I still think there's a possibility this virus was already in the US before 2020. I don't think they ever found a cause to the "mystery respiratory virus" in Virginia from July 2019:
https://www.nbcwashington.com/news/local/health-officials-to...
> Three people have also died, but Dr. Benjamin Schwartz of the Fairfax County Health Department said Wednesday afternoon that those who died were "older" and had complex health problems. Officials don't yet know the extent to which the respiratory illness contributed to their deaths, he said.
Or maybe that weird cold was just a weird cold and nothing more. It seems unlikely to me, but I'm open to it. I hate to make public policy suggestions on anecdotes... but someone should really look into that weird cold. Everyone in New York had it. It sure is weird.
Yes, losing 2x+ the annual number in one quarter should be noticed. But, maybe the virus evolved additional transmissibility over time, or maybe it evolved to be a little more deadly.
It simply seems less likely that this virus was first noticed in November, by China, yet it didn't hit major urban areas in the rest of the world for another four months. We're too interconnected as a species; nearly half a million people came to the US from China alone, after COVID-19 was classified there [1]. It feels more likely that people have been getting it, and dying from it, well before March; these cases were just simply miscategorized as the flu.
[1] https://www.nytimes.com/2020/04/04/us/coronavirus-china-trav...
To make the numbers work for the "weird cold" in early February case, I guess we have to work backwards. Assume that when we went into lockdown was the actual peak, 8 million people in New York City had COVID-19. That means that there is one death for every 500 cases. Then we have to pick a reproduction rate, which I have no idea how to pick, so I'll say that it increases by 1.5x every day (so on day one you have x cases, then on day 2 you have x + 1.5x, then on day 3 you have x + 1.5x + (1.5)^2x, etc. Going back a month from March 20 (which is approximately 30 days, and when a lot of people report their "weird cold"), that would mean we'd expect around 8 million / 383500 = 20 cases on Feb. 20. With 1 death per 500 cases, you'd have 0 deaths at that level.
I know I've pulled these numbers out of my nether region and so they are likely very wrong. But with some back-of-the-envelope math, I think we can have some sick people in February without a lot of deaths.
Obviously my 8 million total cases in NYC number is too high, and the 20 cases on 2/20 is too low for me and my friends to be those cases. But that exponential can be tweaked to make something plausible. If we make it 1.2 instead of 1.5, then we should have had about 7000 cases on 2/20, and that means around 14 deaths. That seems quite plausible to me. So I dunno. There was a weird cold. It's weird. It could mean anything.
I signed up to get an antibody test. 1 test is not data, but it will be very interesting to see the results.
> I know I've pulled these numbers out of my nether region and so they are likely very wrong. But with some back-of-the-envelope math, I think we can have some sick people in February without a lot of deaths.
Yeah, in two ways: That's not how the growth rate math works, but if we went by your math instead of the number, that's about 4-5x faster than what we were seeing in March.
A growth rate of 1.5 means if we had X cases on day 1, we'd have X(1.5^1) on day 2, and X(1.5^2) on day 3. This virus's growth rate at the beginning of the pandemic stage was around 1.4 (or to use your math, 0.4? I'm not sure what you meant by "(1.5)^2x", is that a typo of "(1.5^2)x" or did you mean 1.5^(2x)"? The second one is straight wrong).
Which is to say, you can't just look at the population death rate and really appreciate just how dangerous this is for older populations. The CFR for over sixty is a staggering 15% in WA. That is ridiculously high and completely masked if you look at all cases.
If they're not taking any precautions (because there's no knowledge of the virus in the community) then it can spread to those types of facilities very easily. In New Zealand where only 1,500 people have have COVID-19 (likely to be very accurate, 200,000 tests have been conducted) there's already been two outbreaks in nursing homes.
I just think the total IFR actually undersells how dangerous this is.
She's 29 and otherwise healthy. I'm sure we would have noticed this disease without the high mortality rate among the elderly.
Yes, it can do damage and is very dangerous for an at risk group. No, we don't know who that is, yet. Age clearly proxies for a risk factor. But which one?
Unless you are wanting to claim that no children have gotten this. Which, seems highly unlikely. (Or is the risk whether it will provoke an immune response?)
