Coronavirus Coronavirus: In-Iowa General Discussion (Not Limited)

[bawbie]

8 weeks ago it was a need to Shelter in Place to "Flatten the Curve" so we do not overwhelm the health care system. That has been done pretty much across the country.

What is the new "goal" now if we are not opening up the economy? Are we trying to drive daily new cases and deaths to zero? That is not going to happen without out a complete shutdown / lock-down for 4-6 weeks and a complete destruction of the economy.

Well, the first goal has not been accomplished at this point - cases are still rising at an unacceptable level (doubling every 10 days).

But once the curve is 'flattened' (R0<=1), the goal is to keep the R0 at that level or lower - to stop the curve from spiking again. That means that restrictions can be eased IF proper precautions are bought in on and taken by everyone.

I think that the majority of people understand that there is a new normal and that gatheriings with a lot of closely spaced people is not a good idea. But the vast majority of our day-to-day activities do not fall in that category. These things could be occuring with some new hygeine protocols with the understanding that individual locations / areas could be placed on shelter-in-place / quarintine to address hot spots.

Based on reporting and discussion here, I don't think it is widely agreed that the new normal you describe is necessary. There are large gatherings of people, there are not people wearing masks, there are not people spacing as necessary.

My other concern with prematurely "re-opening" is what we've seen in somewhere like Wapello county. When the Governor "re-opened" it 5 days ago it was at 10 positive cases. Now it's at 108 (in a county of 33k, that's the 15th most in the state per pop).

But there's no criteria to "close" those counties that have spiked after the closure (note: it's not because it closed, these are cases from before that occurred). But there are other counties that will spike because the restrictions are eased as well. But there is no going back - no counties or areas will be "re-closed". You only get one bite at the stay-in-place restrictions. So everyone needs to be careful about "re-opening"

 

[bawbie]

I've posted this before, but the original IHME projection for the US has proven to be very accurate so far. The issue may be that going forward that we should be seeing a decline in deaths which looked like was starting to happen but the number of new cases may keep deaths from declining as expected.

The "backside" slope of their fitted curve was never reasonable - even when ignoring that any social distancing and restrictions would naturally be eased once it was perceived as being "past the peak". My biggest issue is their "uncertainty" area going to zero along with cases/deaths. That's just bad presentation.

 

[GrappleCy]

And a reminder that, barring medical providers figuring out a treatment with significant changes to being able to treat this, our number of actual infections will lag our peak in number of positive tests by 1-2 weeks which will lag our peak in number by deaths by another 2-3 weeks. The people just going in the hospital now are people who caught this around Easter weekend.

 

[bawbie]

The 77 "opened" counties has now increased by 75% since the eased restrictions went into place (again, that's not because of the eased restrictions, it's cases prior to them going into affect). That's on pace to double in 6-7 days.




I was curious and couldn't find it anywhere, so I calculated cases / pop and deaths / pop for each Iowa county.

When sorting by population - Crawford, Wapello and Guthrie are "top 20" counties for cases / pop. Crawford is actually over the national average at 0.56% of the county testing positive. In total there are 13 Iowa counties over the national average of 0.36%.

5 counties are over 1% testing positive, ked by Louisa at 2.5% and Tama at 1.7%.

On the other end of the spectrum, Iowa, Benton and especially Fayette are well below average and many other non-closed states. Fayette actually has the 35th most cases in the state.

On deaths, there are 7 counties with a death rate above the national average, led by Tama at 0.06% of their population having died from the virus (641 / 1M residents, if you want to compare against other reporting).

 

[Acylum]

The people just going in the hospital now are people who caught this around Easter weekend.

Highly unlikely. https://wwwnc.cdc.gov/eid/article/26/6/20-0320_article

 

[dmclone]

On the other end of the spectrum, I just called in to an employee meeting where people were complaining that their electric bill has went up since they've been "forced to work from home", why the company gym isn't open, and if the company would buy them a trash can. I **** YOU NOT.

 

[Stewo]

And a reminder that, barring medical providers figuring out a treatment with significant changes to being able to treat this, our number of actual infections will lag our peak in number of positive tests by 1-2 weeks which will lag our peak in number by deaths by another 2-3 weeks. The people just going in the hospital now are people who caught this around Easter weekend.

According to the CDC, the median is 4 to 5 days and they state that 97.5% of people who develop symptoms will do so by 11.5 days. I think it's probably more accurate to say that those who are just now showing symptoms were actually exposed early last week.

 

[BCClone]

I see the county I work in mostly gained 1 case. This is a situation where people who want to warp things can pull stuff. They had a 50% increase, from 2 to 3. Any common sense would say that you don't look at it that way. The other two are considered recovered.

 

[agrabes]

The 77 "opened" counties has now increased by 75% since the eased restrictions went into place (again, that's not because of the eased restrictions, it's cases prior to them going into affect). That's on pace to double in 6-7 days.




I was curious and couldn't find it anywhere, so I calculated cases / pop and deaths / pop for each Iowa county.

When sorting by population - Crawford, Wapello and Guthrie are "top 20" counties for cases / pop. Crawford is actually over the national average at 0.56% of the county testing positive. In total there are 13 Iowa counties over the national average of 0.36%.

5 counties are over 1% testing positive, ked by Louisa at 2.5% and Tama at 1.7%.

On the other end of the spectrum, Iowa, Benton and especially Fayette are well below average and many other non-closed states. Fayette actually has the 35th most cases in the state.

On deaths, there are 7 counties with a death rate above the national average, led by Tama at 0.06% of their population having died from the virus (641 / 1M residents, if you want to compare against other reporting).

Wapello has a meat packing plant, makes sense why cases are on the rise there. For whatever reason, it hasn't been on the news like the others. That said though, it does prove your point - Reynolds' criteria for re-opening were not good.

