Since smoking is allowed in most casinos, they have extremely powerful ventilation and air filtration systems, so that their non-smoking customers aren't excessively bothered. If you've been in a Vegas casino and seen someone smoking, you notice that the smoke almost instantly gets sucked into the ceiling. This may dramatically reduce transmission in casinos or other venues that allow smoking.

This was often cited as a reason why everyone on a flight won't catch it, just those in nearby rows.

Vegas also doesn't have a subway system, which was cited as why it spread so rapidly in NY.

There's no real evidence to support the thesis that the MTA was a primary vector of spread in NYC. Granular data of infection rate by neighborhood is spotty, but the data that does exist doesn't show any clear trends towards increased infection rates nearer subway lines. And the borough with the highest infection rate is the borough with the least transit ridership, and the borough with the lowest infection rate is that with the highest transit ridership...

(Source cite: https://pedestrianobservations.com/2020/04/15/the-subway-is-...).

The subway is a shared space with poor air quality and many hard surfaces that are touched by many people every hour.

The blog post you are "citing" tries to draw conclusions by zip code in a map that is not granular enough to support the claims. You yourself acknowledge this so I'm not sure why you use that blog post as evidence.

Also, Jeff Harris (the MIT professor who wrote the paper with which the blogger disagrees) is a doctor as well as being an economist. That doesn't mean he is infallible, but I wouldn't be so quick to dismiss his thoughts.

I use an inner city transit system every day on my usual commute, but the transit system hub I access it from is about 15 miles away from where I live. I use a bus and then a regional train network to get to it, then go into the underground.

Yes, subways are crowded, but so is everything else in NYC. As for why NYC is doing much worse than other comparably dense cities worldwide, my thesis is that it's a failure at all levels of civic participation (federal, state, local, and even residential and commercial proprietors) to be proactive in counteracting the spread of coronavirus.

https://www.cnn.com/2020/04/30/opinions/eye-opening-south-ko...

The case study covers infections in a 19-story mixed commercial-residential building. First case was reported on March 9, 2020. The office seating diagram provided in the article shows extended (10 min or 1hr not sure), very close proximity spacing physically is the main reason for the spread.

Note that this was a call center so people were sitting and talking without masks on for extended periods.

* On March 9, one day after the first cases were reported, the entire building was closed. Testing was performed almost immediately on 1,143 people (workers, residents and a few visitors) with rapid results available to those affected and the team working to control the situation. The testing showed that 97 people (8.5% of those occupying the building) were infected. Most of the cases were women in their 30s and almost all (94 of the 97) worked on the 11th floor of the building, in the call center.*

I counted colored seats in the diagram and found 84 people in the call center got infected.

I think NYC got hit particularly hard because of subway cars. Enclosed in nearly airtight space for 10 - 30 minutes at a time.

I agree that everything is more crowded in NYC, but the only thing I can think of more crowded than a subway car is a nightclub. Estimating from ridership numbers, the average New Yorker rides the subway 15-30 minutes per day. The ceilings aren't even that high, just the number of people per unit volume is incredible.

One of the case studies I saw showed it spreading on a long distance bus between people sitting four rows away from each other.

That’s rush hour. Let’s not kid ourselves.

(I'll also point out that you picked literally the busiest station on the entire system to use as an example.)

The thing about the subway is that we all try to hold onto a pole or bar, total vectors for the spread. It’s not just an obvious case of being near each other, we’re forced to touch the same surfaces so we don’t collide every 30 seconds.

Rush hour on a subway is about as close as your going to get (no pun intended) to a clear cut ‘yep, this is how it spread’.

Some countries are still trying to avoid testing. Many Japanese hospitals are turning people away from testing unless they have severe symptoms lasting several days, so naturally, numbers look tiny. And let's be frank, China's numbers just shouldn't be believed.

The US doesn't have high quality national excess death data, apparently. That's surprising. Part of the distorted response to this outbreak is because most countries only seem to publish relatively recent excess death data - often only a few years. But when longer term data is examined it shows that there have been plenty of flu seasons with similar death rates. That's why people keep comparing it to the flu.

At a national level the peak in the USA was at 20,000 excess deaths. In 2017 the peak was at about 7,000

(https://talkingpointsmemo.com/news/cdc-releases-detailed-nat...)

So it must be much worse, right?

