a proportion of younger people was always going to have severe disease, and that as the total number of cases increases, the number of seriously ill young people is becoming clear.

 

I'm not sure about that, Mike. The best evidence we do have so far tends to suggest the opposite.

 

That said, right now the correct message the CDC and just about every leader is trying to send is that this is not something young adults should take lightly. The CDC is saying it from the perspective of how a young adult could end up in a hospital. But for most leaders, I think this is closer to the rhetoric being used:

 

Earlier Sunday, New York Gov. Andrew Cuomo ordered New York City to come up with a plan to reduce the number of people gathering in public spaces within 24 hours. Cuomo said he saw people gathered in large groups and playing recreational sports during a tour of public places in the city on Saturday. He said such activity is “insensitive, it’s arrogant, it’s self-destructive, it’s disrespectful to other people and it has to stop and it has to stop now.”

 

That data from Italy documents that most of the people who died were old, and had a bunch of underlying illnesses. The CDC data essentially backed that up. It is scary that 15 % of patients under 44 ended up in hospitals. But only one of them died.

 

https://www.nejm.org/doi/full/10.1056/NEJMoa2002032

 

I've posted that before, but that's data from 1099 patients in China. Less than half of them live in Wuhan, and the average age was 47. So I think those are people all across China who either traveled to Wuhan, or knew someone who did. This is probably the closest we have right now to a picture of a typical workforce-age population of infected people. 1 % of them were under 14, and 15 % of them were over 65. But the vast majority are basically workforce age.

 

Of these 1099 people, 173 had "severe" symptoms. It does not list their age, but it does say 261 of them had some co-existing disorder. Like hypertension, diabetes, cancer, heart disease, etc. 137 of the total group were smokers.

 

Of the entire group of 1099 people, 15 died. That's a 1.4 % death rate. This is a guess on my part. But based on the CDC data and the data from Italy, it suggests that in three different countries the people at risk of dying probably are those that are old, or sick (significant pre-existing conditions), or both. In the 1918 pandemic, young men and women in their 30's were dropping like flies and dying in a matter of hours. If that were happening right now, we'd know it. It just isn't.

 

I've looked at that Chinese data several times. What I just noticed now is that almost all 1099 patients had pneumonia. When I posted on this several days ago, I assumed that these 1099 people were all caught in this huge national dragnet right after the lock down simply because they tested positive. I assumed they were all sent to hospital in part to be safely isolated.

 

But I think my initial assumption was wrong. If they all had pneumonia, and the average age was 47, that strongly suggests this was a subset of all the people infected. These were likely the ones who had a tougher time beating COVID-19. In other words, the true death rate for a "workforce age" group like this might be lower than what these figures indicate. In South Korea, where lots of younger people were tested, the death rate is currently 1.1 %. That said, if almost all these people had pneumonia, that makes your part. This is not like swine flu. It is serious shit. So if you are 30 or 40 you are very likely not going to die. But like Rep. Ben McAdam, who is 45, you are really going to feel like shit for a few weeks.

 

The reason I think this is important is right now, workers at Amazon or workers in government offices are legitimately scared. If the fact is that 10 % or 30 % of anybody aged 40 or 50 who works at Amazon or for the US government and gets this virus is going to die, we are truly fucked. You can't run a business where going to work and getting sick means you have a 1 in 3 chance of being dead in a few weeks.

 

Who is most at risk in the coronavirus crisis: 24 million of the lowest-income workers

Cashiers, nursing assistants, paramedics: These people are at highest risk of exposure to coronavirus — and make a median wage of less than $35,000 a year

 

That article makes my point. As much as this is a good time to encourage everyone to stay home and be safe, that's just not an option for tens of millions of workers in the US or Canada or Australia right now. Some of them need the money, even if they don't really want the risk. Some of them just would rather work, and are okay with the risk. And we can't keep a partly hibernating economy even for a few months without grocery stores, pharmacies, and government offices.

 

I hope somebody is thinking about this from the standpoint of workforce issues. I don''t want to make this political. But my view is that whether this is Great Depression II or not, it will have the same impact on societal norms: "we are all in this together". So these people working right now, and two and four weeks from now when it's definitely going to get worse, at the very least deserve sick pay. And health care. If they are bagging our groceries, they shouldn't be going bankrupt if they get sick and have to be in a care center or hospital for a few weeks.

 

Again, I get the message that we don't want spring breakers partying on the beach. But we do want them bagging our groceries, and delivering our pizzas. I think it would be helpful if we got this sorted out. We ought to be able to tell people what the risks are, who is best to stay at home, and who can be performing essential services at relatively low risks.

