Working through some arithmetic using Colo. Covid-19 estimates

[CO skier]

"CDPHE gives update on Colorado cases

The Colorado Department of Public Health and Environment (CDPHE) held a virtual news conference Monday to give an update on the spread of COVID-19 in the state.

As of 2 p.m. Monday, Colorado had 5,172 cases of COVID-19, with 976 hospitalizations and 148 deaths, according to CDPHE. Cases have been reported in 54 counties, and 26,875 tests have been conducted.

Jill Ryan, CDPHE executive director, said those numbers don't reflect the reality of infections in the state. She estimated that 17,000 to 18,000 Coloradans have had COVID-19, which is 0.02% to 0.03% of the state's population [ed. -- should be 0.30% of states population; see post #3 below].

She said the numbers indicate widespread community spread of the virus and that there are signs of stress on hospitals. Dr. Eric France, CDPHE's chief medical officer, said they expect 30% to 40% of Coloradans eventually will be infected with COVID-19."

Colorado coronavirus latest, April 6: King Soopers limiting number of shoppers

COVID-19 is in Colorado — we'll continue to post updates and headlines on how Colorado is being affected by the coronavirus.

www.9news.com

Working with the above estimates:

The first Covid-19 case in Colorado was reported on March 5th. Roughly one month into the pandemic results in an estimated 0.30% of the state's population infected, and this ultra-low number is stressing hospitals' ability to cope. The idea of "stay-at-home" orders is to maintain a relatively constant infection rate instead of an exponential rate. If it proves successful and an infection rate of about 0.30% per month is maintained, will it not take many years for the endpoint of 30% to 40% of Coloradans infected to eventually be met?

Colorado's governor has extended the stay-at-home order from April 11 to April 26th. Are the stay-at-home order extensions just kicking the inevitable down the road? With more than 99% of the state's population still available to host Covid-19, a return to the exponential infection rate would be a certainty as soon as the stay-at-home order is lifted or even relaxed.

 

[T_R_Oglodyte]

Are the stay-at-home order extensions just kicking the inevitable down the road? With more than 99% of the state's population still available to host Covid-19, a return to the exponential infection rate would be a certainty as soon as the stay-at-home order is lifted or even relaxed.

That's been mentioned frequently, and the answer is yes, it is just kicking the can down the road. Flattening the curve was never about reducing the number of people infected; it's about reducing the peak load. There is general awareness that once stay in place orders are lifted, new cases will occur. So the stay in place are likely to be lifted gradually.

The other thing that flattening the curve does is it allows time to identify and implement more effective countermeasures and treatments.

 

[PigsDad]

Jill Ryan, CDPHE executive director, said those numbers don't reflect the reality of infections in the state. She estimated that 17,000 to 18,000 Coloradans have had COVID-19, which is 0.02% to 0.03% of the state's population.

Not that it changes the intent of your post, but you (or the source where you got those percentages) are an order of magnitude off. If 18,000 represents 0.03% of Colorado's population, that would put our state's population at 60 million. It is closer to 6 million.

Kurt

 

[DaveNV]

I'd suggest looking at Washington state's numbers, as a comparison. We were a few weeks ahead of the country, in terms of infection rates. And it appears we've been able to flatten the curve some, enough that people are beginning to see the light at the end of the tunnel. Obviously we aren't out of the woods yet, but as Steve says above, it's about giving medical facilities the chance to be prepared to handle the caseload. Take this one day at a time, and don't take any unnecessary risks.

Dave

 

[T_R_Oglodyte]

I'd suggest looking at Washington state's numbers, as a comparison. We were a few weeks ahead of the country, in terms of infection rates. And it appears we've been able to flatten the curve some, enough that people are beginning to see the light at the end of the tunnel. Obviously we aren't out of the woods yet, but as Steve says above, it's about giving medical facilities the chance to be prepared to handle the caseload. Take this one day at a time, and don't take any unnecessary risks.

