LONGECITY

FL is less than 1/6th as bad as NY.

One post after I posit how population density influences R0 you go absolutely comparing two states with not only vastly different population densities, but also vastly DIFFERENT POPULATIONS.

If you weren't trying in each post to manipulate and selectively report stats, you would clearly see sorting by cases per capita (cases per 1 million).. Florida is well on pace to be equal, if not soon WORSE than NYC.  This is especially humiliating given their lesser population density than NYC, what they were able to achieve through political blunders NYC could only achieve by naivete, they were able to boost an R0 value which would be predictably lower based on lower population density to an artificially high level.  Please sing their praise again brother

One post after I posit how population density influences R0 you go absolutely comparing two states with not only vastly different population densities, but also vastly DIFFERENT POPULATIONS.

 

If you weren't trying in each post to manipulate and selectively report stats, you would clearly see sorting by cases per capita (cases per 1 million).. Florida is well on pace to be equal, if not soon WORSE than NYC.  This is especially humiliating given their lesser population density than NYC, what they were able to achieve through political blunders NYC could only achieve by naivete, they were able to boost an R0 value which would be predictably lower based on lower population density to an artificially high level.  Please sing their praise again brother

The point being, these southern states are in far better situations.  Whether that is through population density or the phase of the moon or the price of tea in China is irrelevant.  They simply are in a better state so they are logically the areas that will attempt to open first.  Why would you expect the situation to be different?  Or do you propose that we keep everything locked down indefinitely?  Because opening up, which will happen imperfectly in stops and starts and mistakes will be made, or keeping everything closed are the choices we are presented with.

And please, give me a prediction for when FL will be equal or WORSE than NYC.  Put your estimate out there so we can look back and see how accurate it was.

And these states have re-instituted much of their lock down procedures.

 

Isn't this what we would expect?  You're a state with relatively good numbers. You loosen up on your lock down.  Numbers come up and you conclude that you've loosened up too much so you start re-instituting some of your lock down.  You make attempts and you learn.  That's how these things are going to go while we feel our way around to figure out what level of lock down/openness we can deal with.

 

The alternative is to keep everything locked down indefinitely.  I don't see that being viable.  We're going to grope around until we can find a (relatively) happy medium.  That's really about our only choice since the models and reality have been so highly divergent.

There are only three general ways to deal with the pandemic.

1. Strictly enforce mask mandates and even use elastomerics for indoor or crowded environments.
2. Do occasional lockdowns and have your economy and hospital system get whipsawed forever.
3. Do nothing. Let the hospital system collapse. Have a bunch of older people die. Gamble that another bunch of people won't sustain permanent tissue damage and that the virus won't reinfect and subsequently weaken and eventually kill them and have your economy permanently crippled due to the long-term death rate being a lot higher than anticipated (50% instead of 1%, for instance).

These states, and frankly a lot of the rest of the world where mask wearing compliance is low, seem committed to learning the hard way that the only viable long-term solution is #1. Why anyone would continue to choose #2 is a complete mystery to me.

US military personnel are becoming vectors for transmission in Japan and South Korea.

https://www.cbsnews....a-hansen-today/

There are only three general ways to deal with the pandemic.

1. Strictly enforce mask mandates and even use elastomerics for indoor or crowded environments.
2. Do occasional lockdowns and have your economy and hospital system get whipsawed forever.
3. Do nothing. Let the hospital system collapse. Have a bunch of older people die. Gamble that another bunch of people won't sustain permanent tissue damage and that the virus won't reinfect and subsequently weaken and eventually kill them and have your economy permanently crippled due to the long-term death rate being a lot higher than anticipated (50% instead of 1%, for instance).

These states, and frankly a lot of the rest of the world where mask wearing compliance is low, seem committed to learning the hard way that the only viable long-term solution is #1. Why anyone would continue to choose #2 is a complete mystery to me.

4.) Lock down your vulnerable population - i.e. the elderly and those with significant co-mobidities.

The point being, these southern states are in far better situations.  Whether that is through population density or the phase of the moon or the price of tea in China is irrelevant.  They simply are in a better state so they are logically the areas that will attempt to open first.  Why would you expect the situation to be different?  Or do you propose that we keep everything locked down indefinitely?  Because opening up, which will happen imperfectly in stops and starts and mistakes will be made, or keeping everything closed are the choices we are presented with.

 

And please, give me a prediction for when FL will be equal or WORSE than NYC.  Put your estimate out there so we can look back and see how accurate it was.

No, it isn't we agreed provisionally in the other thread per capita numbers don't have a linear relationship to political competence.  Otherwise Germany would be much wiser, and not merely lucky.  Coumo would be a jackass, and Xi Jinping a hero.

The thing that matters more is they turned a good situation, whether it be through the phase of the moon or some philospher's teapot, into a crummy one.  They suck relative to themselves yesterday, that's what matters in personal and social development.  That's the test they're failing.  One job: re-open (if they had the misfortune of needing to close in the first place) without killing people's grandmas.  And they can't even do that with a level head, not with a clear conscience

It's black and white to say there are only two choices—hastily open up and remain open despite 5 days of concerning trends, OR remain indefinitely closed.  This bullish dichotomy can only stem from a poverty of imagination. Clearly there are subtle gradations, phases, masks, data to mull over, regional policies, honest metrics, walkbacks and monitoring.  That's quite different than the decision being made in Southern states to reopen before 14 days of consistently declining numbers and to not close despite 5 days of increasing hospitalizations.  Those are the White House/CDC guidelines basically 14 days of downward trend to reopen, 5 days up upward trend to close.. the specific cutoffs and proportionalities are sort of vague and open to interpretation, but the idea is clear.  That the South has interpreted so liberally is no accident and no excusable mistake.