 

For all my adult life, there's been no shortage of people over 50 who think people who are 20 should be required to perform "national service". I always thought it was kind of hypocritical. But right now, it's an idea whose time has come. It's just not a good time for some 70 year old women with heart disease to be working in a grocery store. It probably is a far better time for a 25 year old woman who hiked in Peru last summer to be doing that job. And if she is at serious risk of having a bad outcome if she does get sick because she has vaped a lot, or because she has heart disease or is obese, that would actually be a very good health message to get out. But anybody who is willing and able to work in this environment is doing a sort of everyday national service. There are able bodied men and women building emergency hospitals for us right now.

 

Bottom line: we need workers. Including probably a lot of temporary workers who need the money. Employers and politicians are not going to put themselves in a position where they say, "You have to keep working. Even though it may kill you." But if we have really clear information, and let workers make their own choices based on that information, that's probably the best way to get through this crisis.

Edited March 23, 2020 by stevenkesslar

[+ stevenkesslar]

https://tribune.com.pk/story/2181846/1-young-doctor-screening-coronavirus-patients-passes-away-gilgit-baltistan/

 

https://www.huffingtonpost.co.uk/entry/coronavirus-deaths-22-march-2020_uk_5e77544dc5b6f5b7c545fc9c

 

https://www.newsweek.com/olympic-champion-swimmer-diagnosed-coronavirus-calls-it-worse-virus-i-have-ever-endured-1493664

 

https://www.bbc.com/sport/football/51995137

 

https://news.sky.com/story/coronavirus-healthy-nhs-nurse-36-in-intensive-care-after-contracting-covid-19-11962025

 

https://www.cbc.ca/news/canada/toronto/coronavirus-patient-1.5502501

 

I’ve been reading more of these cases in the last 2 days. Athletes, doctors, university students, even young teenagers dying, with no pre-existent conditions or travel history to China, Iran, or Italy. I hope this virus is not mutating and learning how to kill everyone and not only the elders. Please stay safe, self-isolate, and ask your closest providers to do the same and spread the word.

 

 

I read or scanned all six of those stories. So let offer a few other conclusions, which echo the ones above.

 

Of those 6, 3 lived and 2 died. One was a nurse infected while caring for sick people who was on a ventilator when the story was written.

 

The three that lived were two athletes, and a 25 year old guy who looks very athletic. Their point is that they felt like shit, and this was worse than anything they've ever felt before. That said, the story about the 25 year old Gay hottie also said this: "His friend, meanwhile, hasn't experienced any symptoms at all."

 

Congressman with coronavirus feels 'about as sick as I've ever been'

 

There's a brief video in there of Rep. Ben McAdam, 45 and fit, that is worth watching. I think the more of these videos that get out, the better. They make two points: 1) You're not going to die. 2) This is serious shit. Don't toy with it.

 

Both of those are great messages, I think.

 

There are a bunch of people questioning whether the treatment we are giving ourselves is worse than the disease. Why not just tough it out? Apart from the idea that we don't want dead bodies piled up in hospitals that are collapsing from lack of everything, the idea that even trained Olympic athletes find this a rough ride supports the argument that we are probably wise to try to avoid this.

 

One of the two who died and the one on the ventilator were young health care workers. Again, this is not a political forum. So I will say this emphatically, but hopefully nonpartisan. It just seems morally intolerable to me that we are asking young doctors and nurses to face this crisis, where they are most at risk of being exposed, but not giving them all the protective equipment they need. I get that in the poorest parts of Africa they simply may not have the resources. That's why America or Canada or Europe or Bill Gates sends its to them. But in NYC? That's just not okay. It's a disgrace.

 

This is a citation for the article you posted on the young doctor who died:

 

"Dr Usama’s colleagues called his death a “huge loss” and complained that the government had not provided protective equipment to the medical and paramedical staff screening the pilgrims or those deputed at the isolation centre."

 

This is a guess, but there's another possible issue. Hospital ventilators are great places for bacteria to live. That's true anytime. But it's even more true in a crisis where you are reusing equipment and desperately trying to keep as many people as possible alive. So that may or not be an issue with either the doctor who died or the nurse in the ICU. But it is a reason why we should try to avoid putting hospitals in crisis. And, again, it is a reason why we should do everything we can to keep these doctors and nurses well.

