Emergent Ventures prize winners for coronavirus work

I am happy to announce the first cohort of Emergent Ventures prize winners for their work fighting the coronavirus.  Here is a repeat of the original prize announcement, and one week or so later I am delighted there are four strong winners, with likely some others on the way. Again, this part of Emergent Ventures comes to you courtesy of the Mercatus Center and George Mason University. Here is the list of winners:

Social leadership prizeHelen Chu and her team at the University of Washington.  Here is a NYT article about Helen Chu’s work, excerpt:

Dr. Helen Y. Chu, an infectious disease expert in Seattle, knew that the United States did not have much time…

As luck would have it, Dr. Chu had a way to monitor the region. For months, as part of a research project into the flu, she and a team of researchers had been collecting nasal swabs from residents experiencing symptoms throughout the Puget Sound region.

To repurpose the tests for monitoring the coronavirus, they would need the support of state and federal officials. But nearly everywhere Dr. Chu turned, officials repeatedly rejected the idea, interviews and emails show, even as weeks crawled by and outbreaks emerged in countries outside of China, where the infection began.

By Feb. 25, Dr. Chu and her colleagues could not bear to wait any longer. They began performing coronavirus tests, without government approval.

What came back confirmed their worst fear. They quickly had a positive test from a local teenager with no recent travel history. The coronavirus had already established itself on American soil without anybody realizing it.

And to think Helen is only an assistant professor.

Data gathering and presentation prize: Avi Schiffmann

Here is a good write-up on Avi Schiffmann, excerpt:

A self-taught computer maven from Seattle, Avi Schiffmann uses web scraping technology to accurately report on developing pandemic, while fighting misinformation and panic.

Avi started doing this work in December, remarkable prescience, and he is only 17 years old.  Here is a good interview with him:

I’d like to be the next Avi Schiffmann and make the next really big thing that will change everything.

Here is Avi’s website, ncov2019.live/data.

Prize for good policy thinking: The Imperial College researchers, led by Neil Ferguson, epidemiologist.

Neil and his team calculated numerically what the basic options and policy trade-offs were in the coronavirus space.  Even those who disagree with parts of their model are using it as a basic framework for discussion.  Here is their core paper.

The Financial Times referred to it as “The shocking coronavirus study that rocked the UK and US…Five charts highlight why Imperial College’s research radically changed government policy.”

The New York Times reportedWhite House Takes New Line After Dire Report on Death Toll.”  Again, referring to the Imperial study.

Note that Neil is working on despite having coronavirus symptoms.  His earlier actions were heroic too:

Ferguson has taken a lead, advising ministers and explaining his predictions in newspapers and on TV and radio, because he is that valuable thing, a good scientist who is also a good communicator.

Furthermore:

He is a workaholic, according to his colleague Christl Donnelly, a professor of statistical epidemiology based at Oxford University most of the time, as well as at Imperial. “He works harder than anyone I have ever met,” she said. “He is simultaneously attending very large numbers of meetings while running the group from an organisational point of view and doing programming himself. Any one of those things could take somebody their full time.

“One of his friends said he should slow down – this is a marathon not a sprint. He said he is going to do the marathon at sprint speed. It is not just work ethic – it is also energy. He seems to be able to keep going. He must sleep a bit, but I think not much.”

Prize for rapid speedy responseCurative, Inc. (legal name Snap Genomics, based in Silicon Valley)

Originally a sepsis diagnostics company, they very rapidly repositioned their staff and laboratories to scale up COVID-19 testing.  They also acted rapidly, early, and pro-actively to round up the necessary materials for such testing, and they are currently churning out a high number of usable test kits each day, with that number rising rapidly.  The company is also working on identifying which are the individuals most like to spread the disease and getting them tested first.  here is some of their progress from yesterday.

Testing and data are so important in this area.

General remarks and thanks: I wish to thank both the founding donor and all of you who have subsequently made very generous donations to this venture.  If you are a person of means and in a position to make a donation to enable this work to go further, with more prizes and better funded prizes, please do email me.

Comments

Worthy prizes ! Well done to the winners and the Donors.

Congratulations to the winners and thanks to the people behind the prizes.

Congratulations to all winners. These prize announcements are a great idea

Grateful, very grateful, to all.