But I also had a truly "weird cold" go through my workplace early this year in SFBA, so I still have to wonder what that was.
[0] https://www.wolframalpha.com/input/?i=us+death+rate+*+421+pe...
Source? I can only get a rate that high by taking the highest death count I can find (which involves extrapolations to attribute deaths to Covid-19) for New York State and dividing it by the population of New York City (which is clearly invalid).
In anycase, even a rate of ~.1% would be absurd given ~20% of people are testing positive by antibody tests.
I subsequently found what I believe you are working from here: https://www1.nyc.gov/site/doh/covid/covid-19-data.page which does specify New York City (as opposed to New York State) so both the numerator and denominator refer to the same thing.
Interestingly, they appear to be using a larger denominator than your 8.5 million (NYC metro vs. NYC proper perhaps?) and get a rate of 0.175% = 175.66/100,000, eg in the "citywide total" line of https://github.com/nychealth/coronavirus-data/blob/master/by...).
But this is at least closer to your figure than I was able to get previously.
https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-d...
Specifically has numbers for NYC. You can sum the boroughs or use the total listed below. Using confirmed by pcr cases you get ~15k/8.6 = ~.175% as you said.
Using probable excess deaths adds an extra 5k deaths, hence ~.25%
But, wouldn't lengthening the incubation period also be a successful evolutionary strategy regardless of lethality?
It seems to me that there are many possible strategies that a mutating virus might gain an advantage and we shouldn't just assume that the only one that they would use would be to become more mild.
Luckily, sars-cov-2 seems relatively stable.
> Trade-offs between different components of parasite fitness provide the dominant conceptual framework for understanding the adaptive evolution of virulence (Alizon et al. 2009).
...
> By far, the most widely studied trade-off involves transmission and virulence (Anderson and May, 1982; Frank, 1996; Alizon et al. 2009). Transmission and virulence are linked by within-host replication: increasing parasite abundance increases the likelihood of transmission, but also increases the likelihood of host death; mathematically, this assumption can be formalized by making transmission rate β an increasing function of parasite-induced mortality rate ν. Nearly all of the literature we summarize below assumes this trade-off. However, another potential trade-off suggested by an examination of R0 involves virulence and recovery rate (Anderson and May, 1982; Frank, 1996). This trade-off is also mediated by replication rate, with high abundance increasing the likelihood of host death, but also decreasing the likelihood of the host clearing the infection (Antia et al. 1994); mathematically, this assumption makes recovery rate γ a decreasing function of parasite-induced mortality rate ν.
It can very well go the other way as with 1918 'spanish' flu. Or it can change in ways that won't affect overall mortality much.
It was in the middle of world war 1. Soldiers were infected, and the ones that became the most ill were sent home to recuperate, or die. Either way they spread the virus better than the ones who weren't as ill, and who stayed in the field.
So the usual evolutionary pressure was upside down here.
If it's truly random it wouldn't be directional, yeah?
Yeah, I don’t understand why people are so against the idea of it being in the U.S. before 2020. There’s no possible way we can trace every American who may have traveled within the China region or interacted with another person who was in that region around the start of COVID spreading. Just because there were no official cases of COVID does not mean it was not here.
I had a roommate visit Japan in November. He came back and was extremely ill for about a week. No hospitalizations but he was out of commission and isolated by himself.
Sure, if we were talking about mortality rates but we’re not. we’re simply talking about prevalence of COVID prior to the major breakout of February and beyond. These are two completely different things to be looking at.
I’ve worked in nursing homes during that time of December where people were dying. Did we think to send bloodwork off to test for some novel coronavirus? Of course not. Secondly, using the example of a nursing home as the sample population is silly as they are not the ones who were traveling. It’d be their family members and caregivers who traveled and then brought the disease into the facility.
I'm not sure what your counterclaim is? There are no samples in America tested from that time period that would show that there was Covid nor is there any statistical evidence that would suggest there was Covid.
If there was a year-on-year increase of 1-2% in nursing home deaths for a month or two, would that register with anybody? Maybe they would have noticed if a lot of people were being put on respirators? But if no one knew about COVID they would probably just chalk that up to it being a bad flu season.
