The presidential election will be decided in the next month — revision for clarity

Apologies to all for the previous post which was far murkier than it could have been.  The problem was that a ‘case’ of the pandemic coronavirus can mean 3 very different things.  These distinctions are tedious but crucial.

Meaning #1 — COVID19 — People who are clinically ill with the virus (official name SARS-CoV-2).  These are the people that  may die of the illness, although most do not.

Meaning #2 — The viral genome has been found in your saliva.

Meaning #3 — You have antibodies to the virus in your blood.

Here is the distinction between #2 and #3 — Antibodies (proteins) and genomes (RNA) are completely different chemically. Finding the actual genome (RNA in this case) of a virus in an individual  is like seeing a real bear up close and personal.  This can do you some damage.  In contrast, antibodies to the virus are made by an individual who has been infected by the virus in the past.       Antibodies are like seeing the tracks of the bear without the bear itself. You can’t see tracks without the bear having been present at some point in the past.  Antibodies mean you were infected at some point whether you knew it or not.

OK, so here’s another shot at what was I saying in the previous post.

I find it very sad that loosening the restrictions on activity has become so political. The left says that it will be a disaster and that cases and deaths will spike (meaning #1). As far as I’ve seen, they never say they hope they’re wrong.  The right says that deaths will continue, but the rate won’t increase.  There is evidence for both sides, but in the coming months we’ll actually have data one way or the other.

One thing is certain.  The number of cases of positive viral culture (meaning #2) will increase.  It has to because more people will be tested. So far, we’ve only studied around 1/1,000 of the population.  No one has ever said the lockdown will prevent new infection.  It hasn’t, but it has slowed things down.

I’m hoping that cases of COVID19 and death will not explode.  Not because I want Trump to win, but because getting people back to work  would be good for the country.  Should that happen, the anger of those who lost their jobs or businesses during the shutdown will be formidable.  Trump will win.

Should deaths from COVID19 explode (meaning #1) as restrictions are lifted, Trump is toast.

We should also get some idea of the percentage of the population who have been infected (manifest by antibodies to the pandemic virus meaning #3).  It almost certainly will increase, unless those already showing the antibodies lose them (which is unheard of happening this fast inFor  the antibodies we’ve studied in the past).

I’m cautiously optimistic that not much will happen when restrictions are eased. Here’s why.  All the studies on antibodies (meaning #3) done so far show they are 10 – 100 times more prevalent than cases where the virus is cultured (meaning #2).  For example 20% of Manhattan sampled population have the antibodies.  This implies that most infections with the pandemic coronavirus are asymptomatic.  

Another viral disease with a high prevalence of antibodies is infectious mononucleosis.  90% of adults in the USA have antibodies to mono, but far fewer than 90% were ever sick.

So the number of cases with positive culture (meaning #2)  isn’t what’s important.  It’s how many of them get sick with COVID19 (meaning # 1).  I think we have very good past statistics on the number of deaths and cases of COVID19   It will be clear if there is a spike in COVID19.

However be careful not to read too much into the first week’s statistics after restrictions are lifted, as there is a lag period of 2 – 11 days between infection and clinical illness.  Also try to understand which of the 3 meanings of “case” the article you are reading is talking about — this won’t always be possible.

 

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Comments

  • Peter Shenkin  On May 14, 2020 at 10:46 pm

    I believe that the “opening up” should be a titration with an endpoint measured by some acceptable unused ICU capacity threshold. (Open a little; wait 3 weeks; measure the endpoint; make a decision: roll back, continue, or open further.) Some would titrate “cases”, but they usually mean your #2 cases, whereas (as you point out) #1’s are the the ones that are problematic. We actually want more #2s, and continued isolation does not foster this. Having said that, we of course want more #3s as well, and he only way to know whether we have have them is by the proliferation of vetted antibody testing.

  • luysii  On May 15, 2020 at 6:46 pm

    Agree, but new information keeps rolling in, which means we must all rethink eour positions — the following bombshell was posted today

    . https://www.nbcboston.com/news/coronavirus/study-shows-9-out-of-10-boston-residents-havent-been-exposed-to-covid-19/2124944/.

    Some 10% of ASYMPTOMATIC Bostonians have antibodies to the virus and another 3% have a positive culture for the virus. Some 750 people were tested. This means for most people, the pandemic coronavirus doesn’t make you very sick.

    Of course the worst possible spin was put on the news by the Mayor and those interested in continuing the lockdown, namely that 90% of the population is at risk for infection (catch the lead). But so what, if it doesn’t make you sick (if you’re young and healthy). In Massachusetts some 15% of those with a positive viral culture are over 80, but they account for 63% of the deaths. These are the people who must protect themselves (and be protected).

  • Anon  On May 16, 2020 at 12:47 am

    If you really think that the outcome of COVID-19 will have effect on people’s choice in the election, you are completely wrong. Not a single person will change his mind.

    • luysii  On May 16, 2020 at 11:26 am

      Anon — I agree. But there are a lot of people who can’t work from home behind their computer (the vast majority in fact) who have been placed under severe financial stress by the various lockdowns. If it turns out that not much happens (e.g. spike in deaths, overburdening of hospitals) when the restrictions are lifted, these people will be very angry, and likely turn out to vote, even if they haven’t before. They will vote against the lockdown proponents which unfortunately are split on political lines.

      • Anon  On May 17, 2020 at 2:25 pm

        Everyone is a single issue voter now. It won’t make any difference.

  • Mark Thorson  On May 16, 2020 at 6:27 pm

    I think Trump can have it both ways. He can say something like this:

    I know that many millions have lost their jobs and will lose their housing. Not just renters, but homeowners that will suffer in a wave of foreclosures that will make 2008 seem like a picnic. Dr. Fauci wants to keep everybody locked down until who knows when, but he only counts COVID-19 deaths. I’m the President, and I have to count the deaths from suicide, being kicked out of your house, and not having enough money for food and needed medicines. We’re already redlining the economy, but if we all pull together we can stay the course for one more month without blowing the engine. I’ve consulted with the experts, and this seems to be the best compromise between the virus and the economy, so I am now announcing the shutdown will end on June 30, no matter what the numbers say. Our economy can’t take more than that.

  • Peter Shenkin  On May 17, 2020 at 1:08 pm

    @luysii, is there a way we can correspond directly? shenkin AT gmail DOT com.

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