Well, not really. If you look at the longer term data for a hard-hit country like the UK, where there are a lot of lockdown-created excess deaths due to excessively underloading the hospitals:

http://inproportion2.talkigy.com/

You can see that this outbreak had at the end of April an almost identical number of excess deaths so far this year to 2017, 1999 (which was worse), 1998, 1996 and 1995.

It seems flu care might have got better over time, or perhaps vaccinations had the impact. But so far the impact on COVID on the UK is not much different to disease outbreaks throughout the 1990s.

The UK stats will go up and it'll be worse than any other outbreak for sure, because at this point the population is in a state of fear and avoiding hospitals - even if they don't want to, critical treatments for other diseases have been cancelled to free up space for a surge that never came.

https://www.telegraph.co.uk/news/2020/04/27/care-homes-see-r...

"UK's biggest provider says deaths among residents at three times last year's rate, but only half of additional deaths linked to virus"

And this is with almost any death being ascribed to COVID, without requiring tests or evidence. The lockdown will claim more lives than COVID will.

What a rubbish site. Its first argument is that deaths are not worse than 2018, so its not bad. Even though you can see that number of deaths quickly surpasses 2018 in 2-3 weeks and rises a lot higher faster, while it started a lot lower.

It's third argument is even more ridiculous. "Look at this graph showing a strong correlation between lockdown stringency and infection cases, stringent lockdowns increase infections!" is akin to saying people should stop using umbrellas because they increase rain.

(Also that graph is useless because the number of cases is not normalized inhabitants per inhabitants, so its x axis is bad)

talk about ridiculous claims.

However this is only really in over 60s

The explanations would be

1) more covid deaths than have been mentioned on death certificate 2) more deaths from other reasons

I haven’t seen any detailed breakdown of cause of death other than “covid mentioned” (and thus not mentioned)

https://www.theguardian.com/uk-news/2016/sep/29/tube-chat-ca...

You get the impression that a lot of people in Western society would rather risk infection than be seen wearing a mask - defies logic.

So if people got contaminated there, in a couple of days they probably were somewhere else already.

As a similar example, a lot of people in NJ work in NY but a case on a NJ resident would be counted as NJ.

Then again, they can't even give health care workers PPEs.

[1] https://www.google.com/covid19/mobility/ (Look for Nevada under the US)

I believe micro-droplets being evaporated by the notorious South Asian heat is playing a part.

Still I suspect the extreme differences between countries and even regions between countries will be studied for many years to come.

The story I heard is that Vegas hotels/casinos mix in small amount of certain gas/chemical in the circulating air that makes people not want to sleep, which makes people gamble more and spend more money.

Some crazy theories people have...

So I can see (as a non-expert) that the well ventilated casinos is the reason for low infection rate in Vegas.

NYC on the other hand has had the extremely highly infection rate because EVERYONE has to take subway and pretty sure there's not much air circulation in the subway cars...

Either way, I think not spending too much time indoors is the key to avoid covid-19. Unfortunately most all indoor space has recirculated, air-conditioned, stale air.

Edit: I personally think businesses that can leave windows open for fresh air will have lower chance of spreading Covid-19 than ones with barely functioning AC system with little air circulation.

Sure no masks and what may appear crowded is not really that, high ceilings, powerful HVAC heat exchange systems which bring air from the outside and overall low population density in the urban areas make Vegas seem actually a pretty safe place compared to say packed motels during Gra or Spring Break.

P.S. on an anecdotal note about 6-7 years ago after BH USA I’ve personally witnessed a person that was all sweaty and coughing like they are about to die being escorted by security of the floor after about 15-20min of being around the tables.

While I don’t have any sources on to confirm this policy, it really wouldn’t surprise me if casino security monitors people who seem to be ill if nothing else than to avoid the optics of having medics on the casino floor.

No universal healthcare so billing data is available, local and state governments are do not answer to the federal government on most matters.

Press is free and for the most part anyone is free to tweet what ever is going on without the fear of diving out of window.

In many universal healthcare systems there is still clear divison between healthcare providers (doctors and hospitals) and payers (public health insurance), so billing data are also available.

It's behind only New York and Miami in the US, and has more international arrivals than LA, Berlin, Moscow, or Athens.

https://en.wikipedia.org/wiki/List_of_cities_by_internationa...

However, fuel your brain with these bits: if lots of transmissions happened in Vegas then they likely counted against another states numbers when those folks went home.