What do you mean, when will FL equal NYC?  When will the state's number of deaths or cases exceed NY?  When will the per capita deaths exceed Florida's?  Or when will epiphenomenon and county per capita in, say, in Miami-Dade rival NYC in per capita deaths?

Honestly if Florida keeps up with the whole "idk if Gov has a plan, but us city mayors we'll close if there's one more week of increasing numbers" charade.. they could easily be in the top 5 per capita deaths—with states like Rhode Island and Mass (which are 70-90% per capita deaths of NY)—before September.  But honestly what do you care, do you think i'm a crystal ball or some special neural net that can predict both politically and epidemiologically the pandemic?  I would say some place like Arizona, with a relatively lesser number of people but still concentrated in a metropolis (Phoenix) is likelier to become the new disaster zone than a highly populated and distributed hub such as Texas or Florida.  But i'm just a fallible neural net, please take no satisfaction in occasionally proving me wrong

4.) Lock down your vulnerable population - i.e. the elderly and those with significant co-mobidities.

That's not gonna work, because a lot of those people don't reside in nursing homes. A lot geezers live alone or with an extended family. And a lot of younger people are lumps of lard. It wouldn't be practical to isolate all of them, but even if it was, that would just be another form of lockdown. And you're gambling that healthy people won't be reinfected and eventually succumb to the virus or at least develop debilitating symptoms that would last a long time.

Beware of False-Positive Results with SARS-CoV-2 Antibody Tests

Am Fam Physician. 2020 Jul 1;102(1):5-6.

 

To the Editor: Antibody testing will become increasingly important as the coronavirus disease 2019 (COVID-19) pandemic progresses. In the setting of highly selected antigen testing, antibody tests will help public health officials determine the extent of previous infection, even among asymptomatic individuals and those with mild symptoms who did not seek medical care. Antibody testing is also likely to be part of the foundation for determining the pace of relaxing current physical distancing measures. Finally, clinicians will use antibody testing to counsel individual patients about whether they have recently had COVID-19 or to determine their immunity.

 

New rapid antibody tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, are qualitative. Analogous to home pregnancy tests, these antibody tests are positive or negative. By varying the cutoff that defines a positive test result for immunoglobulin G (IgG) or IgM, test developers can choose to favor a high sensitivity, a high specificity, or take a balanced approach. Cellex, the first antibody test approved by the U.S. Food and Drug Administration for the virus, has a reported sensitivity of 94% and specificity of 96%.1 However, as we begin widespread testing in a population in which the prevalence of previous SARS-CoV-2 infection is unknown, there is a risk of false-positive results. When initially diagnosing acute infection, it is important to avoid false-negatives because this can falsely reassure patients and hinder appropriate contact tracing and isolation. However, when assessing whether patients had a previous infection and may be immune, it is important to avoid false-positives so that patients do not think they are immune when they are not.

 

Table 1 summarizes the false-positive rates at various population prevalence for the Cellex test and for a hypothetical test that is 90% sensitive and 99% specific.1 At relatively low population prevalences, which likely reflect current conditions in the United States and elsewhere, we would argue that false-positive rates are unacceptably high with the Cellex test. Many of the other tests with provisional approval by the U.S. Food and Drug Administration have not been appropriately evaluated for accuracy.2

New studies on physical distancing

BMJ. 2020; 370: m2743.

Published online 2020 Jul 15. doi: 10.1136/bmj.m2743

PMCID: PMC7360923

Physical distancing interventions and incidence of coronavirus disease 2019: natural experiment in 149 countries

Objective

To evaluate the association between physical distancing interventions and incidence of coronavirus disease 2019 (covid-19) globally.

Design

Natural experiment using interrupted time series analysis, with results synthesised using meta-analysis.

Setting

149 countries or regions, with data on daily reported cases of covid-19 from the European Centre for Disease Prevention and Control and data on the physical distancing policies from the Oxford covid-19 Government Response Tracker.

Participants

Individual countries or regions that implemented one of the five physical distancing interventions (closures of schools, workplaces, and public transport, restrictions on mass gatherings and public events, and restrictions on movement (lockdowns)) between 1 January and 30 May 2020.

Main outcome measure

Incidence rate ratios (IRRs) of covid-19 before and after implementation of physical distancing interventions, estimated using data to 30 May 2020 or 30 days post-intervention, whichever occurred first. IRRs were synthesised across countries using random effects meta-analysis.

Results

On average, implementation of any physical distancing intervention was associated with an overall reduction in covid-19 incidence of 13% (IRR 0.87, 95% confidence interval 0.85 to 0.89; n=149 countries). Closure of public transport was not associated with any additional reduction in covid-19 incidence when the other four physical distancing interventions were in place (pooled IRR with and without public transport closure was 0.85, 0.82 to 0.88; n=72, and 0.87, 0.84 to 0.91; n=32, respectively). Data from 11 countries also suggested similar overall effectiveness (pooled IRR 0.85, 0.81 to 0.89) when school closures, workplace closures, and restrictions on mass gatherings were in place. In terms of sequence of interventions, earlier implementation of lockdown was associated with a larger reduction in covid-19 incidence (pooled IRR 0.86, 0.84 to 0.89; n=105) compared with a delayed implementation of lockdown after other physical distancing interventions were in place (pooled IRR 0.90, 0.87 to 0.94; n=41).