The Imperial College numbers are insanely overblown and will help cause an economic depression

On what basis are you saying this? Please point us to the alternative analysis you prefer.

Their prediction of 410,000-550,000 UK deaths with no movement controls in place is somewhat speculative, since nobody has allowed the virus to spread much before implementing controls. However, some sort of estimate is needed. Why is their estimate not the best estimate?

On the other hand, their lower predictions for total deaths over two years with controls in place are in some instances lower than deaths already recorded within just a few weeks in Italy (and the curve is still sloping upward in Italy).

Their analysis of ability to limit deaths may prove over-optimistic.

His basis is easy to understand - he doesn't want an analysis that points to the sorts of numbers of cases and deaths that Italy and Spain are experiencing.

You could go to the Johns Hopkins site.

The problem isn't the Wuhan Flu. It's the unlimited power we the people have surrendered to large bunches of morons that are destroying state and national economies over an exaggerated pandemic that is less lethal than several prior.

Seen elsewhere: 'friend forwarded an abstract of a study from the Center for Evidence-Based Medicine estimating that the CFR (case fatality rate–the number of reported deaths per number of reported cases) is only .1%, i.e., one out of a thousand.'

"How do we arrive at this CFR figure?

"The current COVID outbreak seems to be following previous pandemics in that initial CFRs start high and then trend downward. In Wuhan, for instance, the CFR has gone down from 17% in the initial phase to near 1% in the late stage. Current testing strategies are also not capturing everybody: at least 50% on Diamond Princess were asymptomatic who usually wouldn’t get a test; in South Korea, considerable numbers who tested positive were also asymptomatics. Asymptomatic people and mild cases are likely driving the rapid worldwide spread. Early CFR rates are subject to selection bias as more severe cases are tested – generally those in the hospital settings or those with more severe symptoms. Mortality in children seems to be near zero (unlike flu) which will drive down the CFR significantly. In Swine flu, the CFR was fivefold less than the lowest estimate in the 1st ten weeks (0.1%)

"Therefore, to estimate the CFR, we used the lowest estimate, currently Germany’s 0.25%, and halved this based on the assumption that half the cases go undetected by testing and none of this group dies. Our assumptions, however, do not account for some exceptional cases, as in Italy, where the population is older, smoking rates are higher and antibiotic resistance is the highest in Europe, which all can act to increase the CFR. It is also not clear if the presence of other circulating influenza illnesses acts to increase the CFR and whether certain populations (e.g., those with heart conditions) are more at increased risk."

Hat tip to my China Air jumbo jet pilot friend, Wie Tu Low!

Here's the real crisis! I'm almost dead out of Dewars Scotch and all the liquor stores have been unjustly declared "unessential" and closed

Unessential to whom!?

You miss the full point. Even if we accept that the CFR is that low, it's the distribution of cases that matters. Everything hitting within the span of a few weeks overwhelms the health care system's capacity to care which will make your CFR artificially rise from a "natural" baseline.

Furthermore you miss out on the group of moderately sick patients who are sick enough to need hospitalization but not sick enough to need the ICU. This is far larger than 0.25 % of all infected. If they linger and bed block, that will cause CFR to rise as soon as you exceed hospital capacity. See my post at the bottom.

The warden told me I need to get dressed. It ain't fair.

People still go out to buy food, pick up prescriptions, buy Lotto tix.

As we write, the A. C. Moore (in-liquidation) store closing sales are ongoing in Westbury, NY. Despite Il Capo's lockdown orders.

When the going gets rough, the tough get going.

And when the tough start coughing, they whine about getting an ICU bed.

Bring Out Your Dead!

Confucius Say, "Science will discover a vaccine for the Wuhan Flu 100 years before it finds cure for stupid."

And brought out discretely - until the Army is called in to handle the overflow.

At which point, the dying will not be attached to unavailable ventilators. And the Army will still be hauling away the dead bodies. But of course there is no way that what happened in China, and is happening in Italy or Spain, will ever happen to the U.S.

And your 657 yesterday.

Think the U.S. will be magically protected from covid-19?

Try this analysis for a totally different view.

This May work. In case it doesn’t here it is in text https://www.cebm.net/global-covid-19-case-fatality-rates/

And does not explain, in any way, shape, or form, why so many people are dying right now in (northern) Italy, compared to the previous years. Such as 657 dying yesterday.