I guess what happens in Vegas doesn't stay in Vegas.

edit: Also, I misssss you. Hope you're well. <3

My wife presented with symptoms quite similar to covid-19 to A&E (UK: A&E ~= ER) after a cruise we went on in late November. She has never smoked but she did get quite breathless and shook it off after about a week. As you say, there are a lot of anecdotes.

A decent antibody test would be nice but at the moment we don't know enough about how the bloody thing works. Even if you have detectable antibodies after an infection, does that mean you have any immunity to another infection and if so, for how long?

My money is on this thing turning into another 'flu after about five years. It will stop killing large numbers of people and evolve into a sort of status quo, just like the seasonal 'flus. It will still be a killer but not quite so aggressive as it is now. It is not as aggressive a killer as Ebola but it spreads far easier. Evolution will ensure that it will find a "happy" medium where it can carry on spreading but we don't still feel the need to eradicate it because we can live with the consequences of the adjusted version.

My language in the above para is a bit off but the sentiment is the same. We happily jump into cars every day (not so much now) and kill ourselves and others in pretty large numbers across the world but that is judged an acceptable risk. covid-19 will simply become another one eventually. For now, it is a right old shit show and we do not understand the enemy at all well. We do not know how to live with it.

We will.

it is very simple to remember: the one named after the disease is the virus, the one named after the virus is the disease.

/facepalm.

[1]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851497/ [2]. https://www.ncbi.nlm.nih.gov/pubmed/28525597

As far as I'm aware, this does not tell us that it'll be the same for SARS-CoV-2. Maybe it makes it more likely, but that's not the same as knowing for sure.

This is not a message that any politician can ever espouse. It is sadly the way of things.

I suspect that the next novel coronavirus will meet with quite a lot of resistance. It seems we screwed the pooch/jumped the shark/fucked up ... with SARS which was our last warning apart from Bird flu (H5N1) and the other horrendous epidemics and pandemics across the years.

It's a bit embarrassing to have several world class virus killer orgs here in the UK and yet we are only deploying them properly fairly recently. You Yanks can stop sniggering at the back - you've screwed up in the same way we have. It is of course not that simple and we are all unprepared for this. It will be different next time and there will be a next time. All countries are changing visibly with their response to this thing. It is remarkable and quite humbling. Keep your eyes peeled and your brain on point and observe. We will never see the like again in our lifetimes (I hope)

My take away is that we need to get all our govts onboard with real risk assessment.

That's a bullshit line by incompetent politicians who deliberately dismantled the very systems that were put in place to deal with this.

As for warnings: By end of December, the epi community knew something was up. By mid January, there was a pretty loud clamor that we need to address this.By end of January, Covid was a regular occurrence in the intelligence briefing for the president, and the warnings weren't exactly ambiguous. By mid February, anybody who was paying actual attention was preparing one way or another.

As for warning the general public: Bill Gates did a whole song and dance on a TED stage. We had SARS, and Mers, and swine flu.

So, no, we are not "all unprepared". Many closed their eyes and pretended wishing extra-hard makes science go away.

And yes, there's a good chance we'll see another one in our lifetime. As we encroach more and more on animal habitats, it's pretty inevitable. (That, too, is a thing people have been warning about for decades)

In the US, the Trump administration’s bungling incompetence handling of the outbreak is truly staggering. Wildly contradictory statements from moment to the next, no coordinated pandemic plan, “hijacking” PPE shipments enroute from China and Malaysia to the countries that had bought, and paid for, them...this is rogue/failed state level stuff.

Other western countries also messed up big time. In Canada, France, the UK and Spain people in longterm care homes were abandoned and left wallowing in their own filth as COVID-19 burned through these facilities like wildfire, killing scores of elderly inpatients, many of whom were left to suffer and die alone.

It’s striking how some of the most “advanced” countries utterly failed to prepare for and manage a very foreseeable pandemic.

Then again, is it really that surprising that this happened in places where health care systems have been chronically underfunded for decades as permanent homeless camps have become normalized and the middle-class economy replaced by low-wage precarity and easy credit?

It’s like after four decades of “there is no such thing as society” governance the health and well-being of people, of the public, in these places has become an afterthought.

The scramble to blame other countries or pretend that “there is nothing we could have done to prepare for this” is theatre designed to deflect attention from the fact that dictatorships, like China, and places with authoritarian governments, like Singapore and South Korea, care more for the health of their citizens than many of the western liberal democracies, where austerity and massive neglect of public services and infrastructure have become the norm.

Like the market crash of 2008, the coronavirus outbreak of 2020 is showing that the social and economic system underpinning the west is seriously broken and can’t handle even the slightest amount of stress.