Conclusions

Physical distancing interventions were associated with reductions in the incidence of covid-19 globally. No evidence was found of an additional effect of public transport closure when the other four physical distancing measures were in place. Earlier implementation of lockdown was associated with a larger reduction in the incidence of covid-19. These findings might support policy decisions as countries prepare to impose or lift physical distancing measures in current or future epidemic waves.

Also interesting, and likely to have a positive reinforcing effect on those already viewing themselves as responsible or enlightened

People who social distance may be more intelligent, study says

A new study in the Proceedings of the National Academy of Sciences indicates that people who comply with social distancing guidelines have better working memory capacity, which is an indicator of intelligence.

 

“This suggests policy makers will need to consider individuals’ general cognitive abilities when promoting compliance behaviors such as wearing a mask or engaging in physical distancing,” said WeiWei Zhang, an associate professor of psychology at the University of California at Riverside, in a release.

 

Working memory capacity measures how much information can be held in the mind for brief moments, and is strongly correlated with smarts, comprehension, and problem solving. “We propose that this [failure to social distance] may be associated with the limitation in one’s mental capacity to simultaneously retain multiple pieces of information in working memory,” write the authors, who say that people with more working memory have increased awareness of the benefits (versus the costs) of social distancing.

 

The research was carried out in late March on 850 participants, who filled out questionnaires on demographics and social distancing practices, and completed testing on personality and cognitive capacity. The correlation between working memory and social distancing behavior is so strong that individuals’ working memory predicts their social distancing behavior—even when controlling for education, moods, personality, and income levels.

 

Interestingly, the research highlights that social distancing is still an effortful decision that involves working memory, as opposed to a societal habit that does not depend on in-the-moment cognition.

Apologies if the text formatting comes out staggered on mobile devices.  I used pdftotext, should be fine on larger screens.

SARS-CoV-2 seroprevalence in COVID-19 hotspots


Severe acute respiratory syndrome coronavirus 2                          range of 3·7% [both tests positive] to 6·2% [at least
(SARS-CoV-2) has surprised the world with its range of                   one test positive]), with urban areas around Madrid
disease manifestations, from asymptomatic infection                      exceeding 10% (eg, seroprevalence by immunoassay in
to critical illness leading to hospital admission and                    Cuenca of 13·6% [95% CI 10·2–17·8]). These differences
death.1,2 Due to the high proportion of asymptomatic                     in seroprevalence are also reflected in laboratory-
or mild infections (approximately 80%), data restricted                  confirmed COVID-19 cases, which were much higher
to laboratory-confirmed cases do not capture the                         in urban areas than in rural areas. Similar numbers
true extent of the spread or burden of the virus, or its                 were obtained across the 2766 participants in the
infection-fatality ratio.2 Therefore, serological detection              Swiss study,7 with seroprevalence data from Geneva
of specific antibodies against SARS-CoV-2 can better                     reaching 10·8% (8·2–13·9) in early May. The rather
estimate the true number of infections. Due to co-                       low seroprevalence in COVID-19 hotspots in both
circulation of other human coronaviruses, serology for                   studies is in line with data from Wuhan, the epicentre
SARS-CoV-2 is not trivial. Antibody cross-reactivity with                and presumed origin of the SARS-CoV-2 pandemic.
other human coronaviruses has been largely overcome                      Surprisingly, the study done in Wuhan approximately
by using selected viral antigens, and several commercial                 4–8 weeks after the peak of infection reported a
assays are now available for SARS-CoV-2 serology.                        low seroprevalence of 3·8% (2·6–5·4) even in highly
However, despite high sensitivity and specificity, a                     exposed health-care workers, despite an overwhelmed
setting with a low pretest probability, such as current                  health-care system.4 None of the studies reported sex
population-based seroprevalence studies, warrants                        differences, and both the studies from Geneva and
careful validation of results.3 Extensive previous assay                 Spain reported lower seroprevalence in children than
validation in well characterised serum samples and                       in adults.6,7 Whether this reflects a lower susceptibility
confirmation of positive results are thus necessary                      of children to infection in general, or rather that the
to prevent false-positive findings from confounding                      studies were undertaken while schools and day-care
seroprevalence rates.                                                    centres were closed, remains to be elucidated.
  The first SARS-CoV-2 seroprevalence studies from                         The key finding from these representative cohorts is
cohorts representing the general population have                         that most of the population appears to have remained
become available from COVID-19 hotspots such as                          unexposed to SARS-CoV-2, even in areas with
China, the USA, Switzerland, and Spain.4–8 In The Lancet,                widespread virus circulation. These findings are further
Marina Pollán and colleagues6 and Silvia Stringhini and                  supported by the observation that even countries
colleagues7 separately report representative population-                 without strict lockdown measures have reported
based seroprevalence data from Spain and Switzerland                     similarly low seroprevalence—eg, Sweden, which
collected from April to early May this year. Studies                     reported a prevalence of 7·3% at the end of April—
were done in both the severely affected urban area of                    leaving them far from reaching natural herd immunity
Geneva, Switzerland, and the whole of Spain, capturing                   in the population.9
both strongly and less affected provinces. Both studies                    Such seroprevalence studies provide information
recruited randomly selected participants but excluded                    only about previous exposure, rather than immunity,
institutionalised populations (ie, permanent residents                   as no neutralising antibodies are measured. Since
of institutions such as prisons or care homes, as well as                no correlate of protection for SARS-CoV-2 has
hospitalised residents), which is a clear limitation. They               been formally defined, we do not know what titre
relied on IgG as a marker for previous exposure, which                   of neutralising antibodies would protect recovered
was detected by two assays for confirmation of positive                  patients from secondary infection or if non-neutralising
results.                                                                 antibodies could also contribute to protection. By
  The Spanish study,6 which included more than                           analogy to common-cold coronaviruses, immunity
60 000 participants, showed a nationwide seropreva­                      after SARS-CoV-2 infection is thought to be incomplete
lence of 5·0% (95% CI 4·7–5·4; specificity–sensitivity                   and temporary, lasting only several months to a few