Looking much higher than that. 80+ is 15-20% and 70-79 is 8% (https://www.worldometers.info/coronavirus/coronavirus-age-se...). It'll be concentrated more in people with pre-existing conditions so I expect nursing homes would see greater figures than that.
> Statistics from Kirkland now appear to tell the national story. Of 129 staff members, visitors and residents who got sick, all but one of the 22 who died were older residents,
https://www.theguardian.com/us-news/2020/may/11/nursing-home...
So we're not talking about one or two deaths but a large proportion of your residents suddenly getting ill in the same way and of those a large proportion dying over a short period.
The percentages you're citing are from the Chinese CDC [1] and represent the case fatality rate. They don't represent the infection fatality rate, let alone the overall population mortality. There's a big difference between these numbers which has been repeatedly ignored in the popular media, they keep on taking the scariest one (CFR) and presenting it in an unbalanced context. [2]
(To be fair, CFRs are the numbers we are the most certain about, but when you cherrypick the worst ones like the newspapers do they're also the scariest and least useful.)
The working definition of CFR in the Chinese study is basically people who saw a doctor, were suspected or confirmed of having COVID, and then died. But many other people would have caught the disease and not been seen by a doctor. Most of them would have been milder cases and they wouldn't have died. Key point is this number is not at all indicative of total Covid-related mortality in an exposed population.
The Kirkland story is really tragic, but it's just one data point and doesn't prove that ~15% of all nursing home populations will die. The conditions in other nursing homes could be very different, in fact that nursing home in Kirkland has since been investigated and fined $600,000 for unsafe practices [3].
[1] http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9...
[2] https://en.wikipedia.org/wiki/Case_fatality_rate
[3] https://komonews.com/news/coronavirus/kirkland-nursing-home-...
It’d also be kind of hard to go back and rerun tests for people during those months, which shows why it’s very difficult to pinpoint when this disease started to really spread. I mean, if France and China both had cases during the month of November and December, you’d be hard pressed to say it’s not possible there were similar cases in the U.S albeit undiscovered.
however, some may stay longer, but then they have to worry about their condition worsening and eventually not allowing them to do ADLs (bathing, eating, dressing) on their own. the average length of stay before disablement is close to two years [2]
1: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1532-5415....
2: https://academic.oup.com/biomedgerontology/article/74/6/917/...
How many American's were in Asia, China, or surrounding areas between October and December of 2019? How many of them were possibly infected? Nobody knows because there was no plan put in place with regard to travel to mainland China until the end of January 2020; even then since 1 January 2020, there were 430,000 people who traveled from China to the U.S.[1]
0: https://www.scmp.com/news/china/society/article/3074991/coro...
1: https://www.nytimes.com/2020/04/04/us/coronavirus-china-trav...
One thing that's known about covid-19 is that it has an unusual spread pattern. In some circumstances it might not spread too much (eg. average R0 is well less than 10) but in other circumstances where air is recirculating a lot or a particular patient is very contagious, it seems to spread a lot more. Couple that with many people being asymptomatic. So, what if it had been spreading in many places but Wuhan was simply the first place where it was detected? It seems to be capable of spreading without being detected for quite a while in many other parts of the world. (eg. Singapore's foreign worker dormitories)
Corona is so contagious, that combined with Wuhan being an international airport that connects to Shanghai, the #8 international airport in the world, this was the perfect storm for a pandemic.
First deaths in February for the United States.
I was so wiped out that I was taking naps in a conference room at lunch. A friend of mine caught me and was surprised because normally I work through lunch, let alone sleep.
No cough, no fever but just this terribly uncomfortable feeling of congestion in my throat and upper chest. Best thing I can compare it to is postal nasal drip like you said.
I saw a 31yo 2/18 with primarily sore throat, aches/feverish (not documented), and again on 2/20 because the sore throat got significantly worse. I started feeling iffy 2/21 (Friday) evening and worse Saturday with a bad sore throat and fever around 102F, lymphadenopathy, this persisted for at least 2 days. I went to work on Tuesday and did a rapid strep (I did not feel I had strep but the other doctor wanted to do it)... I'm not really thinking that was covid19.
I tested positive for antibodies last week.
Sure would like to try that antibody test.
