The coronavirus spread updated in real time

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Jersey Girl
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Re: The coronavirus spread updated in real time

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Rand Paul wrote:"I don't think you're the one person that gets to make the decision," Paul continued. "We can listen to your advice but there are people on the other side saying there's not going to be a surge and then we can safely open the economy. And the facts will bear this out."
What's the other side? Trump? Fauci has never once said he's the one person who gets to make the decision. He's offered scientifically sound overviews, updates, guidance and now warnings. Wth is Paul talking to him about his making "the decision" for?

The freaking governors (cheered on by President) have made their decisions and are still making them. ALL of them opening not in keeping with CDC guidelines, but in spite of them and prematurely so.

Can none of these people THINK?

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Res Ipsa
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Re: The coronavirus spread updated in real time

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Jersey Girl wrote:
Tue May 12, 2020 6:03 pm
RI I spoke to my medical practice about the antibody test. They referred me to Lab Corp with my question. Went to the Lab Corp website. Here's one of the links where it discusses the test.

https://www.labcorp.com/antibody-testing

p.s. She said that in order to take the test you have to have had a confirmed case. That's not what they said yesterday and the Lab Corp website doesn't say that at all. I told her I was looking right at it and the only criteria stated was if you think you may have had the virus. This was the front desk I spoke to today. :rolleyes: I'll just have to send a message directly to my PCP and find out about it. You would think the front desk would be well prepared to answer questions on testing. But no.
So, LabCorps doesn’t make a serology test. They use different tests that they buy from the manufacturers. From their website:
LabCorp is providing serology testing based on tests from various manufacturers. Such tests have either received an emergency use authorization (EUA) from the U.S. Food and Drug Administration (FDA) or were released for use under FDA guidance, “Policy for Diagnostic Tests for Coronavirus Disease-2019 during the Public Health Emergency - Immediately in Effect Guidance for Clinical Laboratories, Commercial Manufacturers and Food and Drug Administration Staff” that was updated on May 4, 2020. Tests being performed under an EUA have not been FDA cleared or approved and LabCorp has completed independent validation of these tests. In addition, various manufacturers have submitted or will seek EUA for their tests.
So, I’ve got no idea. Also, I combined some info on antigen tests with antibody tests last night — I shouldn’t try and post complicated stuff late at night. The two kinds of antibody tests are ELIZA and LFA. ELIZA gives you a level of antibody present in your blood and an LFA just gives you a yes, no, or indeterminate.

Here are the tests that have had an EUA and the accuracy information on a which the EUA was based: https://www.fda.gov/medical-devices/eme ... erformance.

The chart for each has a line labeled PPV 5%. The value on that line gives the answer to this question: If 5% of population has COVID antibodies, what is the chance that a positive result on my test would be accurate? Some have very high median values, but the 95% confidence range is very wide. Plus, I would be shocked if the prevalence rate is as high as 5% in your area. The lower the prevalence rate, the lower that PPV number will be. There’s a link to a calculator on that FDA page that lets you input specific numbers and gives you the odds that a positive test is accurate.

Just my opinion, but I would not change any of my behavior based on the test result. At a reasonable estimate of prevalence, I think a large part of that 95% confidence level would be at 50% or below — no better than a coin flip.

On the other hand, the prevalence among the population of people who had symptoms Is certainly higher. But we don’t how much. On the other other hand, if you weren’t in contact with a confirmed case and there wasn’t community spread in your locale, you’re likely part of a population with lower prevalence.

See how nice and clear and straightforward this is?

In Bayesian terms, you have to account for the likelihood that you actually were exposed based on the characteristics of the population you are a member of before you see your test result. When prevalence in the population you are a member of is very low and the test produces false positives, the odds that a positive result is a false positive can get very high. (Rate of false positives = 100% minus that PPV percentage. For example, I gave blood today. If the HIV test on that blood is positive, the odds that the result is a false positive approach 100%.

Also, this is what I understand and I’m happy to share it, but I wouldn’t rely on it without confirmation from Lemmie or Analytics or PG or any other person who knows stats better than I do.

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Jersey Girl
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Re: The coronavirus spread updated in real time

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Okay, RI. I have to do something before I actually respond to you.

:surprised: :surprised: :surprised: :surprised: :surprised: :surprised: :surprised:


THIS IS ALL ____!!!!!!!!!