Since you couldn’t be bothered to read through the piece, here’s an excerpt regarding Italy:

Italy

In Italy, there are several reasons why CFR might be higher: the age structure of the Italian population (2nd oldest population in the world); highest rates of antibiotic resistance deaths in Europe which might contribute to increased pneumonia deaths (Italy tops the EU for antibiotic-resistance deaths with nearly 1/3rd of the deaths in the EU). Smoking also seems to be a factor associated with poor survival – in Italy, 24% smoke, 28% men. In the UK, for instance, 15% are current smokers.

Update 20 March: Coronavirus: Is Covid-19 the cause of all the fatalities in Italy?

Sarah Newy reports that Italy’s death rate might be higher because of how fatalities are recorded. In Italy, all those who die in hospitals with Coronavirus will be included in the death numbers. In the article, Professor Walter Ricciardi, Scientific Adviser to, Italy’s Minister of Health, reports, “On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity – many had two or three.”

Recording the numbers of those who die with Coronavirus will inflate the CFR as opposed to those that died from Coronavirus, which will reduce the CFR.

I don't know if the numbers are overblown, but it certainly would cause a level of economic crisis that would make the US look like Zimbabwe. "The major challenge of suppression is that this type of intensive intervention package – or something equivalently effective at reducing transmission – will need to be maintained until a vaccine becomes available (potentially 18 months or more) – given that we predict that transmission will quickly rebound if interventions are relaxed. We show that intermittent social distancing –triggered by trends in disease surveillance – may allow interventions to be relaxed temporarily in relative short time windows, but measures will need to be reintroduced if or when case numbers rebound." The intermittent suppression scenario has the strategies in force for 2/3 of the time until November 2021. Their best case scenario in which all measures are taken, social distancing and school closures are in place 58% of the time and saves 405,000 lives (though it doesn't say anything about life years) over 2 years in the UK. They don't discuss how many of those are excess deaths (i.e. some of those people would have died anyway). They say it's qualitatively similar for US, so probably saves around 2 million lives over 2 years. I saw an estimate from a professor at Berkley that two months of measures would reduce GDP by 6 percent. Extreme measures for 6 months would probably result in much more than 18 percent reduction, but that gives you an idea of what is effective and what measures might not be worth taking. And I'm sure most economists have had the thought about the fiscal benefit of losing lots of old people who don't work and the transfer of wealth to younger generations.

Is there any evidence that "social distancing" is working? It has been 10 days since it was imposed in Italy. There no slowdown in cases in Lombardy or other more populous regions.

These projections are designed to terrify to population into compliance, and the collateral damage is going to destroy the West.

We are literally now setting prisoners free and locking up (and impoverishing) everyone else.

Stop the madness.

The best evidence we have is from China, South Korea, Japan and Singapore. Italy was on track to double the number of cases every two days but has since slowed down to doubling every three days. Whether it is really doing a poor job of containing the virus or whether the continued increase reflects more conscientious testing and reporting remains to be seen but the rate of increase has slowed a bit.

China had 1,300,000,000 people and fewer than 4,000 deaths. Italy has 60,000,000 and just over 4,000 deaths, 99% either aged or suffering massive health problems.

Thanks God I had two-hernia surgery before they seized the hospital and handed it over to the Wuhan Flu hystericals.

"China had 1,300,000,000 people and fewer than 4,000 deaths."

Yes, a good thing they took action when they did as it would have been much, much worse had the infection rate continued to increase exponentially. We will see what happens as China eases up.

What happens if they don't ease up?

China is the valid comparison; can any Western country actually lock down an entire city, region or nation?

I don't believe South Korea or Singapore have enacted anything as self-defeating as what Italy has done. And remember when we say "italy" we mean Lombady -- which is basically half the deaths.

Not sure on Japan, but I don't believe the did anything as drastic.

Remember the Chinese did what they did to prevent 300M people from moving around.

What the lockdowns suggest to me is you're basically letting everyone inside that lockdown (Wuhan, or Lombardy) die as the medical and logistical system collapses.

If you go with the estimate that one death means around 1000 cases, in lombardy you've probably had about 1/3 of the population be exposed to the virus.

