So the Spain article didn’t add much the way I see it. Of course you aren’t getting to herd immunity by shutting down the way Spain did. That doesn’t mean you can’t get there but yeah going that route means dealing with the damage along the way. I thought we all already knew that.

Either burn controlling the curve or lockdown and wait for the vaccine. Those are the high level options. Partially controlled open with all types of control measures is the other option and hard to get right. Spain chose full complete lockdown and are at risk for round two. 

Sweden isn't much closer to herd immunity. Herd immunity is very difficult to achieve naturally, unless you are dealing with a virus that kills WAY more.

16 minutes ago, JohnSnowsHair said:

Sweden isn't much closer to herd immunity. Herd immunity is very difficult to achieve naturally, unless you are dealing with a virus that kills WAY more.

Link?  I think I know more than you do regarding Sweden. 

24 minutes ago, DrPhilly said:

Link?  I think I know more than you do regarding Sweden. 

https://www.businessinsider.com/coronavirus-hopes-fade-for-swedens-herd-immunity-experiment-2020-6

At least as of a few weeks ago the estimates were well short of herd immunity. I've been watching the Sweden experiment very closely.

1 hour ago, JohnSnowsHair said:

https://www.businessinsider.com/coronavirus-hopes-fade-for-swedens-herd-immunity-experiment-2020-6

At least as of a few weeks ago the estimates were well short of herd immunity. I've been watching the Sweden experiment very closely.

Let's take this in two parts.

 

Part 1) Compared to Spain, Sweden is far closer to herd immunity.  That isn't really a debate though naturally that doesn't mean Sweden is close to her immunity (which by the way I never claimed).  Spain went full on lockdown and enforced it for months.  One of my best friends was there until he finally got out mid-May.  He only got outside once a week to walk 5 minutes to the store, shop, and then go straight back home.  If he was off the straight path it was a fine over $1000 and it was enforced (they even had drones up).  Spain shut this thing down to a simmer.  Sweden did no such thing and we've burnt thru a sizable chunk especially in Stockholm.  A price has been paid of course but that is what has happened.  The exact size of the gap is of course unknown but there is surely a rather chunky gap.

 

Part 2) The latest info from the Swedish govt comes in two pieces and I'm going to focus on Stockholm to be fair (we can take overall Sweden in a later discussion).  The most reliable figure I've seen was 17% of people tested positive for the antibodies in Stockholm.  That was three weeks back though so that number is likely higher now.  That is piece #1.  Piece #2 is the information about t-cells.  Here all we have are a few small studies.  In any case, these studies have shown a much higher rate of t-cells as opposed to antibodies, in fact twice as much.  The t-cells provide protection similar to the antibodies (hard to say how much for sure just like we don't know for sure about how well the antibodies work, how long they last, etc.).  From here everything is just theory based on the info at hand.  No ones knows for sure.  However, if you take the two numbers of 17% and the number of 2x t-cells as opposed to antibodies then you get to 51% and that approaches the herd immunity numbers.  NOTE: I'm not saying Stockholm or Sweden has reached or is close to reaching herd immunity.  However, there is science behind the possibility that at least Stockholm is inching closer and Stockholm is the COVID motor for all of Sweden.

 

I prefer to hope that the positive angle is correct but of course the safety needs to stay on the negative side and while we've loosened further here we still have social distancing going on, no events, etc.  I think the logic says the range is between 20-50% in the Stockholm area.  The rest of Sweden is not that far along save for possibly Gothenburg.

Let's try to keep this nuanced.   This is a very fluid topic with very few knowns other than number of deaths and in fact even that number is not normalized across places or time in terms of COVID.

8 hours ago, LeanMeanGM said:

I really don’t understand how schools in general will be able to successfully open almost anywhere. If a teachers spouse tests positive, what happens? Two weeks of substitute teaching at minimum? Do students need mandatory COVID testing in that instance to be present? What happens with a school outbreak? What happens if a child dies? What happens when a principal/FOH staff test positive? Seems like just a ton of inevitable interruption is about to happen. 