 

[ClonesTwenty1]

The 77 "opened" counties has now increased by 75% since the eased restrictions went into place (again, that's not because of the eased restrictions, it's cases prior to them going into affect). That's on pace to double in 6-7 days.




I was curious and couldn't find it anywhere, so I calculated cases / pop and deaths / pop for each Iowa county.

When sorting by population - Crawford, Wapello and Guthrie are "top 20" counties for cases / pop. Crawford is actually over the national average at 0.56% of the county testing positive. In total there are 13 Iowa counties over the national average of 0.36%.

5 counties are over 1% testing positive, ked by Louisa at 2.5% and Tama at 1.7%.

On the other end of the spectrum, Iowa, Benton and especially Fayette are well below average and many other non-closed states. Fayette actually has the 35th most cases in the state.

On deaths, there are 7 counties with a death rate above the national average, led by Tama at 0.06% of their population having died from the virus (641 / 1M residents, if you want to compare against other reporting).

Unfortunately none of these numbers matter to the governor. She basically said this virus will not govern our lives no matter how bad it gets going forward.

 

[GrappleCy]

Highly unlikely. https://wwwnc.cdc.gov/eid/article/26/6/20-0320_article

Did you read what you linked? It is an article about what the fatality rates are and the timeline is just laid out as an assumption at the start. However, their assumption matches what I posted.

However, given the critical need to consider time lags to death when calculating case-fatality risk (3), we used time lags from a recent study from China (4). Yang et al. (4) reported that the median time from symptom onset to radiological confirmation of pneumonia was 5 days (interquartile range [IQR] 3–7 days); from symptom onset to intensive care unit (ICU) admission was 11 days (IQR 7–14 days); and from ICU admission to death was 7 days (IQR 3–11 days). Therefore, a median of 13 days passed from pneumonia confirmation to death ([11–5] + 7 = 13).

That timeline doesn't address the "infection to symptom onset" part of what I posted but otherwise tracks. A median of 5 days from symptoms to pneumonia, then 13 days before the median time to death (if you don't recover). That's 18 days as a median from symptoms to passing, which matches 2-3 weeks.

 

[Die4Cy]

Continued contact tracing from around the world is pointing toward several conclusions.

First, in general, close and prolonged indoor contact over several hours is required for transmission, or within 6 feet of an infected person for at least fifteen minutes. People who have the disease spread it to a household member about 15% of the time. To people outside close contact, less than 1% of the time. This is what you are seeing play out in packing houses and care centers in Iowa, and on public transit systems in places like New York.

Susceptibility increases based on how crowded your environment may be indicates random contacts can have an loading effect if you are in contact with enough affected people.

For whatever reason, children do not often drive transmission in households--they can become ill but do not easily spread it to others. It has also been well established that old age makes transmission easier on the other end of the scale, but this is not well understood.

And most transmission of the disease is by coming into contact with a symptomatic person within their first five days of becoming ill. Asymptomatic transmission is not as likely as originally thought.

https://threadreaderapp.com/thread/1257392347010215947.html

 

[Acylum]

According to the CDC, the median is 4 to 5 days and they state that 97.5% of people who develop symptoms will do so by 11.5 days. I think it's probably more accurate to say that those who are just now showing symptoms were actually exposed early last week.

Correct.

Did you read what you linked? It is an article about what the fatality rates are and the timeline is just laid out as an assumption at the start. However, their assumption matches what I posted.



That timeline doesn't address the "infection to symptom onset" part of what I posted but otherwise tracks. A median of 5 days from symptoms to pneumonia, then 13 days before the median time to death (if you don't recover). That's 18 days as a median from symptoms to passing, which matches 2-3 weeks.

The people dying recently may have been infected by Easter. Anybody infected by Easter is either well on the way to recovery or has been in the hospital for a while.

 

[awd4cy]

So go against federal order that states plants need to stay open. You do know a governor of a state doesn't have power to go against that orrr....

Apparently 2 people think they do, lol

 

[BCClone]

Apparently 2 people think they do, lol

interstate commerce clause can easily strip packing plants away from any governors authority.

 

[MeowingCows]

On the other end of the spectrum, I just called in to an employee meeting where people were complaining that their electric bill has went up since they've been "forced to work from home", why the company gym isn't open, and if the company would buy them a trash can. I **** YOU NOT.

Better expense that electrical bill and new trash can to the company!

 

[bawbie]

Apparently 2 people think they do, lol

The EO didn't actually do anything like what you say. It doesn't order anything to be open or to reopen. It grants authority under existing law to the Ag Secretary and that's about it.
Here's the text if you want to read it:
https://www.whitehouse.gov/presiden...-national-emergency-caused-outbreak-covid-19/

This is directly from the US Ag Secretary:

The Centers for Disease Control and Prevention (CDC) of the Department of Health and Human Services and the Occupational Safety and Health Administration (OSHA) of the Department of Labor have put out guidance for plants to implement to help ensure employee safety to reopen plants or to continue to operate those still open. Under the Executive Order and the authority of the Defense Production Act, USDA will work with meat processing to affirm they will operate in accordance with the CDC and OSHA guidance, and then work with state and local officials to ensure that these plants are allowed to operate to produce the meat protein that Americans need. USDA will continue to work with the CDC, OSHA, FDA, and state and local officials to ensure that facilities implementing this guidance to keep employees safe can continue operating.

https://www.usda.gov/media/press-re...ident-trumps-executive-order-meat-and-poultry

 

[CrossCyed]

Dr. Pence has spoken.

 

[Entropy]

 

[BCClone]

So people were saying only about a fourth of the people at these places got tested? Does that mean these meatpacking plants employ 5000 people? I’m thinking that’s a definitely way more than any meat packing plant I know