No, China and Italy aren't just building a wall around Wuhan and Lombardy and letting everyone there die. They are also preventing people in those areas from leaving their homes to protect the healthy people in those regions, and sending medical resources in those regions to shore up the medical and logistical system. Cases in Wuhan are under control now too. We'll see how Italy does, but it seems to me that we are better off going off with a big-bang of China-style controls for two months and be done with this rather than drag out less extreme controls for 18 months.

That was fast - problem solving through the progress made possible by prizes indeed. All the work starting before the prize announcements were made was clearly spurred on by something that they knew nothing about at the time.

Prior_approval logic:

Prizes for dealing with the Corona virus are bad, because GMU fired me 30 years ago for incompetence.

You tell ‘em, prior. Something something Kochs

That's right, have your money associated with any of the prizes personally selected by Tyler Cowen.

And watch progress in action.

I wonder in a few years hence if someone will write a study that we tanked the global economy to preserve elderly smokers.

. "In South Korea, for example, which had an early surge of cases, the death rate in Covid-19 patients ages 80 and over was 10.4%, compared to 5.35% in 70-somethings, 1.51% in patients 60 to 69, 0.37% in 50-somethings. Even lower rates were seen in younger people, dropping to zero in those 29 and younger."

Zero?

If young people get a cold and it passes easily but the same cold is lethal to a man who is 80 years old and a lifetime smoker... did the man die of old age...or from a cold? I am not moralizing, but does anyone know the fraction of smokers in those people over 80 who have died after exposure to the cold virus Covid-19?

Cancer kills 600,000 Americans this year, and will next year and the year after that and the year after that. Cancer is often caused by carcinogens released into the environment.

Should we shut down the economy to clean up all carcinogens in the environment?

In comparison to the costs of global war on Covid 19---perhaps 10% of global GDP lost for a couple years, maybe $20 trillion---does the Green New Deal look expensive anymore?

I hope I am wrong. But I think we have seen the first couple legs of the Bear Market. Two more legs to go.

You unwittingly make the argument for flattening the curve.

First, we are in a period of huge uncertainty -- buying time to gather data on how this thing spreads and how to treat it is the rational, responsible thing to do.

In the case of cancer, fortunately, it is not a contagious disease and does not hit everyone at once. The curve is already flat and reasonably predictable although campaigns and laws to discourage smoking and to vaccinate young adults for HPV have flattened it even more. Beyond that, preventive measures to limit exposure to carcinogens would be controversial and would need to be maintained over decades to have a real impact.

By contrast, no one is suggesting lockdowns continue for decades. The debate seems to be between those who accept that it will run through the human population but hopefully after we have better treatment options and those who are hoping a vaccine can become available while the virus is contained. The former strategy is more or less what we are doing with cancer but requires we not let there be millions of cases around the world in 4 weeks.

What you are saying is that we are planning to get to herd immunity, but flatten out the peaks. I can't say that is a bad idea---but egads, are you aware of the financial and economic costs under consideration? And why not tell the truth? As in. "Okay, we will get to 50% to 60% infection rates, and lot of you will die. Just not in one clump."

Stray thought: If we feel compelled to go to heroic pandemic battle stations and tank the global economy, as elderly smokers are dying in waves, do we have the right to outlaw smoking?

"financial and economic costs"

Indeed, but what about the alternatives? Let's assume we don't take measures now and the virus doubles every three days in early stages and otherwise follows the logistic function in spreading. Let's also assume a 1% death rate. Those assumptions are a bit on the conservative side. By April 21, we will have well north of 10 million cases and more than 100,000 either already dead or destined to die (exponential growth, even under the eventual slowdown implied by the logistic function, is a bitch). And it gets worse from there. The vast majority of those people would have been infected in the past two weeks and therefore contagious and we don't know how many would be medical front-liners put out of commission by illness or fears they would infect patients.

As I said, every month we buy is one month that can be devoted to gathering evidence on treatment and containment options. But the above scenario will probably not happen because even the hard-headed people going around mocking everyone taking this seriously and declaring it as a hoax will know someone who is seriously affected by it, except for those who have no friends or family.

More Americans would be killed in riots/social unrest, or starvation, than from the Wuhan Flu.