              years.10,11 A subset of asymptomatic SARS-CoV-2 cases            Geneva Centre for Emerging Viral Diseases, Geneva University Hospitals, Geneva,
                                                                               Switzerland (IE); and Centre for Vaccinology, Department of Pathology and
              shows a lower antibody response and titres that wane             Immunology, University of Geneva, Geneva, Switzerland (BM)
              quickly.12 It is unknown whether these patients are              1    Vetter P, Eckerle I, Kaiser L. Covid-19: a puzzle with many missing pieces.
              protected by other immune functions, such as cellular                 BMJ 2020; 368: m627.
                                                                               2    Wu Z, McGoogan JM. Characteristics of and important lessons from the
              immunity. In summary, such individuals would not be                   coronavirus disease 2019 (COVID-19) outbreak in China: summary of a
              detected by serological assays but might confound the                 report of 72314 cases from the Chinese Center for Disease Control and
                                                                                    Prevention. JAMA 2020; published online Feb 24. https://doi.org/10.1001/
              true exposure rate.                                                   jama.2020.2648.
                                                                               3    Meyer B, Torriani G, Yerly S, et al. Validation of a commercially available
                In light of these findings, any proposed approach to                SARS-CoV-2 serological immunoassay. Clin Microbiol Infect 2020; published
              achieve herd immunity through natural infection is                    online June 27. https://doi.org/10.1...cmi.2020.06.024.
                                                                               4    Xu X, Sun J, Nie S, et al. Seroprevalence of immunoglobulin M and G
              not only highly unethical, but also unachievable. With                antibodies against SARS-CoV-2 in China. Nat Med 2020; published online
              a large majority of the population being infection                    June 5. https://doi.org/10.1...1591-020-0949-6.
                                                                               5    Sood N, Simon P, Ebner P, et al. Seroprevalence of SARS-CoV-2-specific
              naive, virus circulation can quickly return to early                  antibodies among adults in Los Angeles county, California, on
                                                                                    April 10-11, 2020. JAMA 2020; 323: 2425–27.
              pandemic dimensions in a second wave once measures
                                                                               6    Pollán M, Pérez-Gómez B, Pastor-Barriuso R, et al. Prevalence of SARS-CoV-2
              are lifted. In addition, the geographical variability                 in Spain (ENE-COVID): a nationwide, population-based seroepidemiological
                                                                                    study. Lancet 2020; published online July 6. https://doi.org/10.1016/
              and the dynamic of weekly increasing seroprevalence                   S0140-6736(20)31483-5.
              rates during the early phase of the pandemic                     7    Stringhini S, Wisniak A, Piumatti G, et al. Seroprevalence of
                                                                                    anti-SARS-CoV-2 IgG antibodies in Geneva, Switzerland (SEROCoV-POP):
              highlight that these studies are only snapshots in                    a population-based study. Lancet 2020; published online June 11.
              time and space, and reflect the circumstances of the                  https://doi.org/10.1...6736(20)31304-0.
                                                                               8    Ng D, Goldgof G, Shy B, et al. SARS-CoV-2 seroprevalence and neutralizing
              period in which they were done. As we are still in the                activity in donor and patient blood from the San Francisco Bay Area.
                                                                                    medRxiv 2020; published online May 27. https://doi.org/10.1101/
              midst of an unprecedented global health crisis, such                  2020.05.19.20107482 (preprint).
              seroprevalence data will continue to be necessary                9    Public Health Agency Sweden. Första resultaten från pågående
                                                                                    undersökning av antikroppar för covid-19-virus. May 20, 2020.
              for public health authorities to estimate exposure                    https://www.folkhals...eter-och-press/
              rates, especially in areas with little testing capacity for           nyhetsarkiv/2020/maj/forsta-resultaten-fran-pagaende-undersokning-av-
                                                                                    antikroppar-for-covid-19-virus (accessed June 24, 2020).
              acute cases. If and when a vaccine is widely available,          10   Callow KA, Parry HF, Sergeant M, Tyrrell DA. The time course of the immune
              ongoing seroprevalence studies will be able to provide                response to experimental coronavirus infection of man. Epidemiol Infect
                                                                                    1990; 105: 435–46.
              information about the extent and duration of vaccine-            11   Reed SE. The behaviour of recent isolates of human respiratory coronavirus
                                                                                    in vitro and in volunteers: evidence of heterogeneity among 229E-related
              induced herd immunity.                                                strains. J Med Virol 1984; 13: 179–92.
              We declare no competing interests.                               12   Long QX, Tang XJ, Shi QL, et al. Clinical and immunological assessment of
                                                                                    asymptomatic SARS-CoV-2 infections. Nat Med 2020; published online
              *Isabella Eckerle, Benjamin Meyer                                     June 18. https://doi.org/10.1...1591-020-0965-6.
              isabella.eckerle@hcuge.ch

Even 95% specific can cause many false positives, so maybe even Roche antibody isn't as bulletproof as initially advertised

medRxiv preprint doi: https://doi.org/10.1...5.20066407.this version posted July 7, 2020. The copyright holder for this preprint
(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
                                       It is made available under a CC-BY 4.0 International license .




