California Covid-19 traffic report finds silver lining

No, there is not. When the circumstances change, habits change too.

When people go back to work, they will have less time at their hands. They will have to adjust to commuting again, taking kids to/from school again, being somewhere at time again.

All of that will cut into their exercise time. All the people who are exercising out of boredom now will stop exercising out of being tired of doing lot of things again.

Congratulations! Keep it up!

The truth of it all is still very much not known.

Early antibody studies have shown that prevalence is much, much higher than positive case count would indicate.

Potentially 50x - 85x more cases than positive tests based on the Santa Clara / Stanford study.

In Boston last week they mass tested at the Pine St homeless shelter and found 50% of them positive and 100% of those were asymptomatic.

If when the dust settles the reality is that the curve wasn’t flattened at all, most everyone was already exposed, and the true IFR was more like 0.25%.... then we flushed $6 trillion down the toilet.

Even in vulnerable groups, the case fatality rate doesn't seem high enough that it would make a big impact in future statistics for that reason (probably bigger impact through lasting behavioral changes.)

Not really actually! In your age category 50-59 your case fatality rate is 1.3% [1] and given the way it affects the older end of the band more significantly than yourself in the middle of the band, it wouldn't be at all unlikely that your case fatality rate is right around 1%.

Further, we have been seeing anywhere from 30-80% of cases are asymptomatic or result in mild flulike symptoms and therefore not accounted for in case fatality rates. Indeed the Gangelt study put the overall infection fatality rate at 0.37% when Germany's case fatality rate is around 2%. It wouldn't surprise me at all if your risk was about 7X lower than the stated 1.3%, as low as 0.25%

I also wouldn't be so quick to assume car crashes are a pleasant way to go.

[1] https://www.worldometers.info/coronavirus/coronavirus-age-se...

Your risk of dying is, accepting the 0.37% for the sake of argument, 0.37% if you're infected. The actual chance of anyone, even of someone in a more dangerous demographic, of dying of Covid in their lifetime is significantly lower than that.

Additionally, I believe the 1% chance of dying in a car crash is over the course of a lifetime. A 55 year old has likely lived well over half their life and has also aged past a significant chunk of the riskiest time to be in a car (likely 16-30).

I actually dedicated much of my comment to addressing that, specifically pointing out that COVID represents a lifetime risk that's been front-loaded and so it's fair to compare COVID's infection fatality rate to your lifetime risk of dying in a car accident. I also called out explicitly that COVID has been front-loaded.

Also, it's not a fair comparison between the flu and COVID because the flu has that unfortunate feature known as horizontal gene transfer. That's why you can get re-infected by the flu each year, and why in spite of a massive vaccination campaign the flu causes 45,000,000 illnesses each year in the US alone (and 60,000 deaths) -- and 650,000 deaths worldwide.

Each year. And each upcoming year. COVID will, based on what we know so far, happen once.

> Because the ratio of recoveries to deaths is way higher in germany than the united states. The risk of covid varries a lot by geographic region and usa seems like one of the worst.

You'd need to be a lot more specific. Which state are you referring to? Most US states are safer on Covid mortality than Germany. California + Texas + Florida (the three largest by population) combined have the same population as Germany with half the per capita death rate.

It would be like combining Italy, Spain and Greece and pretending they're all seeing the same situation.

Germany has a per 100k mortality rate of 5 for Covid.

Texas has a per 100k mortality rate of 1.5. California is 2.7. Florida is 3.6.

Germany has 89m people with 4,538 deaths. Texas has 29m people with a mere 453 deaths.

California + Texas + Florida = 89m people, with 2,290 deaths.

More large states? Ohio is 3.9. Virginia is 3. Arizona is 2.4. North Carolina is 1.5.

So as you can see, most of the US in fact doesn't look like New York, New Jersey, Michigan. Just like most of Europe doesn't look like Spain.

More countries in Europe for comparison (per 100k rate):

Belgium 47, Spain 44, Italy 38, France 29, Britain 23, Netherlands 21, Switzerland 16, Sweden 15, Ireland 11.6, Portugal 6.7, Denmark 6, Austria 5, Norway 3, Finland 1.6.

The three largest US states combined have a rate of 2.5.

> As for your final paragraph, it is wholly unreasonable to imply that covid (which is killing thousands of Americans per day despite a massive distancing effort) is less serious than the flu (which has persisted over a much longer period of time and which was not subject to special responses).

I didn't say or imply that. It's worse than the flu, probably 5-10X worse. Not bad, not great.

I'm suggesting that people are freaking out because there's "bodies on the street" and we're all in serious danger (we're overwhelmingly just not) when the death toll to date is about half of what we paid zero attention to whatsoever over the same time period.