If we're really lucky! In a few years, the US will not look like episode 200 of "The Walking Dead" or Nicaragua and Zimbabwe.

I'm not hopeful.

Some valuations still are overblown. Soon, huge buying opportunity.

I'm ready to buy once it looks like a bottom (S&P 1800 or 1900). Because when it all goes to (At this moment, The USA is on the Highway To Hell) Hell, US Treasuries also will be worthless. That's why I hold Scotch whisky, gold and ammunition.

I would love to see a cost-benefit analysis be in the next round of prizes for this.

Boomer Remover! 'How sharper than a serpent's tooth it is to have a thankless child' - they clearly earned it,

https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6912e2-H.pdf
30 percent of cases but 45 percent of hospitalizations, 53 percent of ICU admissions, and 80 percent of deaths in US from Covid 19 are of people 65 or older. Should we spend trillions either in government largesse or reduced economic activity to save a few extra years? That's not thanklessness. That's what all those old people who supposedly love their kids and grandkids should be asking themselves.

Hi Tyler, as a front line clinician, I have a few thoughts on the COVID crisis for MR discussion. I've tried to strip it of as much mood affiliation as I can. My overall sense is that at the US is repeating the same mistakes that Wuhan initially did, and Italy after them. By dithering on the initial lockdown decision to avoid economic damage, they actually prolong the amount of lockdown needed to bring the disease under control.

At the current trajectory of rise in Europe and the US, there will be widespread death and misery.

1. Medical personnel do not have PPE. The estimates I have read are 10-20% infection rate in health care workers, which served in China as a major vector for transfer to patients. Problems start to arise when your health care work force starts to die off or get sick.

2. I see plenty of MR comments focusing on the overall fatality rate being not so bad (e.g. Nature's 1.4% estimate). The key here is to understand that the number is still being fine tuned and that rate is variable depending on local circumstance. We're most worried about overloading hospitals and ICUs. Let's say NYC has a capacity of 2000 ICU beds (using this number as an example). Any patient volume below that will have a 1.4% mortality. Any number above that will have 100% mortality. You can see how this modeling can rapidly change a particular region's mortality rate. You also need to consider how long a bed is occupied. We're seeing that a sick COVID patient needs to be intubated and take up an ICU bed for several weeks. Patients don't just get better in one day to where you can kick them out and reuse the bed. Using my though experiment, once NYC gets past 2000 concurrent hospitalized ICU patients, you have to resort to wartime triage for anyone who shows up afterwards. That could be in a day or two at the present rate of rise.

3. A similar situation applies to moderately sick individuals who need hospitalization for e.g. oxygen therapy but are not so bad (yet) to need intubation and ventilator care. There is a higher limit of regular hospital beds for these patients, but once you cross that threshold, the "run of the mill" admissions for sepsis, MIs, and strokes won't be able to get treated. This does not directly count as morbidity and mortality from COVID but it should.

4. As for rapidly scaling up capacity, test kits, PPE, and ventilators can be scaled up rapidly. Hospital beds can even be made in a creative fashion; we have talked about tents in the lawn or renting out hotel rooms. However, you lack the personnel to staff them. It's much harder to scale up nurses, doctors, and respiratory therapists to care for a severely sick COVID patient.

5. I am less sanguine than most that a successful vaccine can be developed in 12-18 months. Certain viruses are hard to develop vaccines for, and one hasn't been developed for traditional coronaviruses or classic SARS. We are also underestimating Coronavirus's ability for rapid mutation due to being an RNA virus.

6. Herd immunity is not guaranteed. The virus can mutate. Humans may not develop a robust long-term immune response. The immunity can wane over time. Even if immunity develops, high cumulative exposure may still induce a massive cytokine storm (the main cause of ARDS). I don't think we can count on this to save us.

7. Therapeutics such as chloroquine or remdesivir have some promise, but the jury is still out on widespread use. Even if they are effective, scaling up production for mass distribution in the short term is also an issue.

8. There is much we don't know about the virus. There are case reports of severe heart failure as a result of an infection, even in young people.