                                       Antibody testing for COVID-19:
                                      A report from the National COVID
                                          Scientific Advisory Panel


        AUTHORSHIP:         National COVID Testing Scientific Advisory Panel*

        *The authors’ names, degrees and affiliations are provided at the end of manuscript.

        KEYWORDS:     COVID-19, SARS-CoV-2, serology, IgG, IgM, antibodies, immunoassay, ELISA,
        lateral flow, exposure, epidemiology

        RUNNING HEAD:          Antibody testing for COVID-19

        CORRESPONDING AUTHOR:



        Prof Derrick Crook
        Department of Microbiology, John Radcliffe Hospital, Oxford, OX3 9DU, United Kingdom
        derrick.crook@ndcls.ox.ac.uk
        

        ABSTRACT

        Background: The COVID-19 pandemic caused >1 million infections during January-March
        2020. There is an urgent need for reliable antibody detection approaches to support
        diagnosis, vaccine development, safe release of individuals from quarantine, and population
        lock-down exit strategies. We set out to evaluate the performance of ELISA and lateral flow
        immunoassay (LFIA) devices.
        
        Methods: We tested plasma for COVID (SARS-CoV-2) IgM and IgG antibodies by ELISA
        and using nine different LFIA devices. We used a panel of plasma samples from individuals
        who have had confirmed COVID infection based on a PCR result (n=40), and pre-pandemic
        negative control samples banked in the UK prior to December-2019 (n=142).
        
        Results: ELISA detected IgM or IgG in 34/40 individuals with a confirmed history of COVID
        infection (sensitivity 85%, 95%CI 70-94%), vs. 0/50 pre-pandemic controls (specificity 100%
        [95%CI 93-100%]). IgG levels were detected in 31/31 COVID-positive individuals tested ≥10
        days after symptom onset (sensitivity 100%, 95%CI 89-100%). IgG titres rose during the 3
        weeks post symptom onset and began to fall by 8 weeks, but remained above the detection
        threshold. Point estimates for the sensitivity of LFIA devices ranged from 55-70% versus RT-
        PCR and 65-85% versus ELISA, with specificity 95-100% and 93-100% respectively. Within
        the limits of the study size, the performance of most LFIA devices was similar.
        
        Conclusions: Currently available commercial LFIA devices do not perform sufficiently well
        for individual patient applications. However, ELISA can be calibrated to be specific for
        detecting and quantifying SARS-CoV-2 IgM and IgG and is highly sensitive for IgG from 10
        days following first symptoms.

What do you guys think about testing for coronavirus? I don't think they are 100% effective. Now there is a super mutated version of it that is different and can't be detected at all.

https://www.worldsta...rKByi64D8rK4t90

I'm not sure that "World Star Hip Hop" is a source for the most reliable information on covid-19.  Is there some journal article on this super mutated version of the virus?

Physical distancing interventions and incidence of coronavirus disease 2019: natural experiment in 149 countries

 

Participants
Individual countries or regions that implemented one of the five physical distancing interventions (closures of schools, workplaces, and public transport, restrictions on mass gatherings and public events, and restrictions on movement (lockdowns)) between 1 January and 30 May 2020.

Results
On average, implementation of any physical distancing intervention was associated with an overall reduction in covid-19 incidence of 13% (IRR 0.87, 95% confidence interval 0.85 to 0.89; n=149 countries). Closure of public transport was not associated with any additional reduction in covid-19 incidence when the other four physical distancing interventions were in place (pooled IRR with and without public transport closure was 0.85, 0.82 to 0.88; n=72, and 0.87, 0.84 to 0.91; n=32, respectively). Data from 11 countries also suggested similar overall effectiveness (pooled IRR 0.85, 0.81 to 0.89) when school closures, workplace closures, and restrictions on mass gatherings were in place. In terms of sequence of interventions, earlier implementation of lockdown was associated with a larger reduction in covid-19 incidence (pooled IRR 0.86, 0.84 to 0.89; n=105) compared with a delayed implementation of lockdown after other physical distancing interventions were in place (pooled IRR 0.90, 0.87 to 0.94; n=41).
 

Conclusions
Physical distancing interventions were associated with reductions in the incidence of covid-19 globally. No evidence was found of an additional effect of public transport closure when the other four physical distancing measures were in place. Earlier implementation of lockdown was associated with a larger reduction in the incidence of covid-19. These findings might support policy decisions as countries prepare to impose or lift physical distancing measures in current or future epidemic waves.

But another study claims that lockdowns produce poor results compared to other interventions.