 

The 18 year old who died in the UK was described as having "pre-existing conditions." It did not state what they were. I'll reiterate my point above. My guess is there is a subset of young people that are at higher risk. Anyone with lung or heart problems, for sure. Maybe vapers, but we don't know.

 

This is a citation from the article on the 18 year old you posted:

 

"In England, 37 more people who tested positive for Covid-19 have died, bringing the total number of confirmed deaths there to 257.

 

Those who died - including the teenager - were all in vulnerable groups, including with underlying health conditions."

 

 

I think the easy out on this is to say that young people are at risk, and everybody should just stay home. The reality is that is just not an option. Some people want to work, and some people need to work. To me the better way to deal with this is to be brutally honest and grounded in facts. If they are 30 and they are willing to work at Amazon or a grocery store or a hospital, we need their labor, arguably more then ever. But we ought to have their back. And if we know that vapers are 5 times more likely to die, we should be telling them that.

Edited March 23, 2020 by stevenkesslar

[mike carey]

@stevenkesslar I wasn't suggesting that the age distribution of cases was changing, just that as the total number of infections increases, even a very small percentage of young people with the disease will become a large number of cases. 0.01% of 100 people is no-one. 0.01% of a million is 100. My purpose in saying this is to suggest that rather than it indicating that the virus may have mutated, it could be that the sample size is now large enough for cases of young people with serious disease to emerge.. Or put another way, the larger number of cases is improving scientists' understanding of the disease. Of course, that doesn't rule out the possibility that the virus is mutating,

Edited March 23, 2020 by mike carey

[+ stevenkesslar]

@stevenkesslar I wasn't suggesting that the age distribution of cases was changing, just that as the total number of infections increases, even a very small percentage of young people with the disease will become a large number of cases. 0.01% of 100 people is no-one. 0.01% of a million is 100. My purpose in saying this is to suggest that rather than it indicating that the virus may have mutated, it could be that the sample size is now large enough for cases of young people with serious disease to emerge.. Or put another way, the larger number of cases is improving scientists' understanding of the disease. Of course, that doesn't rule out the possibility that the virus is mutating,

 

Thanks for the clarification. We agree.

 

Estimated Influenza Illnesses, Medical visits, Hospitalizations, and Deaths in the United States — 2017–2018 influenza season

 

If you click on the link, there's a great example there of your point.

 

Dr. Fauci is estimating 1 % of the people who get COVID-19 will die. So if you say that, by comparison, 0.1 % of the people who get the flu die, that sounds a lot less deadly. If you say that 0.01 % of people aged 5-17 who get the flu die, that sounds like almost nobody. And those are the actual numbers for 2017-2018 flu season.

 

If you say 528 kids aged 5-17 died, that doesn't sound very good. You could say that sounds very scary. But that is how many died of flu in 2017-2018. And some are arguing that we didn't shut down the global economy over that.

 

Age of Coronavirus Deaths

 

That's from the WHO-China Joint Mission Data. I think it includes data from the front of the outbreak, when a lot higher percentage died because nobody knew what this was. So the numbers may be overestimates. But whether you look at it as a percentage, or as real people who died, it is scary.

 

For children under 17, the death rate for the flu in 2017-2018 was 0.01 %, as I said above. For COVID-19, it's 0.2 % in that study for kids over 10. Twice as deadly as a normal flu season is for EVERYONE. And 20 times as deadly as a normal flu season is for children.

 

To translate that into real numbers, in 2017-2018 an estimated 11.2 million US children get the flu. 46,000 of them ended up in hospital. 643 of them died.

 

If you use the estimated Coronavirus rate of 0.02 %, using the number of kids that got the flu in 2017-2018, that number rises to well over 10,000 dead children. Even if you only base on kids aged 10 or higher.

 

For the entire US population, about 44 million people got the flu in 2017-2018. 800,000 were hospitalized, and just under 61,000 died. That's a "normal flu" death rate in the ballpark of 0.1 %, as Dr. Fauci keeps saying.

 

Where it really gets scary with COVID-19 is 65 and older. The death rate for "normal" flu for that group goes up to 1 %. In 2017-2018, about 6 million US seniors got the flu, about 550,000 ended up in hospital, and about 51,000 died.

 

If you use the estimated Coronavirus death rate, it's 3.6 % for people aged 60-69 alone, and much higher for everyone older.

 

So of 6 million US seniors, at least 200,000 would die, if you use the 3.6 % estimate. If you go with Italy, and say 10 %, that's over half a million seniors killed by Coronavirus. And probably 2-3 million of them would need hospitalization. The hospitals would collapse just based on seniors alone. And, yeah, they would be the ones pulled off ventilators to try to save the lives of the tens of thousands of kids with COVID-19 in the hospital.