I am sympathetic to the concerns many have about long-term damage to the economy. Surely deaths of despair count just as much as deaths from infection. The silver lining here is that we may not have to employ a draconian lockdown for month. East Asia's experience suggests that there are low hanging fruit that we can use and still drive R0 below 1. This is my hypothesizing now, but I wonder if there can be a sustainable culture change using a combination of widespread mask wearing in public, no handshakes/hugs with strangers, and more frequent hand washing can get us to low level background transmission as Japan has done. Then local clusters of infection that then arise can be isolated with testing+backtracing contacts+quarantine. Call this modified social distancing + enhanced testing.

Rick, can you help me?

(i) A blogger assures me that in Wuhan only 5% of the virus patients sent to ICU survived. Do you know whether that's true?
https://market-ticker.org/akcs-www?post=238556

(ii) Can you tell me a typical figure, in normal times, for the survival of patients sent to the ICU?

I can't verify that China data. Also, I have skepticism overall regarding the veracity of data coming out of China. Anything from there I prefer to corroborate with SK, Japan, Taiwan, Singapore experiences.

Also note Wuhan and the surrounding province was hit hard and hit first. The higher mortality rather there - was it from overwhelming the health care system? How much improvement did they see after rushing in medical staff from other provinces and building hospitals overnight? You'd need to see a time series of mortality against interventions.

As for normal survival rates, it varies by condition. It's far easier to survive an intracranial hemorrhage or DKA admission to ICU than septic shock or ARDS. For ARDS overall, mortality is about 40% from what I remember from medical school, though there have been incremental improvements in technique like proning and paralysis. Mind you, the longer you keep a previously "hopeless" case alive, the longer that ICU bed is occupied and eventually you'll bed block new admission, which is really my limiting concern for American cities.

At a certain point, you'll have to do wartime triage and hail Bentham as Tyler would say.

In Japan it's common courtesy to wear a mask in public if you have even just a cold. You see people wearing them on the streets all the time. Not just not unusual. Common!
Would that we could get the same custom going here as ordinary practice, not just pandemic emergency response.

+1 all good points
the point that is underrated is
at this point in a viral pandemic
prioritizing/improving health care worker safety is
gonna directly improve patients health care outcomes

> Problems start to arise when your health care work force starts to die off or get sick.

And of course China mitigated that by sending in medics from other parts of the country. But you can't do that when the whole country is affected.

> ...ventilators can be scaled up rapidly... It's much harder to scale up nurses, doctors, and respiratory therapists

But surely you could train people to run a ventilator in an emergency? The highly-trained personnel are there to handle complications. There must be some percentage of patients who could be saved by even minimally-trained intervention.

It would be like the difference between a cab driver assisting in a birth when the mother doesn't make it to the hospital on time vs. an experienced obstetrician. Or a layperson performing CPR, or administering naloxone to an opioid overdose, or using a portable defibrillator on a heart attack.

Rick you make some very strong statements in your post.

“ Any patient volume below that will have a 1.4% mortality. Any number above that will have 100% mortality. ” —> this is completely innumerate.

“ Herd immunity is not guaranteed” — come on. Nothing is guaranteed, of course. Any claim is true with that disclaimer. If I take the concept you are putting forward “that there will not be herd immunity against the virus” then that is an extraordinary claim and will require extraordinary evidence.

“ There are case reports of severe heart failure as a result of an infection, even in young people.” — All research to date points to this having minimal to no impact upon the young. If you have diverging data publish and get your prize.

otoh you sed
"Any patient volume below that will have a 1.4% mortality. Any number above that will have 100% mortality. ” —> this is completely innumerate. "

"100% mortality" is completely numerate in the posters original context of patients needing ventilator support who don't have a ventilator!

Well one of those numbers doesn't belong. The overall mortaity is measured at 1.4% not the ICU mortality.

"All research to date points to this having minimal to no impact upon the young."

No, the research does not show that. I pointed to the CDC numbers showing a 14% hospitalization rate among 20-44 year-olds and was challenged that these numbers are meaningless because we aren't doing proper testing. Indeed, we are not! But that also means we don't know how many people are in the hospital right now because of coronavirus and it also means there may be people out there in bad shape who should be hospitalized but haven't yet checked themselves in.

The numbers so far say that being a young, in-shape, non-smoker works in your favor but in no way does that imply "minimal to no impact." And, again, even if the vast majority of young patients who are hospitalized make a full recovery, we can only count on that in the future if we have enough doctors, nurses and supplies to treat them all.