It needs to be replaced with an arrangement that reins in the ability of the avaricious banker and CEO class to dictate how the economy should be run. The health and well-being of all people in society needs to come first or these places will degrade even further.

It does highlight that highly individualistic societies struggle more than places that put a higher value on collective wellbeing.

We (humans) are trying to impose evolutionary pressure by isolating potential carriers. Maybe that will help.

The Influenza causing the Spanish flu became deadlier in the second wave, it then evolved to be milder in the third wave, however, still more dangerous than in the first wave.

The evolutionary pressure is for reproduction, and if other factors facilitate reproduction, like a large window during which the infected are asymptomatic but contagious, or maybe airborne transmission, then the virus can very well be deadly.

It appears SARS-Cov-2 is very well adapted given how contagious it is. Personally I fear a more dangerous second wave in autumn or next year.

My understanding is that viruses typically cause symptoms because they cause the virus to spread, things like coughing spread the virus. If a virus induces too strong of a reaction then the host dies or can't function while they have it and it doesn't spread.

It's probably unlikely for a virus to develop an infectious period where the symptoms are mild but strong enough to spread and then shift phases to become lethal, as a virus has no coordination between itself.

I think typically viruses are either in an asymptomatic phase, where they're less likely to spread and don't cause symptoms (because they haven't replicated much), and a symptomatic phase where spreading is more likely but obvious the person has it.

As a last bit, my understanding is that "novel" viruses, such as this novel coronavirus, are particularly concerning when they cross over from a non human host and become infectious because they haven't developed to have mild symptoms that are amenable to spreading well, and so can be more deadly than viruses that evolved alongside or within the human population.

I didn't mean we will evolve. The virus will be doing the evolving. We live for years, this virus "lives" for days.

It's really very unlikely that any of you had covid 19 in Las Vegas in late December.

I think this needs to be repeated more often. Everyone who had a sniffle in the last 6 months thinks they had COVID-19. There are always a lot of different diseases going around in the winter.

But beyond that, this trend I've seen of people thinking they had it because they had the sniffles is dangerous if it makes them think they're now somehow safe.

If we learn that people who've had it have resistance then we should all get tested, capacity allowing.

Having had a cold at some point is almost irrelevant, because it seems that most carriers are asymptomatic, and that most people with mild covid19-like symptoms don't actually have it. The predictive value really isn't that high.

People who were sick in December (I mean, be real: a lot of people were sick in December!) are overwhelmingly more likely to have had the flu than a disease that even in Wuhan was at just a few thousand cases at most.

That's what they said in France too before this new study

Perhaps a lot of those visitors left the area before symptoms developed.

But, if it became endemic in Vegas it would start to infect locals. The blackjack dealer and the waitress and the floor manager are still there after you come home.

My flight was delayed, so I was in the airpot for about 8 hours. I decided to walk a lot during my time at the airport (I do that when I have long flights), so I walked about 20,000 steps in total back and forth in the waiting hall.

About one week later (beginning of March), I started with symptoms and since then it has been a nightmare from which I still haven't completely recovered.

This take has held up pretty well. Look at how much more mid-range NYC is humidity-wise than the others:

https://twitter.com/JeromeRoos/status/1236733607902937089

Some viruses, like flu, prefer dry air. That's actually the reason flu spreads better in winter -- because colder air is less humid.

https://news.yale.edu/2019/05/13/flu-virus-best-friend-low-h...

Also, there's a chance your stats are being thrown off by the fact that Las Vegas the city doesn't have very many world-class casinos. All the popular areas are actually in unincorporated Clark county, in an unincorporated community known as Paradise, NV. Make sure you include those.

1. Visitors who are vulnerable went home and took Covid with them. They contributed to their home city counts.

2. Vegas natives who work on the strip are protected via second hand smoke inhalation. Source: https://www.economist.com/science-and-technology/2020/05/02/...

/crazy

Most people who work in customer facing roles in Vegas are already extremely paranoid and careful about hygiene. Gloves, constant cleaning of commonly touched surfaces, etc. Being a low level casino/hotel employee teaches you very quickly that humans are just sentient germ dispersal machines.

https://www.lvcva.com/stats-and-facts/visitor-statistics/faq...

I play a lot of table games, and casino chips are pretty disgusting in the best of time. I Immediately washed my hands every time I left the table.

[1] counting Kent county and all adjacent counties.