The effectiveness and perceived burden of nonpharmaceutical interventions against COVID-19 transmission: a modelling study with 41 countries
https://www.medrxiv....5.28.20116129v2

Conclusions: Our results suggest a surprisingly large role for schools in COVID-19 transmission, a contribution to the ongoing debate about the relevance of asymptomatic carriers in disease spreading. We identify additional interventions with good effectiveness-burden tradeoffs, namely symptomatic testing, closing high-risk businesses, and limiting gathering size. Closing most nonessential businesses and issuing stay-at-home orders impose a high burden while having a limited additional effect.

Both studies ignore mask wearing in Japan, Taiwan, Hong Kong, and South Korea.

But another study claims that lockdowns produce poor results compared to other interventions.

 

The effectiveness and perceived burden of nonpharmaceutical interventions against COVID-19 transmission: a modelling study with 41 countries
https://www.medrxiv....5.28.20116129v2

 

 

Both studies ignore mask wearing in Japan, Taiwan, Hong Kong, and South Korea.

This is a black and white approach.  In Japan, many restaurants and venues remain closed^[1], Tokyo residents are excluded from the 50% domestic travel discount^[2], restrictions remain in place for schools^[3], and even Toyota Japan has not recovered staff or production fully^[4].

Similar shades of grey exist in Taiwan, Hong Kong and South Korea.  And it remains to see if the masks will be enough in the Fall, where weather and indoor activities favor the spread

As for the study?  Huge error bars, sweeping contradictions, and placing testing as the least important?  Lots of red flags here, would like to see some follow ups.. seems shaky and dubious til then

Results: Eight NPIs have a >95% posterior probability of being effective: closing schools (mean reduction in R: 50%; 95% credible interval: 39%-59%), closing nonessential businesses (34%; 16%-49%), closing high-risk businesses (26%; 8%-42%), and limiting gatherings to 10 people or less (28%; 8%-45%), to 100 people or less (17%; -3%-35%), to 1000 people or less (16%; -2%-31%), issuing stay-at-home orders (14%; -2%-29%), and testing patients with respiratory symptoms (13%; -1%-26%).

Here is some graphical context, comparing COVID to the Spanish Flu of 1918.

In every country, including the U.S. the story remains the same. This respiratory virus affects mainly the elderly. In the U.S. deaths from the Spanish Flu were 667 per 100,000. For COVID (through June 27th, 2020), it is 39 per 100,000. This thread was started, in order to provide data about this novel(?) respiratory virus. So many other recent disease outbreaks were accompanied by unwarranted fear and panic. This time around there is actually good data, and the data shows the overall population mortality rate is a fraction of one percent. Does this mortality rate justify the economic destruction, the fear, the panic, and all of the other ill-effects? I don't think so, but obviously some people disagree.

This is a black and white approach.  In Japan, many restaurants and venues remain closed^%5B1%5D, Tokyo residents are excluded from the 50% domestic travel discount^%5B2%5D, restrictions remain in place for schools^%5B3%5D, and even Toyota Japan has not recovered staff or production fully^%5B4%5D.
 
Similar shades of grey exist in Taiwan, Hong Kong and South Korea.  And it remains to see if the masks will be enough in the Fall, where weather and indoor activities favor the spread
 
As for the study?  Huge error bars, sweeping contradictions, and placing testing as the least important?  Lots of red flags here, would like to see some follow ups.. seems shaky and dubious til then

While some stuff was voluntarily closed, Japan never had a real lockdown (mandatory stay-at-home orders and closure of all non-essential businesses). Schools have reopened (and they never closed in Taiwan). The venues you referred to closed back in April, but now, most have reopened. Toyota suspended some factory operations in Japan due to weak demand, and factory output has gotten even worse due to even weaker demand today.
 
Any study is shaky if it doesn't examine mask wearing properly. As for testing, Japan didn't do much of that.
 
So, again, the only common and consistent factor that Taiwan, Hong Kong, South Korea, and Japan share is mask wearing with high compliance. Avoidance of large gatherings might also be another factor, but when and how those were instituted varied.

Japan also experience a huge resurgence of cases since the end of June, suggesting the gradual lifting of restrictions between then and March had a negative effect on controlling spread. Really just common sense.

It is also likely the Eastern nations also have cultural factors on their side, above and beyond simple mask diplomacy.  The sense of collectivism and respect for elders much greater there.  More willing to make sacrifices on the perceived common good. Probably a bit more cautious too personally (even 30-40 year olds) than their carefree entitled Yankee counterparts in the West.

Boiling it down to "simply masks" is no doubt an over-simplication, though to what degree it remains a matter of opinion.

The point is that lockdowns aren't needed to control this pandemic; mask wearing and perhaps avoidance of large gatherings are good enough. A few thousand cases is still not that much. If it really gets out of control, large gatherings will be avoided again and cases should come down as they did before.

I don't buy the sacrifice and collectivism argument that much. The same thing was said about lockdowns, but that didn't stop most of the world from embracing them. And mask wearing and closing some large venues seems a heck of a lot easier to stomach than a lockdown.

The point is Japan was one of the first to lock down, and has yet to survive a Fall season without imposing draconian restrictions.  Much of its success in May and June was attributable to its early and aggressive response.  Had it taken Sweden's lackadaisical approach, it would have to lock down later. You cannot escape the responsibility of tomorrow by evading it today.

You missed the point; Japan didn't do a lockdown, just high-compliance mask wearing and avoidance of some large gatherings.