My fiance is a first grade teacher. Just trying to understand how they could successfully open raises about a million questions. People just aimlessly barking "They have to open" I think are just missing their normal lives. Honestly if the cases continue to go up and somehow schools are forced to open, she probably will take a year off, as I'm sure a lot of teachers would.

8 minutes ago, BirdsFanBill said:

My fiance is a first grade teacher. Just trying to understand how they could successfully open raises about a million questions. People just aimlessly barking "They have to open" I think are just missing their normal lives. Honestly if the cases continue to go up and somehow schools are forced to open, she probably will take a year off, as I'm sure a lot of teachers would.

My sister-in-law runs kindergarten and first grade here in Sweden and she caught it from the kids as we never shut those schools down.  Luckily she did her one week down and is now fine.

Personal note - I've had some gallstone issues and spent a couple partial days in the hospital the last week.  Several of the staff there told me they had been COVID sick a few months back.  They also told me they had zero COVID patients in the hospital now and that all Stockholm hospitals were completely back to normal operations.

16 hours ago, LeanMeanGM said:

(CNN) - Spain's large-scale study on the coronavirus indicates just 5% of its population has developed antibodies, strengthening evidence that a so-called herd immunity to Covid-19 is "unachievable," the medical journal the Lancet reported on Monday.

Help me out here.  Are they saying 5% of the population has antibodies or 5% of the people that caught it has antibodies.

 

Because one means that it is impossible to achieve while the former means they haven't had enough exposure to it yet.  (And the math doesn't work according to here, where they claim 298,869 cases out of a population of  46,755,120)

2 minutes ago, paco said:

Help me out here.  Are they saying 5% of the population has antibodies or 5% of the people that caught it has antibodies.

Sounds like the former. Does that mean they believe the people who don't have the antibodies could get it again? I would think we'd hear more about people testing positive more than once (I swear I've only heard of that being the case a handful of times).

10 minutes ago, paco said:

Help me out here.  Are they saying 5% of the population has antibodies or 5% of the people that caught it has antibodies.

 

Because one means that it is impossible to achieve while the former means they haven't had enough exposure to it yet.  (And the math doesn't work according to here, where they claim 298,869 cases out of a population of  46,755,120)

I'm reading the former.

1 hour ago, DrPhilly said:

Let's take this in two parts.

 

Part 1) Compared to Spain, Sweden is far closer to herd immunity.  That isn't really a debate though naturally that doesn't mean Sweden is close to her immunity (which by the way I never claimed).  Spain went full on lockdown and enforced it for months.  One of my best friends was there until he finally got out mid-May.  He only got outside once a week to walk 5 minutes to the store, shop, and then go straight back home.  If he was off the straight path it was a fine over $1000 and it was enforced (they even had drones up).  Spain shut this thing down to a simmer.  Sweden did no such thing and we've burnt thru a sizable chunk especially in Stockholm.  A price has been paid of course but that is what has happened.  The exact size of the gap is of course unknown but there is surely a rather chunky gap.

 

Part 2) The latest info from the Swedish govt comes in two pieces and I'm going to focus on Stockholm to be fair (we can take overall Sweden in a later discussion).  The most reliable figure I've seen was 17% of people tested positive for the antibodies in Stockholm.  That was three weeks back though so that number is likely higher now.  That is piece #1.  Piece #2 is the information about t-cells.  Here all we have are a few small studies.  In any case, these studies have shown a much higher rate of t-cells as opposed to antibodies, in fact twice as much.  The t-cells provide protection similar to the antibodies (hard to say how much for sure just like we don't know for sure about how well the antibodies work, how long they last, etc.).  From here everything is just theory based on the info at hand.  No ones knows for sure.  However, if you take the two numbers of 17% and the number of 2x t-cells as opposed to antibodies then you get to 51% and that approaches the herd immunity numbers.  NOTE: I'm not saying Stockholm or Sweden has reached or is close to reaching herd immunity.  However, there is science behind the possibility that at least Stockholm is inching closer and Stockholm is the COVID motor for all of Sweden.