 

No politician wants to talk about numbers, or choices, like that. Nor does any doctor - although they are the ones who are having to make these battlefield triage decisions.

 

I think we agree, either completely or almost completely.

 

The point I feel most emphatic about is that right now this is a huge workforce issue. To put the bullseye on Amazon, Jeff Bezos wants his employees to come to work. I just talked to a friend tonight who ordered toilet paper on Amazon. He's also thinking of going to work at Amazon, since he has no income right now.

 

So it's probably fair to say some of us want these Amazon employees to go to work, too. And many of them "want" to go to work, if only because they need the money. A few of them have already gotten sick, as this article describes. Amazon will give them two weeks of sick pay. That article is about European employees. So they presumably all have public health insurance. But who wants to be in an Italian hospital now?

 

The article says Amazon wants to hire 100,000 people in the US to meet exploding demand. You'd get health insurance, but with thousands of dollars in deductibles and co-pays.

 

So there are two issues here, but they are intertwined. One issue is are we saying that everybody - 100 % -of workers in their 20's or 30's or 40's should stay home, because the risk to their health is too great? And if we are not (reality check: we're not) what does it mean to say we have their back?

Edited March 23, 2020 by stevenkesslar

[+ stevenkesslar]

I'm adding this WSJ article, to put this discussion in another context:

 

Questioning the Clampdown

Will people lose faith when they find out they are expected to get the virus anyway?

By Holman W. Jenkins, Jr. Wall Street Journal

 

The cost to Americans of the economic shutdown is vast. What are they getting for their money? Essentially less excess demand for respiratory ventilators and other emergency care than can currently be supplied.

 

Some number of respiratory deaths will be avoided (really delayed since we all die) but we’ll be spending a lot more than we’ve ever been willing to spend before to avoid flu deaths. Eighty-three percent of our economy will be suppressed to relieve pressure on the 17% represented by health care. This will have to last months, not weeks, to modulate the rate at which a critical mass of 330 million get infected and acquire natural immunity. Will people put up with it once they realize they are still expected to get the virus? Wouldn’t it make more sense to pour resources into isolating the vulnerable rather than isolating everyone? Basically aren’t we really just praying that summer will naturally suppress transmission and get us off the hook of an untenable policy?

 

The U.S. may or may not be a test case of a large continental country where hot spots of contagion shock other places into buttoning up and hunkering down, curbing excess local demand for intensive-care beds. But the cost will be astronomical. Essentially we are killing other sectors indefinitely to manage the load on the health-care sector.

 

Understandably, politicians believe faith in government requires avoiding Italy-like scenes. But turned on its head here is the 50-year-old “QALY” revolution: the idea of measuring the burden of disease and benefit of health care based on “quality-adjusted life year,” typically valued at $50,000 to $150,000. In the present instance, the cost isn’t just medical intervention (e.g., ventilator use) but the cost of an economywide shutdown to limit the number of candidates for ventilation at any one time. I don’t know what the figure is, but the QALY value we are placing on avoiding Italy-like deaths is surely a high multiple of any figure previously considered realistic.

 

A British estimate is that 12 people have the virus for every one found by testing. In any case, testing becomes a tad mootish now if the goal is to isolate even young and healthy people.

 

 

That's probably the best example of the case for why this is all just a big overreaction. And it does get into all these arguments you have to get into, that nobody really wants to think about. What is a 50 year old life worth?

 

The implicit assumption is that a certain additional numbers of older and sicker people dying is better than screwing up the economy for everybody else. The unstated assumption is that "everybody else" doesn't include the people who work in the health care sector, who will ensure a year of torture. Of the people who get really sick, or survive but with permanent lung impairments. Or the occasional 18 year old who had the misfortune of vaping or having some pre-existing condition. What's obvious is that no country really wants to go through this hell.

 

That said, the Wall Street Journal has some very good points that we haven't even begun to answer. If we do suppress this virus, how do we keep it suppressed when we try to get back to business? Can we do this for 6 month? 12 months? 18 months? The WSJ is not wrong to question whether this is an "untenable policy".

 

The part of their argument that seems inhumane is that people all over the world obviously don't want to let nature run its course and make this their country like Italy, or five times worse, or ten times worse. The part of their argument that makes sense is that to have an economy, someone has to work. And if this goes on for 6 months or 12 months are 18 months, the cost just keeps mounting. They are also right to ask: if I'm going to get this virus, anyway, why not just get it out of the way, so I can go back to work?