Dave

During dinner last night (DW, #3 son (36 yrs old), and me) I mentioned that sheltering in place doesn't prevent infection, because when shelter in place ends we're going to be exposed. So it's just a matter of us being exposed later rather than sooner. She scowled at me and said we should change the subject.

 

[Panina]

I'd suggest looking at Washington state's numbers, as a comparison. We were a few weeks ahead of the country, in terms of infection rates. And it appears we've been able to flatten the curve some, enough that people are beginning to see the light at the end of the tunnel. Obviously we aren't out of the woods yet, but as Steve says above, it's about giving medical facilities the chance to be prepared to handle the caseload. Take this one day at a time, and don't take any unnecessary risks.

Dave

During dinner last night (DW, #3 son (36 yrs old), and me) I mentioned that sheltering in place doesn't prevent infection, because when shelter in place ends we're going to be exposed. So it's just a matter of us being exposed later rather than sooner. She scowled at me and said we should change the subject.

I rather get it when the medical facilities aren’t at capacity and are able to pay better attention to my needs. Many are so overworked now and have so many patients. Plus the later in the curve you get it the better chance that there will be a treatment that works to reduce the rate of death. Plus some people probably will not get it.

 

[DaveNV]

During dinner last night (DW, #3 son (36 yrs old), and me) I mentioned that sheltering in place doesn't prevent infection, because when shelter in place ends we're going to be exposed. So it's just a matter of us being exposed later rather than sooner. She scowled at me and said we should change the subject.

There's truth in your words. It's more a matter of "when" than "if." And if people think they can just run about after the stay-at-home is lifted, they're in for a rude awakening. My concern is it's all going to get really bad, really fast at that point.

Dave

 

[T_R_Oglodyte]

There's truth in your words. It's more a matter of "when" than "if." And if people think they can just run about after the stay-at-home is lifted, they're in for a rude awakening. My concern is it's all going to get really bad, really fast at that point.

Dave

Some weeks back, when herd immunity was being dissected, there were estimates that 80% of the population would need to attain immunity for virus transmission to die out. So the pandemic is going to continue until we get to whatever the required percent of immunity is. We get there when the percentage of survivors with acquired immunity reaches whatever that fraction of the total population. Or a vaccine becomes available that will induce immunity in people who haven't already attained immunity.

 

[Panina]

Some weeks back, when herd immunity was being dissected, there were estimates that 80% of the population would need to attain immunity for virus transmission to die out. So the pandemic is going to continue until we get to whatever the required percent of immunity is. We get there when the percentage of survivors with acquired immunity reaches whatever that fraction of the total population. Or a vaccine becomes available that will induce immunity in people who haven't already attained immunity.

Depending on who is right, they say between 10% to 50% might have had it asymptomatic. Hoping for the 50% but most probably somewhere in between.

 

[T_R_Oglodyte]

Depending on who is right, they say between 10% to 50% might have had it asymptomatic. Hoping for the 50% but most probably somewhere in between.

And since we're not doing mass testing we don't know what that number is.

 

[Panina]

There's truth in your words. It's more a matter of "when" than "if." And if people think they can just run about after the stay-at-home is lifted, they're in for a rude awakening. My concern is it's all going to get really bad, really fast at that point.

Dave

If they just lift it with no rules it will be bad again within a few weeks. Hopefully there will be a clear message of the real risk still being with us and they will give us clear instructions on what is expected of us.

 

[Panina]

And since we're not doing mass testing we don't know what that number is.

Mass testing could be a blessing or maybe not.

 

[artringwald]

Basic calculus says that flattening the curve doesn't imply that the area under the curve changes, i.e. the same number of people are going to get sick. Vaccines seem to be too far off to help reduce the number either. About the only advantage of hitting an early peak, is because the people that recover will be able to return to work sooner, without fear of infection.

 

[CO skier]

Not that it changes the intent of your post, but you (or the source where you got those percentages) are an order of magnitude off. If 18,000 represents 0.03% of Colorado's population, that would put our state's population at 60 million. It is closer to 6 million.

Kurt

I linked the article that was quoted. You are correct, and I have edited the original post.