 

I prefer to hope that the positive angle is correct but of course the safety needs to stay on the negative side and while we've loosened further here we still have social distancing going on, no events, etc.  I think the logic says the range is between 20-50% in the Stockholm area.  The rest of Sweden is not that far along save for possibly Gothenburg.

Let's try to keep this nuanced.   This is a very fluid topic with very few knowns other than number of deaths and in fact even that number is not normalized across places or time in terms of COVID.

Part 1: Spain's response was likely necessary, given their trajectory compared to Sweden: https://ourworldindata.org/grapher/daily-covid-cases-per-million-three-day-avg?tab=chart&country=SWE~ESP  We'll know more as we get along here, but Spain was on a trajectory that might have seen MUCH higher death tolls had they not locked down swiftly.

Part 2: Yes, 17% tested positive. But that is only among those who were tested, which tend to be higher than the antibody rate in the population at large which is what the study by Lancet reported. Also, during the time period that is feeding the numbers for both Sweden and Spain there were almost twice as many tests done per capita: https://ourworldindata.org/grapher/daily-tests-per-thousand-people-smoothed-7-day?time=2020-04-20..&country=ESP~USA~SWE (I threw in USA because, for as much as our response has been maligned, we have at this point tested MANY more per capita than other nations)

If only 17% of those tested were positive, and we operate on the assumption that those who are getting tested will tend to have a higher rate of positives than the overall population, I think believing Stockholm antibodies being north of even 20% is quite optimistic. Those who get tested tend to be those who are most likely to test positive, because the motivations for getting tested are that you think you may have been exposed a good portion of the time. Other than people who are high-risk who are getting tested as a precaution, individuals are unlikely to get tested "for the hell of it".  You certainly cannot just extrapolate the positive test case number out. I'm less familiar with the T-cell response, beyond the basics of that immune systems that have responded to viruses similar to SARS-CoV-2 seem to be better equipped to deal with the virus. But I don't know that it means you can simply double the number of positive anti-body tests on an assumption that a better equipped immune system either 1. would not also produced the antibodies needed to make a positive test and 2. not be able to carry the virus and pass it on. Speculatively, it may mean that someone with an immune system just strong enough (given the appropriate T-cells to respond to the virus) to not form an infection, can actually contract the virus multiple times and spread the virus more. I don't know for sure. 

It's certainly a fluid topic, and comparing numbers across locations is fraught with complications. But it also doesn't mean comparisons are worthless, and can be discarded if they do not align with expectations.

Achieving herd immunity for a population without a vaccine means that this virus would have to naturally reproduce at a very high level. The basic reproduction number (R0) of the virus seems to be settling around 3.0, which is higher than the flu and much lower than, for example, polio and the measles. None of these have achieved herd immunity in a population via natural reproduction. Chicken pox is around 11-12, and due to its nature of afflicting children much less severely, it was common to achieve a vaccine-like effect through parents purposely infecting their children with the disease when they were young so that they achieved immunity before adulthood. 

The minimum number given for herd immunity for the SARS-CoV-2 has been around 60%. That assumes an R0 number at the low end of the current range. If it is at 3.0 for example, that number is 67%. It would seem to me, and this is just my intuition but seems logical, that general resistance among the population does increase even up to this number - the number is the percentage of the population required to have immunity that results in negative case growth of the virus because it cannot find a sufficient number of hosts to infect. What I'm trying to say here then is that as more of the population builds antibodies, the slower its growth will be and the harder it will be to climb towards the herd immunity number. It's not a linear growth; it's harder to go from 20% of the population with antibodies to 30% than it was from 0%-10% or 10%-20%. Again, that's my speculation, but it seems to make sense. The R0 number is based on an assumption that no antibodies exist, and that number will naturally decrease as fewer hosts become available. 

The basic point I'm trying to make is that achieving herd immunity without a vaccine is VERY unlikely. I know that Tegnell has claimed variously that this is not the goal, but for certain the goal is to build up enough resistance in the population that the virus has much more difficulty passing on. This is a risky approach in that we also do not know the long-term effects of dealing with the virus, and it appears that there may indeed be some serious conditions coming out of recovered patients. I don't know the prevalence there, nor do we know whether these are permanent or if they will repair over time.