You missed the point; Japan didn't do a lockdown, just high-compliance mask wearing and avoidance of some large gatherings.

Like I said it's all shades of grey.  Japan definitely imposed more restrictions than Sweden.  And they may be under-reporting cases.

The black and white thinking—that California did lock downs while Japan did not—is naive and mistaken.

26 Mar 2020 | 11:54 AM UTC

Japan: Stay-at-home policy implemented in Tokyo effective March 26 /update 15

Authorities ask Tokyo residents to stay home amid COVID-19 pandemic; further international spread of the virus likely

TIMEFRAME expected from 3/26/2020, 12:00 AM until 4/30/2020, 11:59 PM (Asia/Tokyo). COUNTRY/REGION Japan

And later in June,

03 Jun 2020 | 03:17 AM UTC

Japan: Authorities issue stay at home warning for Tokyo citizens June 2 /update 29

Tokyo governor warns citizens to stay at home where possible amid new rise in COVID-19 infections June 2; follow authority directives

TIMEFRAME expected from 6/3/2020, 12:00 AM until 6/17/2020, 11:59 PM (Asia/Tokyo). COUNTRY/REGION Japan, Tokyo

Sporting events canceled in Japan early,

Japan's sports world puts itself on hold in fight against coronavirus

In a united effort, the Japanese sports world has introduced a drastic range of self-imposed restraints to combat the coronavirus outbreak ahead of this summer's Tokyo Games.

 

Sports organizations nationwide are heeding a call to postpone, cancel or otherwise modify big events over coming weeks to mitigate the spread of the pneumonia-causing virus, which has resulted in around 900 cases of infection in Japan, many of which were linked to a quarantined cruise ship docked in Yokohama.

 

The J-League, Japan's top soccer competition, took the unprecedented step Tuesday of becoming the first professional league in any sport to suspend official matches in the country.

It's commonly understood that to do a lockdown, mandatory stay-at-home orders must be issued and all non-essential businesses must close. Using that definition, it should be completely clear to anyone that Japan did not do a lockdown but that California did. While stay-at-home requests (it wasn't a legally-binding order, as far as I know) were issued, compliance wasn't that great even given Japan's conformist culture. And there was no mandatory closing of all non-essential businesses. Yeah, there was some voluntary social distancing going on and some large venues and restaurants voluntarily closed, but that's not a lockdown.

I am just not buying into the great difference in government action between Japan and California for which you have so fortuitously importuned

Tokyo closed gyms and airports.  Freight was so delayed my tea arrived two months late.  Schools were closed for several months.  Industries put on hold.  Do not believe catchy Time magazine titles suggesting Japan did nothing.

Japan entered an early lockdown from which only cultural factors enabled them to exit the more early and gracefully than California.

The bottom line is virtually every—if not every—nation imposes governmental restrictions in response to rising numbers, which are often a function of cultural factors and left up to political discretion.  It is also true things exist in shades of grey.. in the minds of men particular ideas exist, whereas the world itself only describes the general truth of things.  I am skeptical therefore of anyone issuing blanket statements over what a particular country has done, even if they should reside in the same.

You seem to think that there's no practical difference between what Japan and California (and most of the rest of the United States) did, but that's not really the case.

Similarities

• Restrictions on international travel
• School closures

Differenrences

• Business: A lot of non-essential businesses remained open in Japan, but all non-essential businesses closed in California.
• Stay-at-home: Most had no choice but to stay home in California (because almost everything was closed), but that wasn't the case in Japan.
• Masks: Lots of mask wearing in Japan but a lot less in California.

Stats

• Japan deaths: 985
• California deaths: 7,605
• Japan cases: 24,132
• California cases: 373,259

The bottom line is that Japan has done a better job than California at containing the pandemic will a lot less restrictions, economic pain, and mental anguish.

https://globalnews.c...kdown-defiance/

https://nssac.bii.vi...d-19/dashboard/

You seem to think that there's no practical difference between what Japan and California (and most of the rest of the United States) did, but that's not really the case.

Differenrences

• Business: A lot of non-essential businesses remained open in Japan, but all non-essential businesses closed in California.
• Stay-at-home: Most had no choice but to stay home in California (because almost everything was closed), but that wasn't the case in Japan.

What are you talking about?  Do you have friends there, or have you been following their news, or what?

Tokyo closed bars, gyms, schools, movie theaters.  Japan was informally locked down a month before the WHO declared this a pandemic.  To say they did less than California is not even marginally true.

On May 22, Tokyo Gov. Yuriko Koike outlined a road map for easing social distancing measures and business closures in the capital in three stages. Cinemas will start reopening in the second stage, which may begin as by the end of May.

Source: https://www.japantim...rs-coronavirus/

The difference is in politics and the use of force and fiscal punishment.  Japan merely issued the kind request that Tokyo businesses close, it was against the Japanese constitution to make any such enforcement.

Q. DOES A STATE OF EMERGENCY CAUSE A TOKYO LOCKDOWN?

 

A. No, Abe and officials say Japan cannot legally enforce hard lockdowns. Public transportation is operating as normal. Most state of emergency measures are requests and instructions. Violators cannot be punished unless they fail to comply with orders related to storage or shipment of emergency relief goods and medical supplies.

Source: https://abcnews.go.c...ckdown-70037511

What are you talking about?  Do you have friends there, or have you been following their news, or what?

