Friday, April 17, 2020

COVID-19 Weird Data

This post is all about anecdotal reports and my inferences.  I'll talk about possibilities, some that may sound like conspiracies, but I don't have a high confidence in any of the data or the conclusions I may draw below.  Take it for what it's worth.

First, we have China with its 85,000 total cases and 3,500 deaths.  Only one hot spot breakout (Wuhan and its province), a two month lock down, and the virus seems to disappear.  Why?  How is that possible for a reportedly quickly spreading virus significantly more contagious than the flu?  Especially when a third of the city of Wuhan left before the lock down.

Next we have Sweden.  Effectively no government ordered mitigation or lock downs.  Sure, individuals may take safety precautions.  But videos show the malls, shops and restaurants all open and well filled.  But their mortality rate is not significantly different than that in the US and nations where mitigation occurred.  And their hospitals are not overrun.  How can this be?

The epicenter seemed to move from Wuhan to southern Europe to the New York metropolitan area.  Sure, international travelers were likely to seed hot spots in those areas and probably in that order.  But there are lots of big cities around the world that get international travelers.  And China is a big exporter of everything, including travelers.  Why haven't we seen other big hot spots?  Sure, we instituted lock downs.  But those are pretty poor lock downs.  Everyone goes out for food.  The streets in New York look empty, but the roads in the rest of America where we don't use public transportation are almost as crowded as ever.  There's plenty of opportunities for an aggressive virus to spread through the rest of the world.  But where are those big hot spots?

Then there's the ever-falling model mortality rate in the US chasing the actual mortality rate.  Sure, the models are too complex to be accurate, but you would have thought one of them would have been in the ball park.  Kind of like pollsters; someone ought to have guessed the actual outcome.  Yet, there doesn't seem to be anyone that claims their model was close.  Why?

If the data peculiarities were limited to China, I could accept that China is lying or hiding something.  Some say they couldn't hide big break outs or a vaccine or an effective therapeutic.  I'm not so sure about that.  They control the media, communications, and their Internet portal.  With international travel stopped, they could hide anything.

Let me focus on the 'rest of the world' for a moment.  They saw China, Europe, and the US be cut off from all international travel and effectively quarantined.  They have limited resources for testing, and probably average to poor hospital systems.  Why would they do extensive testing and reporting to the WHO?  So they can be the next epicenter?  Or get their own border shutdown for international travel?  With no testing, no vaccines, and no therapeutics, will they just treat patients for their symptoms like they've been doing for years?  Unless they want COVID-19 crisis support from other countries, they are not going to report themselves into the next 'epicenter.'  They are going to do as much mitigation as they can and get by.

Finally, apparently their is a California study where they tested asymptomatic volunteers.  They found a 50 to 84 fold increase of those with antibodies over the reported number of cases.  Keep in mind, the US is generally only testing those with severe COVID-19 symptoms.  The California study suggested a very much greater spread of the virus than currently reported.  And those numbers would drop the mortality percentage way down.

So something is wrong with our understanding of the virus and how it is spread.  If it weren't for Sweden, you might say we don't really understand the effectiveness of various mitigation techniques.  And actually, I'm pretty sure we don't. 

Those mortality models we see in the US should have included models of how the virus affects the human body once it is gets there, how the virus is spread from human to human, how the mitigation measures slow the spread, and how the mitigation varies from region to region.  Way too many variables and unknowns to create an accurate model.  And the data is just not there to do good validation of a model.

But like I said earlier, somebody should have gotten a model in the ball park, just from random chance.

What I'm hoping is that the virus is at least as contagious as the experts suspect, but that it's mortality is way lower, and the various mitigation techniques' effectiveness is less than anticipated.  You'll see why in a moment.

Suppose the elderly or those with comorbidities (serious chronic diseases) are really the only ones, for the most part, that are going to have serious problems and potential death.  Those people are, or should be, hiding.  Some won't be able to (no family support structure) and some won't be willing to give up their few remaining years of freedom to hide in their homes.  Some may feel they've had a good life and if the Lord wills it, they are ready to move on.

But my point is that, given that assumption, there is only a certain percentage of the population that is going to be hospitalized.  Say 10% of the population is at risk.  75% of those are hiding.  So 2.5% of the population has a high risk of getting the virus.  Only some of those are going to come in contact with infected people.  And it will happen over time, with either a short peak or a flattened peak.

We would see small rises in cases, hospitals able to handle the load, and just a few moderate hot spots once mitigation (hiding of the susceptible) takes place.

If you don't get that high persistent fever, or serious trouble breathing, or endless painful coughing, you won't go to the hospital or get a test.  If the virus is spreading rapidly, and the symptoms for 90 to 98% of the infected do not rise to that level, we can get by.

That might explain most of the weird data.  New York and southern Europe got hit before the susceptible population went into hiding.  The susceptible in Sweden saw what was happening in time and went into hiding on their own.  In China, the Wuhan lock down made the situation obvious to everyone.  But they also locked down a lot of other cities--cities that never reported monumental cases like Wuhan.  Once could explain that by a combination of timely hiding and Chinese information control.

New York city and northern Italy suggest the contagion rate must be about as high or higher than believed.  So we are left with the mortality rate and mitigation/hiding effectiveness as critical unknowns.  Let's hope the mortality rate is really low and that those susceptible are successfully (and will continue to be) hiding.

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