 

[csodjd]

Some weeks back, when herd immunity was being dissected, there were estimates that 80% of the population would need to attain immunity for virus transmission to die out. So the pandemic is going to continue until we get to whatever the required percent of immunity is. We get there when the percentage of survivors with acquired immunity reaches whatever that fraction of the total population. Or a vaccine becomes available that will induce immunity in people who haven't already attained immunity.

This is all true, though I believe herd immunity takes a bit higher percentage. But with COVID-19 we have an illness that MOST people get through with little complication. Give ourselves and our researchers another 60-90, or 120 days (and a chance to catch their breath) and they will likely have some good information for predicting who is at risk of being in the that unfortunate 20%, who is most at risk of needing ICU or ventilation, and quite likely some effective treatment options for preventing the most serious sequel. If many of us are going to be infected before a vaccine is available, I'd like to be the only one in the ICU with it, three pulmonary specialists walking around well rested, and half a dozen clinical trials completed.

 

[T_R_Oglodyte]

Basic calculus says that flattening the curve doesn't imply that the area under the curve changes, i.e. the same number of people are going to get sick. Vaccines seem to be too far off to help reduce the number either. About the only advantage of hitting an early peak, is because the people that recover will be able to return to work sooner, without fear of infection.

Likely faster will be the identification of treatment options. Still the same number of people getting sick, but getting better treatment means more recovery and less debilitating effects.

 

[CO skier]

There's truth in your words. It's more a matter of "when" than "if." And if people think they can just run about after the stay-at-home is lifted, they're in for a rude awakening.

I think "back to normal" or "run about" or "skyrocketing economy" is what the vast majority of the American people, and some of the highest public policy officials including governors, probably think will be the case after we "flatten-the-curve and start down the other side." That is the message I get when I listen to the Covid-19 news. That is the message I get when the initial stay-at-home order was issued for a duration of 3 weeks, then extended for another 2 weeks.

It was not until I ran the numbers for myself that I understood just how "hooked on flattening-the-curve" society has become, and how SAH extensions will likely have to roll through the summer and beyond just like an addiction, or there will be another spike in infections requiring re-instating SAH orders.

Dr. Fauci alludes to a long time time frame, and couches his statements carefully, in the daily White House briefings. The policymaker(s) in the room do not seem to have the same time frame in mind with the 15 30 Days To Slow The Spread (probably 45 and well beyond).

 

[T_R_Oglodyte]

I think "back to normal" or "run about" or "skyrocketing economy" is what the vast majority of the American people, and some of the highest public policy officials including governors, probably think will be the case after we "flatten-the-curve and start down the other side." That is the message I get when I listen to the Covid-19 news. That is the message I get when the initial stay-at-home order was issued for a duration of 3 weeks, then extended for another 2 weeks.

It was not until I ran the numbers for myself that I understood just how "hooked on flattening-the-curve" society has become, and how SAH extensions will likely have to roll through the summer and beyond just like an addiction, or there will be another spike in infections requiring re-instating SAH orders.

Dr. Fauci alludes to a long time time frame, and couches his statements carefully, in the daily White House briefings. The policymaker(s) in the room do not seem to have the same time frame in mind with the 15 30 Days To Slow The Spread (probably 45 and well beyond).

We'll probably two types of response. Some areas will lift SIP requirements when it looks as if things are undercontrol, and a second wave of infection will be unleashed. Other area will lift restrictions gradually, trying to match case rates to health system capacity.

Until a vaccine is developed, strategies need to focused on managing infection rates; lacking vaccine prevention isn't really feasible.

 

[DaveNV]

Yes, to both of you.

Dave

 

[DaveNV]

Mass testing could be a blessing or maybe not.

The thing about testing is that it is just to test whether you are shedding the virus, or have antibodies to it, right? What's to say you can't get it again? Different strains, and all that. And just because a person recovers and may be considered immune, it doesn't mean their at-risk family member is also immune. So running about after lifting the stay-at-home order seems very risky.