Tokyo closed bars, gyms, schools, movie theaters.  Japan was informally locked down a month before the WHO declared this a pandemic.  To say they did less than California is not even marginally true.
 
The difference is in politics and the use of force and fiscal punishment.  Japan merely issued the kind request that Tokyo businesses close, it was against the Japanese constitution to make any such enforcement.

 
Here's what my friends are saying:
 

Under Japan’s coronavirus state of emergency, people have been asked to stay home. Many are not.

Some still have to commute to their jobs despite risks of infection, while others continue to dine out, picnic in parks and crowd into grocery stores with scant regard for social distancing.

Prime Minister Shinzo Abe has insisted Japan will not adopt European-style hard lockdowns that would paralyze the economy.

Three-quarters of people responding to a recent survey by the Asahi newspaper said they are going out less than usual. But just over half felt they could comply with Abe’s call to reduce their social interactions by 80%.

People of all ages are shrugging off the stay-at-home request. The popular “scramble” intersection in downtown Tokyo’s Shibuya looked uncrowded, but eateries and pubs on backstreets were still busy. In the western suburb of Kichijoji, narrow shopping streets were jammed during the weekend with families strolling and heading to lunch. Pachinko pinball parlors have drawn ire for staying open despite name-and-shame announcements and other pressure to close. Bars and restaurants are ignoring a requested 8 p.m. closing time.

Abe did not ask non-essential businesses to close. But Koike, the Tokyo governor, fought and prevailed in requesting that schools, movie theaters, athletic clubs, hostess bars and other such businesses in the city be asked to close. Most restaurants and pubs still can operate from 5 a.m. to 8 p.m., and grocery and convenience stores and public transport remain open as usual.

California closed all non-essential businesses in the entire state. Not even Tokyo requested that all non-essential businesses close. California imposed more restrictions (while neglecting to issue a strict mask mandate) but did worse.

California closed all non-essential businesses in the entire state.

That's not even true.  They placed 12 counties on the watch list, and shuttered places of social gatherings.. mostly bars and restaurants which had prematurely opened.  The extent of things being called essential is shocking (liquor/tobacco stores, and more).

While it's true California imposed more restrictions and still did worse, it is possible they did so despite the lock-down and not because of it. Places with unfavorable social factors may be forced into issuing more drastic policies which are still not terribly effective. So it is rather a case of correlation than causation. If people in California were more selfless as in the East, the measures may not be needed. And even if we do worse in spite of it, it is not evidence that the lock-down was of no use, or that it wasn't needed in some extent. A mask mandate was issued in Nashville but no one is paying it any attention. I doubt there is a good way to handle this in the West.

Newsom's tweet from a week ago.  Seems outdoor gatherings are still being permitted.

@GavinNewsom

 

Jul 13

NEW: #COVID19 cases continue to spread at alarming rates.
 
CA is now closing indoor operations STATEWIDE for:

-Restaurants
-Wineries
-Movie theaters, family entertainment
-Zoos, museums
-Cardrooms

Bars must close ALL operations.

 

California closed all non-essential businesses in the entire state.

That's not even true.  They placed 12 counties on the watch list, and shuttered places of social gatherings.. mostly bars and restaurants which had prematurely opened.  The extent of things being called essential is shocking (liquor/tobacco stores, and more).

 
Yeah it's true. Here's the proof:
 

On March 19, 2020, an Executive Order (PDF) and Public Health Order (PDF) directed all Californians to stay home except to go to an essential job or to shop for essential needs.
 
On May 4, 2020, an Executive Order (PDF) informed local health jurisdictions and industry sectors that they may gradually reopen under new modifications and guidance provided by the state per the May 7, 2020 Public Health Order (PDF).

See essential jobs and open sectors

While it's true California imposed more restrictions and still did worse, it is possible they did so despite the lock-down and not because of it. Places with unfavorable social factors may be forced into issuing more drastic policies which are still not terribly effective. So it is rather a case of correlation than causation. If people in California were more selfless as in the East, the measures may not be needed. And even if we do worse in spite of it, it is not evidence that the lock-down was of no use, or that it wasn't needed in some extent. A mask mandate was issued in Nashville but no one is paying it any attention. I doubt there is a good way to handle this in the West.

The most likely explanation for why California did worse was simply because it failed to issue a mask mandate during the lockdown, and even after California issued the mandate, it hasn't been strictly enforced.

Newsom's tweet from a week ago.  Seems outdoor gatherings are still being permitted.

Gatherings of more than 250 people were prohibited during the lockdown.

Any way you cut it, chop it, slice it, or dice it, there's no reason to do a lockdown.

Off topic political post.  Deleted. - Dan Cooper

Your suggestion (which was in your post before it was removed due to its political content) that lockdowns were necessary because citizens are stupid (including in California presumably) is unsupportable. The evidence shows that the lockdown in California was less effective than what Japan did and lack of compliance wasn't an issue. California could have easily clamped down only on large gatherings and businesses such as restaurants, bars, and gyms as the circumstances warranted like Japan did, but instead, it clamped down on everything. And the evidence from Japan suggests that there's no advantage to more citizens staying at home like they did in California. Citizens were also told take masks were useless and not to wear them. Even after they were told the opposite, it took a while for California to even recommend mask wearing and never issued a mask mandate during the lockdown. All of this was due to the stupidity of politicians and health officials and other "experts," not of citizens.