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Re: The coronavirus spread updated in real time

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Okay I'm better now. I wasn't thinking clearly last night posting to you either. Before I went to sleep last night I actually remembered other symptoms I had but, no worries. Let's start at the beginning.

The antigen tests detect active cases.
The antibody tests detect antibodies for CV-19 indicating that you've already had it. In other words, titers.

This is what I figure could have happened in my case. I could have been exposed to someone with a low viral load and in response, developed a low viral load myself. If that were the case then I'm starting to think that the antibody tests would be nothing more than a roll of the dice because don't we need to fight all out war in order to build up enough antibodies? I'm not sure if the experts know the answer to that question as it relates to CV-19 and this is my reasoning. We are hearing reports that people have contracted it a second time. What does that mean? Were they exposed and developed a low viral load...then what, they were exposed to the viral load from hell having never developed substantial antibodies to begin with?

This is way above my pay grade. Ask me how to respond to challenging behaviors. Ask me how to make homemade finger paint.

I would never change what I'm doing based on test results which only begs the question of why get tested to begin with? My answer is some small bit of peace of mind. Not walking on eggshells even when double masked and socially distancing.

I don't even know if it matters though because we're learning about how this virus behaves in real time.

Think about it. In the beginning they were warning people like me who take ACE inhibitors like Lisinopril or ARB's like Losartan that they could cause an up-regulation in the process where all hell could break loose and now they are saying the exact opposite.

I will just ask my PCP when I see her for a lab follow up. There, I've changed my mind how many times already? :confused:

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Re: The coronavirus spread updated in real time

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The Daily Beast is reporting on the previously rumored plan to have the CDC start lowering their mortality numbers referring to a pressure campaign by Dr. Birx to adopt a much stricter criteria to revise the count downwards:

https://www.thedailybeast.com/team-trum ... ath-counts

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Re: The coronavirus spread updated in real time

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EAllusion wrote:
Wed May 13, 2020 7:28 am
The Daily Beast is reporting on the previously rumored plan to have the CDC start lowering their mortality numbers referring to a pressure campaign by Dr. Birx to adopt a much stricter criteria to revise the count downwards:

https://www.thedailybeast.com/team-trum ... ath-counts
So Birx has become a shill for Trump? Fauci just said yesterday the numbers are most certainly an undercount.

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Re: The coronavirus spread updated in real time

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[quote]So Birx has become a shill for Trump? Fauci just said yesterday the numbers are most certainly an undercount.[/quote]Uh, she's been shilling for Trump for a while.

This is probably the funniest example:

https://twitter.com/atrupar/status/1243556939369496576

But that's not isolated.

Dr. Fauci makes compromises for Trump, but they are not as overt. The benefit of the doubt argument for Dr. Birx long has been that she needs to preserve her position to do good within the admin because if she's replaced, it'll be by an even bigger hack loyalist with an even more liberal attitude towards dishonesty that will lead to even more harm. To that, I say that at a certain point the harm of Dr. Birx is providing an air of legitimacy to the Trump admin's actions and positions does greater harm than by her not being there and this logic of compromise is how Trump morally corrupts anyone who sticks in his orbit.

Anywho, Dr. Birx says the CDC numbers can't be trusted, are likely significantly overcounting deaths, and is reported to be leaning on the careerists to revise their methodology so the numbers lower. This, coincidentally, echoes both Trump's now long-standing pattern of trying to downplay coronoavirus numbers, or any numbers that he thinks makes him look bad, and recent reports that the Whitehouse has a deliberate political strategy to try to downplay COVID mortality numbers.

I know this is all about working press expectations and therefore the tone of coverage from a few idiot editors and producers in very influential posts, but if you overlook that part I wonder how anyone can even see that big of a difference in what your political reaction should be between, say, 70k dead and 120k dead.

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Res Ipsa
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Re: The coronavirus spread updated in real time

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Jersey Girl wrote:
Tue May 12, 2020 9:54 pm
Okay I'm better now. I wasn't thinking clearly last night posting to you either. Before I went to sleep last night I actually remembered other symptoms I had but, no worries. Let's start at the beginning.

The antigen tests detect active cases.
The antibody tests detect antibodies for CV-19 indicating that you've already had it. In other words, titers.