My argument is that we shouldn't be nearly as freaked out about COVID as we are, and we should be more freaked out about the flu.

There's reason to take precautions, especially if you're in a risk category, but not at all to the extent of the panic we've seen to date.

In fact Sweden's plan of literally just that is going great, they've not shut anything down, and told people to stay home if they're sick (shocking, I know) and the serious-case infection growth rate has flattened out by itself. [1, 2]

[1] https://www.bloomberg.com/news/articles/2020-04-19/sweden-sa...

[2] https://aatishb.com/covidtrends/?location=Canada&location=Sw...

> Also there is not enough evidence to believe COVID happens only once per person.

There's also no evidence it doesn't. What we do know is that the disease hasn't mutated significantly to date, and we see strong antibody response. [1] In time, we'll have a vaccine and it may require a number of booster shots, but what we know so far suggest reason for optimism, not pessimism.

[1] https://www.washingtonpost.com/health/the-coronavirus-isnt-m...

That death rate is skewed. A COVID death is counted if the person had the infection and died, even if a co-morbidity would have killed them anyway. A person that has no symptoms or mild symptoms isn’t necessary known to have had the disease, which means there is a significantly lower death rate because the known infections is what’s used for the death rate, not the actual number of infections. A newly released study showed that 4% of Santa Clara County had exposure, but the “confirmed cases” is vastly lower than that. A 5% mortality rate is just false. Confirmed infections can’t be used to determine mortality because the number of actual infections is obviously going to be much higher. Mild or asymptomatic people aren’t going to the hospital to be tested so they aren’t being included in mortality calculations.

Re 1: Hardest hit would be the most helpful place to study. And I look forward to continued updates. The Stanford study, while there's certainly questions, has numbers in line with the Gangelt study. [1]

Re 2: Because much of the audience here is American, and there's not a similar study of the US population.

Re 3: No, the COVID-19 mortality rate is not 5.3%. The case fatality rate is 5.3%. Those are not the same, for an obvious reason -- currently the overwhelming majority of tests are carried out on people who go to hospital because they're sick. It's adverse selection bias.

For instance, it'd be like trying to measure the fatality rate of skydiving by measuring the odds that someone who ends up in the hospital with a skydiving injury dies. You'd think it's 99% fatal, but of course, it's not.

All you know is the numerator, not the denominator.

[1] https://www.stanforddaily.com/2020/04/17/santa-clara-county-...

> No, it hasn't.

Yes, it has. Citation needed, because I provided data and you didn't.

> You're not counting covid-19 deaths and flu deaths using the same methods so you can't compare yet. The method you're using for flu is inclusive and will tend to overcount. The method you're using for covid-19 deaths excludes some deaths and we know it's undercounting covid-19 deaths.

[citation needed]

> When we get the figures for care home and nursing home deaths included we'll see large increases in covid-19 deaths.

That's a totally dishonest way of approaching this when we know for a fact people under 50 have basically no risk from COVID and that folks who are over 70 have easily two orders of magnitude higher risk. In Italy, 99.2% of people who died were age 80.5 and had an average of 3 underlying diseases.

Age 30-39 they had 5 deaths, under 30, 0 deaths at the time this article was written [1] as compared to 852 deaths aged 80-89.

You and I both know the young aren't affected meaningfully, and for them, they won't go to the hospital with a mild cough or with no symptoms at all and so aren't counted in the denominator. You're advocating growing the numerator without growing the denominator to make your case seem stronger than it is.

> It is dishonest to point to a severe flu season and talk about "flu killing 60k people per year". The range is 12k to 61k. https://www.cdc.gov/flu/about/burden/index.html

I don't think it's crazy to compare a "bad COVID year" to a "bad flu year" do you? Our response to a bad flu year is exactly the same as our response to a good flu year. Most people don't really know there is such a thing.

[1] https://www.bloomberg.com/news/articles/2020-03-18/99-of-tho...

Indeed but that's not evidence of re-infection. That's evidence that re-infection should be thoroughly investigated. Rather, it's evidence of smoke not evidence of fire.

Given enough time, an unchecked virus with the attributes of this Coronavirus will saturate through semi-rural and even rural populations. It’s it might take more time, but that’s usually coupled with more spread out medical services.

Without significant efforts to lower the R value (Aka the actions I alluded to; facial covering, social distancing, track and trace) - it’s only a matter of when, not if.

Minus a wonderful medical breakthrough, come find me next winter and let’s see how sure you are with such a quip.

Oh, and by then, a great expense to life, the cities will likely have reached herd immunity, but I won’t quip back, as it would be in bad taste.

That's a sobering argument. But I wonder how it compares to other major disruptions, such as major wars. Or even the 2008 recession.

That’s an interesting fact, but that doesn’t mean it couldn’t function as a transit-oriented city.