Dave

 

[isisdave]

Another reason to "get sick later rather than sooner" is that there is still a lot we don't know about the illness. For example, will there be long-term lung problems, not just in the elderly but in perhaps younger people who only got mild symptoms? And in the last few days there were some reports about long term heart problems. And who knows what else will turn up in a year? The longer you stay well, the better chance of some of these questions being resolved, hopefully with solutions.

I think what's needed most is a reliable, quick, antibody test that would permit supposedly-now-immune people, especially healthcare workers, to go back to work. Next, better treatment modalities, while at the same time research on various kinds of vaccine continues.

 

[T_R_Oglodyte]

Another reason to "get sick later rather than sooner" is that there is still a lot we don't know about the illness. For example, will there be long-term lung problems, not just in the elderly but in perhaps younger people who only got mild symptoms? And in the last few days there were some reports about long term heart problems. And who knows what else will turn up in a year? The longer you stay well, the better chance of some of these questions being resolved, hopefully with solutions.

I think what's needed most is a reliable, quick, antibody test that would permit supposedly-now-immune people, especially healthcare workers, to go back to work. Next, better treatment modalities, while at the same time research on various kinds of vaccine continues.

mass antibody testing will also generate information on how many people have been asymptomatically infected.

 

[csodjd]

mass antibody testing will also generate information on how many people have been asymptomatically infected.

It will also help determine immunity. You can track people over time and see if any or what % get infected. If nobody or almost nobody that was antibody positive gets sick you know you have immunity, at least until that starts to change.

 

[CO skier]

I like the part of the daily White House briefing where the medical experts answer questions. Notice the difference in responses to one of this afternoon's questions.

To Dr. Fauci's point about SAH orders will be lifted, and medical experts will be able to judge the "rebound" in time for summer camps to decide what to do about their contracts? Doubtful, to say the least. Dr. Fauci must not understand the logistics of summer camps.

(1:36:12)

Question for Dr. Birx or Dr. Fauci, … secondly, as a lot of parents are sitting at home with their kids, maybe wondering maybe resigned to the fact that their kids are not going back to school this year but are looking ahead, what do you think summer camp holds and what do you think the start of next school year holds, if you could look down the line? Do you think school will start on time? Do you think school next year starts on time?

Vice President Pence: Look. Can I say a word on behalf of teachers, since I am married to one? My wife was all day yesterday at the elementary school she teaches at loading up about 500 bins of art supplies for kids. And she is just one of millions of teachers across this country, who find themselves having to “distance teach” kids. And I am proud of Karen, lately I am proud of every teacher in this country.

Secretary of education was here not long ago talking about our efforts to expand distance learning resources even in K through 12. To all the teachers who are out there, we just want to say, “Thank you. Thank you for what you are doing continuing learning in this challenging time, and even to the kids: Just because you are home does not mean you do not need to continue doing your school work.”

…

Dr. Fauci: Well, my daughter is a school teacher, so she asked me the same … question. Uhm, you know it is unpredictable, but you can get a feel for if we start talking about the things where the curve goes down and we really have minimum, um, how we respond and what kind of a rebound we see or don’t see, I think is going to have a lot of influence probably more immediately on summer camps than it does in the fall.

I fully expect, though I am humble enough to know that I can't accurately predict that by the time we get to the fall, we will have this under control enough that it certainly will not be the way it is now; where people are shutting schools.

My optimistic side tells me that we will be able to renew, to a certain extent, but it’s going to be different, because remember now, this is not going to disappear, so we are going to have to have in place the capability of doing the things we talk about all the time on this stage – to identify, to isolate, to contact trace -- #1. #2, by that time, we’ll have a better feel with an antibody test about what the actual penetrance of this infection was in society. How many people have actually been infected? Who’s protected? If you have antibodies, it is very likely you are protected.

Who’s vulnerable? Do you treat “vulnerables” different than you treat the people who are protected? All of these things are going to go into the decision of just how much back to the original way we would like it to be in the fall. Bottom line is no absolute prediction, but I think we are going to be in good shape.