And to be sure, I am and have been rooting for Sweden. How could you not? How fantastic would it be if we could just sit back and rely on our immune systems to respond, accept the consequences of being human, and endure? But the cost has been pretty high for Sweden. Maybe other nations will catch up and in the end it will all even out, with our "second waves" pumping our numbers up to normalized with a long-plateaued Sweden in a year. 

10 minutes ago, DrPhilly said:

I'm reading the former.

The doctor has spoken.

25 minutes ago, Paul852 said:

Sounds like the former. Does that mean they believe the people who don't have the antibodies could get it again? I would think we'd hear more about people testing positive more than once (I swear I've only heard of that being the case a handful of times).

So if it is the former AND the fact that the number of reported cases falls well under 5% with antibodies, would this be positive news?  Meaning a LOT more people (over 2 million) actually caught it, had no symptoms and now have antibodies.

 

Then again, where the hell did they get the 5% number from.  Have they tested everyone on the same day?  F it, I'm out

 

6 minutes ago, Paul852 said:

The lame doctor has spoken.

FYP

 

 

BOOM!

there's a segment of the population who just won't wear masks...whether it's because of ignorance, politics, selfishness, or a combination of all...they just won't. and mask wearing is only effective if everyone wears one. the wearers are protecting the idiots who refuse to wear one.    

honestly, if i have to go out in public for some reason, i'm gonna wear one of the n95 masks the gubbament told us not to buy at the beginning of all this that i bought anyway. 

 

 

4 minutes ago, paco said:

So if it is the former AND the fact that the number of reported cases falls well under 5% with antibodies, would this be positive news?  Meaning a LOT more people (over 2 million) actually caught it, had no symptoms and now have antibodies.

 

Then again, where the hell did they get the 5% number from.  Have they tested everyone on the same day?  F it, I'm out

 

I have no idea. I'm honestly hopeful that many more people have had this and we're closer to recovery than people think. However, that still doesn't mean things aren't going to be bad for quite a bit.

The bottom line is we simply don't know where we are with this thing.

8 minutes ago, paco said:

So if it is the former AND the fact that the number of reported cases falls well under 5% with antibodies, would this be positive news?  Meaning a LOT more people (over 2 million) actually caught it, had no symptoms and now have antibodies.

 

Then again, where the hell did they get the 5% number from.  Have they tested everyone on the same day?  F it, I'm out

 

FYP

 

 

BOOM!

They didn't test everyone, just 61,000. Of the 61k, 5% was found to have antibodies. 

The article in itself doesn't mean much, at least IMO. All they are saying is that not enough people have antibodies for natural herd immunity so it could resurge in a second wave, especially since they are unsure how long the antibodies even last for. 

1 minute ago, DrPhilly said:

The bottom line is we simply don't know where we are with this thing.

This

5 minutes ago, DrPhilly said:

The bottom line is we simply don't know where we are with this thing.

We don't know precisely. But we know a lot more than we did.

I hope the Sweden experiment works out. I started off as skeptical, but optimistic. I cannot help but think the skeptic side is more correct at this stage, but we have a lot to go for sure. I don't think herd immunity is achievable without a vaccine. That said, if we get to where 20-30% of the population has immunity, that should reduce reproduction of the virus significantly compared to pre-COVID.

6 minutes ago, LeanMeanGM said:

They didn't test everyone, just 61,000. Of the 61k, 5% was found to have antibodies. 

The article in itself doesn't mean much, at least IMO. All they are saying is that not enough people have antibodies for natural herd immunity so it could resurge in a second wave, especially since they are unsure how long the antibodies even last for. 

This

But, that DOES mean a lot. Because there was a good bit of hope out there that if enough of the population developed immunity it would help us get a handle on thing.

4 minutes ago, JohnSnowsHair said:

But, that DOES mean a lot. Because there was a good bit of hope out there that if enough of the population developed immunity it would help us get a handle on thing.

Can't remember when but I thought the idea of that was given up awhile ago. 