This is what I figure could have happened in my case. I could have been exposed to someone with a low viral load and in response, developed a low viral load myself. If that were the case then I'm starting to think that the antibody tests would be nothing more than a roll of the dice because don't we need to fight all out war in order to build up enough antibodies? I'm not sure if the experts know the answer to that question as it relates to CV-19 and this is my reasoning. We are hearing reports that people have contracted it a second time. What does that mean? Were they exposed and developed a low viral load...then what, they were exposed to the viral load from hell having never developed substantial antibodies to begin with?

This is way above my pay grade. Ask me how to respond to challenging behaviors. Ask me how to make homemade finger paint.

I would never change what I'm doing based on test results which only begs the question of why get tested to begin with? My answer is some small bit of peace of mind. Not walking on eggshells even when double masked and socially distancing.

I don't even know if it matters though because we're learning about how this virus behaves in real time.

Think about it. In the beginning they were warning people like me who take ACE inhibitors like Lisinopril or ARB's like Losartan that they could cause an up-regulation in the process where all hell could break loose and now they are saying the exact opposite.

I will just ask my PCP when I see her for a lab follow up. There, I've changed my mind how many times already? :confused:
I think changing one's mind is healthy, especially in a situation like this where we have a firehose of information, ranging from reliable to complete crap, constantly hitting us in the face. There's what appears to be a pretty solid study that found people who tested positive while symptomatic can continue to test positive for 30 days after symptoms disappear. But a PCR test can only tell you whether there is virus RNA in the sample. It can't tell you whether the virus is capable of replication. So, it could be that the body is slow to shed enough remnants to get below the levels that a PCR test can find. That could explain "reinfections," but its still pretty speculative.

That same study had two sample pools. The first consisted of people who had previously tested positive. The second was people who had never been tested, but had been symptomatic and one of the following: had a doctor say they likely had COVID, lived with someone who tested positive, or were themselves a health care worker.

The people in the first group almost all developed antibodies after 3-4 weeks. Of those in the second group, only 1/3 developed antibodies in the same time frame. That could mean that cases with milder symptoms don't invoke an immune response. Or, it could mean that it's really hard to diagnose a mild case based on symptoms alone.

For me, it's easy. I have no reason to believe I've been exposed. No symptoms. Very few trips out of the house. No clusters, let alone isolated cases, in my family or people I regularly associate with. So, I'm not trying to be tested. I think it makes much more sense give antibody tests to people who tested positive with a PCR test, health care workers who were exposed, and others as part of a surveillance study. But that's just me.

It's way above my paygrade, too. But there are lots of folks on #epitwitter who will take the time to explain as long as you're civil about it.

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Re: The coronavirus spread updated in real time

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In a surprise to no one, the Wisconsin Supreme Court has struck down our stay-at-home order. 

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Re: The coronavirus spread updated in real time

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EAllusion wrote:
Wed May 13, 2020 4:19 pm
In a surprise to no one, the Wisconsin Supreme Court has struck down our stay-at-home order. 
5-2 Conservative majority, who woulda thought.

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Re: The coronavirus spread updated in real time

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The ruling was 4-3 with one conservative joining the liberals in dissent.

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Re: The coronavirus spread updated in real time

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EAllusion wrote:
Wed May 13, 2020 4:45 pm
The ruling was 4-3 with one conservative joining the liberals in dissent.
I look forward to Trump's tweet storm attacking that poor soul.

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Re: The coronavirus spread updated in real time

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EAllusion wrote:
Wed May 13, 2020 4:19 pm
In a surprise to no one, the Wisconsin Supreme Court has struck down our stay-at-home order. 
I think it works in a similar way in Washington. Emergency orders have to be ratified by the legislature at a certain point. I can’t recall if it’s at an extension or a set number of days.

It looks like local governments can and have imposed imposed their own orders.

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Re: The coronavirus spread updated in real time

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Welp. Brazil just recorded its deadliest day. ‘_’ We were adjusting our plans to look at a possible travel date in December thinking things might be safer in 6 months, but then I just read Rick Bright’s assessment of the incoming second wave of this thing in the Fall/Winter.

CONSPIRACY ALERT!

____’s gonna get real weird once people get past caring about this virus. I just saw a graph of the H1N1 outbreak, and its second wave was bigger than the first. So. Yeah. I ain’t doin’ ____ until there’s a vaccine.