This site is better than a simple case count, I think - shows which countries are likely next to be overrun.

https://chrisbillington.net/COVID

These things seem to be true.
CV-19 spreads exponentially with a rate dependent upon behavior.
When it shows up hospitals get crowded, people die, including doctors and others on the front lines.
Mortality varies based on a variety of factors.
Long term effects will be unknown until the long term. CV-19 is probably not good for your lungs.
May be multiple viral mutations clouding the picture.
There are no quick fixes. Some drugs may help you not die. An effective vaccine is unlikely.
The information provided so far is vague which means no one has a clear understanding yet (most likely) or there is a huge conspiracy (not impossible, but unlikely).
The understanding of what this is and how it works will improve rapidly through testing, doc’s experience, and research.

My opinion
Right now this is primarily a behavior problem.
Mingling has to be reduced somehow. It is the most effective tool currently available.
It is not possible to do this with logic.
Shelter in place is the result.
This is a time out until the understanding becomes clear.

People do not understand viral transmission. Most never will.
Need to modify people’s behavior .
One tool in this is their phone.
Dollars for distance app based on a personal R naught score.
Your phone knows if you are coughing. It knows a lot more than that based on your behavior. Not difficult to get it to diagnose you based on changes in activity, movement, and search history. This is already in use for marketing.
Algorithm separates sick and healthy. Big data tracks the hot spots (where phones detect those who are ill). You are allowed into areas if you haven’t been in other high risk areas, have minimized contact with others, and been maintaining distance from general population. A combination of a virtual and actual barrier system. Include incentives that encourage a reduction in spreading behavior. Earn for how well you social distance.
Combine big data with statistical testing of areas as suggested in other threads here to make the best use of the currently limited testing. This would make it possible to slow transmission without restricting all activity.
This data can be used to help understand this and other viral patterns.

I hope someone is already working on this but this is not my world. Please pass this along if you or someone you know can build this. Someone needs to get some version of this going. Now.

That's a solid list. Good work Tyler.

Not a single award winner would be doing anything different than they already did.

This is nothing but the exact same style of prize PR that the Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel provided the template for.

You don't think Helen Chu might have emptied some research accounts in her haste? Either way, she sounds like the kind of person who is going to put it to good use.

I am very pleased that the prize is giving fast money to active workers in this emergency.

These prizes are just part of the same longer term strategy that has led to the hollowing out of the U.S. that started in the Reagan era. Who needs to pay taxes if we have an eminently respected, and well financed, public intellectual dispensing money, without any apparent restrictions.

Progress indeed. Now, if the money was actually being directed towards a future problem that needs to be solved, we would actually have a metric to value the worth of such prizes. Be assured that this is not the point of these prizes.

Prior, it’s this innumeracy and poor critical thinking skills that got you fired from GMU in the first place.

https://fred.stlouisfed.org/series/FYFRGDA188S

So not only is what you said untrue, it’s not even relevant.

Prior_approval logic: Prizes that reward extremely important work with money and publicity are inherently bad, because Cowen will enter a time machine and go back to the 1980s to trigger a “hollowing out of the US” that never happened.

Nothing enrages prior_approval more than a heroic doctor like Helen Chu receiving a prize.

Other than maybe referring to the Nobel in economics as a Nobel prize, instead of “insert pedantic bullshit here”

Imagine being this upset at losing your job for incompetence..over 30 years ago.

Use your handle prior_approval, you’re not fooling anyone.

State of play in Los Angeles:

"Los Angeles County health officials advised doctors to give up on testing patients in the hope of containing the coronavirus outbreak, instructing them to test patients only if a positive result could change how they would be treated."

Not only is this insane, it clearly shows that the U.S. has yet to even begin to have the barest bones testing capacity. Which might just explain the lock downs, as that is the absolute final line of defense in a public health sense.

It might be that, but it might be worse.

They might be preparing for a triage situation where doctors can't waste their time on the may be sick and have to concentrate on the known sick.

its actually a quite sane use of resources in the context of a viral pandemic and the current reality of not enough tests/personal

That is, it is insane that after weeks of obvious need for testing, the U.S. is still unable to actually test in any helpful way.