 

I think there's two conclusions that seem like certainties.

 

First, if the goal is suppression, we're going to have to be all in, like China and South Korea and Singapore are. When the lock down ends, and until we have a vaccine, "test, trace, treat" has to be everyone's mantra.

 

Second, someone has to work while this virus is running amok. And they will be taking a risk by doing so -whether they work in hospitals, or for Amazon. So we ought to be thinking about what it means to have their back. Or to make sure their employers have their back.

 

I haven't seen the study that says 12 young and healthy people have the virus for every one found in testing. That article the OP posted of the 25 year old who went to Florida suggests that even the young and healthy can get very sick. So that is going to remain a mystery until we have more testing. The testing in South Korea does suggest that a significant number of young adults and children get this virus and don't even know they have it. They simply may help spread it.

 

Unless we really do want to have a Great Depression, we can't just give the entire global economy a year off with sick pay. Or however long it takes until we have a vaccine, or the virus just dies out.

 

I don't agree with the WSJ. But I do agree with the idea that we have to figure out how to create a safe worker environment, sooner rather than later. And for a year or so, until there is a vaccine, we may have to find ways to isolate the vulnerable rather than isolating everyone else. We actually have to do that anyway, now. If it's true that lots of college students who work in the dining rooms of nursing homes can be carrying this virus without knowing it, that alone is a good reason to think about how to do a better job of isolating those seniors from a killer virus.

 

There's one other reason that suppression may make sense, which goes back to the idea of a more virulent mutation. I'm not a scientist. But everything I've read suggests a more deadly mutation is unlikely. That said, such a mutation would be a random ticket in the biological lottery. And the more people that get infected, the more random lottery tickets COVID-19 gets. If we give it 1 billion lottery tickets, it has a far better shot of developing an even more deadly mutation than if we limit it to only 1 million people's bodies. So far, we're at 343,421 lottery tickets and counting.

Edited March 23, 2020 by stevenkesslar

[+ stevenkesslar]

[MEDIA=twitter]1239518642510761984[/MEDIA]

 

One more germane to this topic.

 

Seth Doane of CBS is not exactly a 20-something. And the fact that he got through this without too much drama offsets some of these other stories on this thread about how horrible this is. A bunch of people anecdotally have said that the worst part of having COVID-19 is having that swab stuck up your nose.

 

The main reason I posted this is what he talks about as the psychological part of this virus. In his case, he says the psychological part of calling people he may have infected was worse than the physical part of the illness itself. But imagine if you are 25 and you get COVID-19 and you have to wonder whether you are the one who gave Grandpa, or that nice senior you work with, the infection that killed them? I know how shitty I felt knowing that I gave a client an STD that it took a shot and a week of not having sex to get rid of. I wouldn't feel very good if I knew I did this to somebody.

[+ stevenkesslar]

[MEDIA=twitter]1240968861236822016[/MEDIA]

 

NAFTALI BENNET: I want to share with you the single most important insight of the entire corona epidemic. The most important thing -- more than social distancing, more than testing, testing, testing, more than anything else -- is to separate old people from younger people.

 

The single most lethal combination is when grandma hugs her grandson. Why is that? Because corona is a unique virus in the sense that it is way more lethal for old people than for young people.

 

In many countries, zero young people died. Countries where many people died, 0.1% were folks under the age of 30 or 20. Whereas old people over the age of 70 and 80, one out of five of them who get the virus die.

 

So what we need to do over the next period of time is to take care of grandma and grandpa from far away. Lots of WhatsApp and Skype and you name it. Bring them food, clean the box before you leave, and then they take it in the house. But do not enter the house, do not hug them, because you're risking them.

 

Finally, people ask me: Will the old people have to be isolated forever? The answer is no.

 

Over the next few months, gradually the rest of the population, want it or not, is going to get the coronavirus. Most, the overwhelming majority of people who get the coronavirus, won't even know it. It will take three or four weeks, they won't know they have the virus, and by the end of those four weeks, they'll be immune.

 

It will start with 1%, 5%, 20% -- when it reaches just about 60-70% of the population that will be immune, the epidemic is over and then grandma and grandpa can come out.

 

It might take a month, two or three months, maybe a bit more, but that is the plan. Good luck. Take care of grandma and grandpa.

[+ stevenkesslar]

Friedman is pushing the same "herd immunity" plan as the Israeli Defense Minister.