3 minutes ago, JohnSnowsHair said:

We don't know precisely. But we know a lot more than we did.

I hope the Sweden experiment works out. I started off as skeptical, but optimistic. I cannot help but think the skeptic side is more correct at this stage, but we have a lot to go for sure. I don't think herd immunity is achievable without a vaccine. That said, if we get to where 20-30% of the population has immunity, that should reduce reproduction of the virus significantly compared to pre-COVID.

Mostly agree with you here though I tend to believe we are much further along than we all think.

One thing that I think we can be more clear about is the fact that we can absolutely get to herd immunity.  If we did absoltuely nothing we'd get there.  At a terrible cost of course but we would get there.  That's the natural order of things.  What I interpret you saying is "herd immunity is not achievable thru any reasonable strategy" which is a quite different thing altogether, very relevant mind you.

1 minute ago, DrPhilly said:

Mostly agree with you here though I tend to believe we are much further along than we all think.

One thing that I think we can be more clear about is the fact that we can absolutely get to herd immunity.  If we did absoltuely nothing we'd get there.  At a terrible cost of course but we would get there.  That's the natural order of things.  What I interpret you saying is "herd immunity is not achievable thru any reasonable strategy" which is a quite different thing altogether, very relevant mind you.

I'm not sure that's strictly true. If it were so, then the common cold, polio, and the measles would have achieved herd immunity without intervention.

I believe that mathematically it's not possible without a vaccine. Once you get to, say, 30% of the population having immunity, it becomes much harder for the virus to reproduce. At some point it hits a ceiling beyond which natural reproduction is very difficult - this is where vaccines come in. They basically reproduce the virus in a way to achieve immunity at levels that are impossible to reach naturally.

1 minute ago, JohnSnowsHair said:

I'm not sure that's strictly true. If it were so, then the common cold, polio, and the measles would have achieved herd immunity without intervention.

I believe that mathematically it's not possible without a vaccine. Once you get to, say, 30% of the population having immunity, it becomes much harder for the virus to reproduce. At some point it hits a ceiling beyond which natural reproduction is very difficult - this is where vaccines come in. They basically reproduce the virus in a way to achieve immunity at levels that are impossible to reach naturally.

I think you more or less described herd immunity.  The virus can't reproduce because there aren't enough susceptible people out there in relation to the level of contagion in the specific virus.  It doesn't mean the virus goes away completely.

13 minutes ago, DrPhilly said:

I think you more or less described herd immunity.  The virus can't reproduce because there aren't enough susceptible people out there in relation to the level of contagion in the specific virus.  It doesn't mean the virus goes away completely.

Herd immunity is the point at which case growth is no longer positive - when it stops being able to spread. For covid-19 it's believed this is around 60%. 

What I'm saying is that even if we get to 30% it has a harder time spreading, but it would still continue to spread. Just at a slower pace because one of the ~3 people (assuming R0 = 3) are already immune. So its growth rate will be less than what it was. But it will still spread. 

That has two effects: it helps to reduce how quickly it spreads through the population, but it also means the time it will take to get to 60% from 30% has increased because the pace of spread has slowed. So if, theoretically, it took 6 months to get to 30% immunity, it might take another 12-18 months to get from 30-60% because the pace of spread will reduce as more of the population gains immunity.

5 minutes ago, JohnSnowsHair said:

Herd immunity is the point at which case growth is no longer positive - when it stops being able to spread. For covid-19 it's believed this is around 60%. 

What I'm saying is that even if we get to 30% it has a harder time spreading, but it would still continue to spread. Just at a slower pace because one of the ~3 people (assuming R0 = 3) are already immune. So its growth rate will be less than what it was. But it will still spread. 

That has two effects: it helps to reduce how quickly it spreads through the population, but it also means the time it will take to get to 60% from 30% has increased because the pace of spread has slowed. So if, theoretically, it took 6 months to get to 30% immunity, it might take another 12-18 months to get from 30-60% because the pace of spread will reduce as more of the population gains immunity.

Ok.  At this point we don't know where we are in regard to the burn thru.

Have you taken a look at the t-cell studies?