- Doc

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Re: The coronavirus spread updated in real time

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Doctor CamNC4Me wrote:
Thu May 14, 2020 12:02 am
Welp. Brazil just recorded its deadliest day. ‘_’ We were adjusting our plans to look at a possible travel date in December thinking things might be safer in 6 months, but then I just read Rick Bright’s assessment of the incoming second wave of this thing in the Fall/Winter.

CONSPIRACY ALERT!

____’s gonna get real weird once people get past caring about this virus. I just saw a graph of the H1N1 outbreak, and its second wave was bigger than the first. So. Yeah. I ain’t doin’ ____ until there’s a vaccine.

- Doc
Right there with you. I got a few people I need to have a discussion with who apparently think I'm still traveling in September. Not happening.

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Re: The coronavirus spread updated in real time

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Res Ipsa wrote:
Wed May 13, 2020 11:16 am


For me, it's easy. I have no reason to believe I've been exposed. No symptoms. Very few trips out of the house. No clusters, let alone isolated cases, in my family or people I regularly associate with. So, I'm not trying to be tested. I think it makes much more sense give antibody tests to people who tested positive with a PCR test, health care workers who were exposed, and others as part of a surveillance study. But that's just me.

It's way above my paygrade, too. But there are lots of folks on #epitwitter who will take the time to explain as long as you're civil about it.
You talked me right out of it, RI.

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Re: The coronavirus spread updated in real time

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https://www.thedailybeast.com/trump-fea ... ays-report

The Financial Times is reporting via anonymous sources that Trump deliberately slow-walked COVID preparations in order to avoid spooking the stock market on the advise of Jared Kushner. That seems to be what was occurring right out in the open - he liked the numbers where they were - but uncovering a hidden story is sexier and so this is getting a lot of coverage at the moment. I'm not sure that it actually moves the ball much.

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Re: The coronavirus spread updated in real time

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Here's a study indicating that social distancing policy has a very sizeable effect on the transmission rate of coronavirus in the United States:

https://www.healthaffairs.org/doi/full/ ... urtemanche

And here's a video Donald Trump is promoting on his twitter:

https://twitter.com/DC_Draino/status/12 ... 9089101830

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Re: The coronavirus spread updated in real time

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So Birx has become a shill for Trump? Fauci just said yesterday the numbers are most certainly an undercount.
Will you allow people to go back to work if we elect a Democrat president? I guess under the left's reasoning, the economy is functioning at 75%. We can keep the shutdown for the next 3 to 4 years or until a vaccine/cure is found. Better yet, let's not go back to work until death is cured.

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Re: The coronavirus spread updated in real time

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The whole point of restricting certain businesses is / was to buy time to have a testing, tracing, and isolation system in place to keep the spread to a minimum while also building up medical supplies and not overwhelming the medical system with an unmanageable surge of seriously ill patients. This is something that is manageable to obtain well before "3-4 years" which is your pessimistic take on vaccine availability generally estimated to be 18 or so months out.

You should be livid with the Trump admin because while society has been trying to buy time to put these measures in place like *other countries have*, our federal government has been badly bungling it to the point that we've just been treading water and still don't appear anywhere close.

This also continues to be delusional about how certain businesses, say sports bars, are going to function while a sizeable % of their customer base avoids them because they recognize that it isn't safe to be there. Businesses running on low margins are going to be sensitive to sizeable drops in consumer demand.

You've repeatedly indicated you are OK with mass death if it means that managers at a Lids can get back to their work, and for you, I'm not sure that's so much about you misunderstanding the scale of harm as not caring if lots of people die. There's a pretty consistent theme in your posting history, including at one point supporting genocide, that you don't care if people live or die as long as you get yours. Then you brag about how your religion gives you moral purpose that unbelievers lack.

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Re: The coronavirus spread updated in real time

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ajax18 wrote:
Fri May 15, 2020 8:06 am
So Birx has become a shill for Trump? Fauci just said yesterday the numbers are most certainly an undercount.
Will you allow people to go back to work if we elect a Democrat president? I guess under the left's reasoning, the economy is functioning at 75%. We can keep the shutdown for the next 3 to 4 years or until a vaccine/cure is found. Better yet, let's not go back to work until death is cured.
Ajax, why do you continually make stuff up about the “left’s” who are promoting lockdown for 3-4 years.

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