The John Hopkins website indicates a cumulative total of 20705 identified cases of coronavirus-infected people in Germany, and 72 deaths.
That's a mortality rate of 0.35%, and since not all people are tested, but it is unlikely that many deaths due to coronavirus have been unnoticed in Germany, this is an **upper bound** of the fatality rate of Coronavirus
when properly treated.

Now I have not been able to find anywhere the number of persons currently in ICU for coronavirus in Germany? Can anyone help me with that. I would be very thankful.

Basically, various German governments (Germany having a very federal system) are ramping up their facilities as quickly as possible, because there is no way that current ICU capacity will be able to handle what is coming in the first wave.

Which explains why Germany pretty much went on lockdown last weekend - the people running the public health response are not innumerate.

"It’s Monday, and during the course of the day, nurses and doctors have to watch as his condition deteriorates. They notify his wife and daughter, who arrive around noon. Under the new rules for these corona times, only one relative is allowed into the isolation room for 30 minutes. The woman sits beside her husband in full protective clothing and gloves and places one hand on his forehead and one near his heart. The head of the ward responsible for care decides to bring the daughter in as well. He equips her with protective clothing and lets her go to her father. Both are permitted to sit there for as long as they want.

The man passes away at 3:15 p.m., with the resident issuing the death certificate. .... The man passed away at St. Antonius Hospital in Eschweiler, North Rhine-Westphalia, only 30 kilometers (19 miles) from Heinsberg, the largest known cluster of infections in Germany to date. A ventilator was available for him, but the help came too late."

So, getting past out of date news, as this Spiegel article is actually from March 21 - 'And that wave will come - that much is certain. "We expect that things will really heat up in the next two weeks, also here in Germany," says Axel Fischer, managing director of the München Klinik, a Munich-based chain of hospitals. His hospital treated the first patients infected with the coronavirus in January. He fears the crisis will have a "massive impact.”

And - "We are preparing for imminent catastrophe,” says Rudolf Mintrop, head of the Dortmund Klinikum, the city’s main hospital. He calculates that the wave of sick will hit hospitals at full force in 10 to 14 days. The chancellor has warned that German hospitals will be "completely overwhelmed" if too many patients with serious coronavirus infections have to be admitted within a very short period.

The article gives a good overview of just how a pandemic exploits every single weakness of a health care system, and the society if functions within.

spiegel.de/international/germany/the-big-wave-of-corona-cases-will-hit-german-hospitals-in-10-to-14-days-a-45cd754c-e179-4dbb-8caf-8f6074e641cf

"only an assistant professor." Must not let a pandemic prevent credentialism losing its grip.

Give that man a prize

Prizes are worthless....free riding in others reputation

jeez these comments are something..!

good job prizewinners

Vaccine hunters and pandemic pros are getting the money.

Their statistical base is huge, hundreds of thousands of blood samples and medical records collected. They will slow the spread, they are really good at this. But how soon?

Right now the doubling rate is not scary, it is starting from zero. Only 2% die, mostly old folks. The survival time seems to be about two weeks to a month. Each of the hundreds of thousand survivors are observed, their antigen make up studied and re-infection rates soon known. The lock downs will help. They will get a partial vaccine, one that attacks similar virus structures and slow down infection rates among key workers. The symptom treatment will improve, and anti-body support for new patients will help.

Not simple, highly risky race, but the systems in place to study the virus among this huge statistical data base got activated quickly. Powerful tools, automatic blood analysis, data sharing, real time responses available everywhere.

And ther lockdowns.
Locking down towns in response to pandemics is normal, since the arrival of new paper in the 1700s. A fast rider and the news of a ship infestation arrives before the infestations. Stay at home is common for flu pandemics. It works. Today is the same game, except our news paper has grown a hundred fold in efficiency on the web. Information about the virus and our response to it will lead to a sufficient solutions,buy plenty of time. This will be one of the great flu epidemics, certainly, but civilization is well adapted to solve it.

The single lowest hanging fruit is universal mask wearing. We need to get the attention of the CDC bigwigs somehow. Or, we need to get enough social media influencers to make videos of themselves cutting up some homemade masks and wearing them in public.

Masks wearing is better nowadays ...We should quarantine ourselves till end of this pandemic ...& Shud limited our meetings .

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