If you read online, you see people swear they had it at some point this winter. So, if you had a 'flu like' symptoms in Feb or early March, perhaps it was just that...
It cost $110 and personally I think it was worth it... (it is a reminder to be more careful as I can still get it)...
This test has not been reviewed by the FDA.
Positive results may be due to past or present infection with non-SARS-CoV-2 coronavirus strains, such as coronavirus HKU1, NL63, OC43, or 229E.
Negative results do not rule out SARS-CoV-2 infection, particularly in those who have been in contact with the virus. Follow-up testing with a molecular diagnostic should be considered to rule out infection in these individuals.
Results from antibody testing should not be used as the sole basis to diagnose or exclude SARS-CoV-2 infection or to inform infection status.
https://www.questdiagnostics.com/home/Covid-19/HCP/
Other sources state the following, however its important that not a lot of research has been done to validate the manufacturers specifications, of these tests such as specificity. Only over time and independent review will these numbers be more accurately quantified:
"The company started out using the Euroimmun AG Anti-SARS-CoV-2 ELISA IgG antibody test and then added the Abbott IgG antibody test. It is continuing to use both tests, although the Abbott test has become the primary platform. Euroimmun is a division of Perkin Elmer.
Both tests have received emergency use authorization from the FDA; only 10 serology tests have received this designation from the agency. The Euroimmun IgG test has a reported specificity of 96% and sensitivity of 65%, while the Abbott test claims a sensitivity of 100% and specificity of 99.5%. The FDA has just cracked down on serology tests requiring supporting validation documentation to be submitted within 10 business days of an initial notification."
It makes me wonder what exactly is going on with this test. Do some people not produce antibodies? Is it overly specific to one strain of the virus and other people in NYC got a different strain that doesn't produce compatible antibodies? Was there some non-COVID-19 respiratory infection that hit NYC at around that same time that went under the radar? Is this test somehow just not as good as we think it is?
Not really under the radar, there are always a lot of respiratory illnesses. In my area, after reducing non-covid cold/flu by an order of magnitude due to social distancing, we're testing everyone with cold/flu symptoms, and they're still ~96.5% not covid-19.
We can therefore assume that about 1 in 25 bad-cold or flu-like illnesses are caused by a coronavirus.
Probably just a different coronavirus or flu. I was sick for weeks in October 2019 with a dry cough and body aches plus lethargy that sound superficially similar, but the fact that whatever it was didn't produce packed ICUs seems to strongly indicate that it was something else.
Lengthiest cold ever for me, though.
Whatever I had in February was completely different. The cough is all I really remember. It is so rare for me to get a cough that even though I was around people that were coughing, I didn't really expect to get sick. But get sick I did. (Oddly the thought of COVID-19 never crossed my mind even once during the whole thing. I knew about it but I didn't make the connection at all. It seems so strange to me in retrospect.)
[edit] Make that tomorrow at 1245p. Turns out "as soon as I can" is pretty soon!
Two things come to mind: The first is that the day I went to the hospital, there were so many of us with similar symptoms that we overflowed down the hallway. Second, when the triage nurse was talking to me, she off-handedly commented that everyone was saying they'd gotten their flu shots, yet there we were. We both kind of shrugged and guessed it just wasn't a very effective year.
Now I very much wonder.
Now, maybe more people went to the hospital precisely because that sequence of reporting led them to think it was serious when they may not have before, so the timing was a self-fulfilling prophecy. Ultimately, we'll really know so little for certain until we've had ubiquitous testing and a lot more time to study this, and the best we can do until then is extrapolate & theorize from what little data we do have. But the "weird cold" stories I've heard from February and even as far back in November just don't seem consistent with what pneumonia patients hospitals have seen - because that's how this was initially noticed as being unusual in Wuhan.
I don't remember all the symptoms, but I remember thinking how weird it felt and that "with a cold or the flu I usually get X"
Not gonna call it covid because I don't have any proof, but a "weird cold" is definitely going around
Before that I had gone to see my GP for a med update for refills. Apparently my doctor also saw what would be one our area’s earlier coronavirus patients that same day. I’m presuming I got put into the same waiting room as that guy.
I’d like to try an antibody test, too.