 

 

A Plan to Get America Back to Work

Some experts say it can be done in weeks, not months — and the economy and public health are at stake.

 

By Thomas L. Friedman

 

Dr. John P.A. Ioannidis, an epidemiologist and co-director of Stanford’s Meta-Research Innovation Center, pointed out in a March 17 essay on statnews.com, that we still do not have a firm grasp of the population-wide fatality rate of coronavirus. A look at some of the best available evidence today, though, indicates it may be 1 percent and could even be lower.

 

“If that is the true rate,’’ Ioannidis wrote, “locking down the world with potentially tremendous social and financial consequences may be totally irrational. It’s like an elephant being attacked by a house cat. Frustrated and trying to avoid the cat, the elephant accidentally jumps off a cliff and dies.’’

 

As Katz argued, governors and mayors, by choosing the horizontal approach of basically sending everyone home for an unspecified period, might have actually increased the dangers of infection for those most vulnerable.

 

“As we lay off workers, and colleges close their dorms and send all their students home,’’ Katz noted, “young people of indeterminate infectious status are being sent home to huddle with their families nationwide. And because we lack widespread testing, they may be carrying the virus and transmitting it to their 50-something parents, and 70- or 80-something grandparents.’’

 

“Now that we have shut down almost everything, we still have the option of pivoting to a more targeted approach. We may even be able to leverage the current effort at horizontal, population-wide, interdiction to our advantage as we pivot to vertical, risk-based, interdiction.’’

 

How? “Use a two-week isolation strategy,’’ Katz answered. Tell everyone to basically stay home for two weeks, rather than indefinitely. (This includes all the reckless college students packing the beaches of Florida.) If you are infected with the coronavirus it will usually present within a two-week incubation period.

 

“Those who have symptomatic infection should then self-isolate — with or without testing, which is exactly what we do with the flu,’’ Katz said. “Those who don’t, if in the low-risk population, should be allowed to return to work or school, after the two weeks end.”

 

Meanwhile, we should do our best to sequester from any contact with potential carriers the elderly, people with chronic diseases and the immunologically compromised for whom coronavirus is most dangerous. And “we could potentially establish subgroups of health professionals, tested to be negative for coronavirus, to tend preferentially to those at highest risk,” Katz added.

 

This way, Katz said, “the most vulnerable are carefully shielded until the infection has run its course through the rest of us — and the tiny fraction of those of us at low risk who do develop severe infection nonetheless get expert medical care from a system not overwhelmed. … We are not counting on zero spread after the two weeks; we cannot achieve zero spread under any scenario. We are counting on minimization of severe cases by sheltering the most vulnerable from spread whether by those with, or those without, symptoms.’’

 

That is why we should also use this two-week (or longer, if that is what the C.D.C. decides) transition period to establish through data analytics the best possible criteria for differentiating the especially vulnerable from everyone else. For instance, some younger people have been killed by coronavirus. We need to better understand why. There is some research, Katz says, that suggests many of them, too, had other serious chronic primary medical conditions, but this needs more data and analysis. Who exactly is at high risk must be based on the most current data and updated routinely by the relevant public health authorities.

 

This is why pushing the federal government to expand testing as broadly and quickly as possible is so important.

 

 

 

This sounds like a plan that will work better in theory than in practice. That said, if the alternative plan is to suppress the virus by keeping everybody not essential at home for a year, that won't work all that well in practice, either.

 

https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/

 

If you look at the demography of who is at most risk, thinking about a more targeted approach makes sense - at least as something to think about.

If those numbers are right, if you are under 50 the overall risk of dying is one half or one quarter of what it would be for seniors over 65 in a normal flu season. If you eliminate people under 50 with serious pre-existing conditions, it's getting in the ballpark of the typical risk of the entire population in a "typical" flu season.

 

How this gets organized in the next 4 or 8 weeks is a good question. And whether it's practical that young people will comply and old people can be kept in a bubble until ................... well, whenever ........................... is a good question, too. And keeping a quarter or a third of the population in bubble wrap for three months or six months still means the economy takes a major hit.

 

That said, this is what California is planning on, as far as I can tell. Right now, the immediate goal is to lower the transmission rate while the state ramps up care capacity and builds temporary hospitals and manufactures respirators. But implicit in that is the idea that we can't stop the course of the virus at this point. The "flatten the curve" plan is to just slow it down and try to shelter the people most at risk.

[hypothetically]

with no pre-existent conditions

 

...as far as we know.