Joseph Cox - Comments
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Joseph Cox is the Director of Solve for Success, a small business consulting company.
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Changing The Way We Fight Covid-19
5 years ago

Not from the virus. There have been fewer than 650,000 globally (https://www.worldometers.info/coronavirus/) from the beginning of the epidemic. There may well be undocumented deaths in the poorer parts of the world, but nowhere near 1 million a day.

Changing The Way We Fight Covid-19
5 years ago

Maybe you can totally shut down.

Changing The Way We Fight Covid-19
5 years ago

I mentioned rolling immunity because our immunity doesn't last more than a few months. A possible way to explain this community not regressing is that our immune system might stay primed for the disease due to some level of continued exposure. For me, masks remain important even if you *want* to encourage exposure. We know not all exposures are equal. If you get a big viral load it will hit far far harder. Virus will get through a mask, but probably not a blast of it which helps those who get infected. Masks, I believe, might well lead to far better outcomes even with infection. (Of course, as I said in the article, I'm not an expert - I'm just looking at the data.) The Haredi community is not the only interesting one. Take Sweden. They got hit hard (5% initial death rate vs. statistical infection rate vs 1.4% in NY and 0.14% in Israel because they basically didn't treat the over 70s or protect nursing homes). But they never really locked down. Nonetheless, their new case rate has fallen from 128 cases per million to 30? The people who had it three months ago don't seem to be getting it again. Their death rate has fallen from 10 per million to 1.5 - without lockdowns. The virus is still there, the positive test rate is still 3.5%. But new cases and deaths are falling nonetheless. For tests there can be all sorts of reasons (testing methodology being one). But for deaths we've got better treatment, weaker virus or increased immunity. This suggests some sort of increased immunity of either a healthcare or biological type.

Changing The Way We Fight Covid-19
5 years ago

Newer reports indicate kids 0-9 are the least infectious group while those 10-19 are the most infections group (of any age). So school might be spreading but kindergarden is less likely to do so. Thus the suggestion that younger kids go to school but older ones do not.

The latest study in Israel indicates 67% were infected at home.

Coronavirus: Let's Move On
5 years ago

It happens with lots of sicknesses.

Take chickenpox:

"A person with chickenpox is contagious beginning 1 to 2 days before rash onset until all the chickenpox lesions have crusted (scabbed)"

Mumps:

"The infectious period is considered from 2 days before to 5 days after parotitis onset" (which can last for 10 days)

I'm no doctor, but I think most respiratory diseases are infectious while you are coughing - that is how they are designed to spread. But a virus that causes an immune overresponse (for example) might cause coughing even after the virus itself is no longer capable of replicating.

Coronavirus: Let's Move On
5 years ago

I don't think there are any definitive facts. Masks are actually really complex to model and heavily dependent on a load of factors (how the virus travels, how it is expelled, how it enters the target, environmental factors etc...). Likewise the reality/meaningfulness of the virus surviving on objects (sunlight, media in the air, how it gets into your system etc...)

Relatively speaking, I think the period of infectivity is simpler. You can test people's breath/coughs and see if there is any active virus in it. This is a very standard question. Few people have tried to figure out how effective masks are against flu/chickenpox etc... or how well they survive on surfaces - but when one is no longer contagious is generally pretty understood.

All that said, it is the scientific process. You try to move towards truth, without necessarily getting there. The greatest risk I see is political truth driving scientific truth (e.g. Trump is wrong/right so this scientific theory is wrong/right). We are seeing an enormous amount of that going on and it is really not productive.

Coronavirus: Let's Move On
5 years ago

From the CDC:

Available data indicate that persons with mild to moderate COVID-19 remain infectious no longer than 10 days after symptom onset. Persons with more severe to critical illness or severe immunocompromise likely remain infectious no longer than 20 days after symptom onset.

Coronavirus: Let's Move On
5 years ago

Because 98% are no longer infectious after 11 days. You can be infected, but unable to spread.

Coronavirus: Let's Move On
5 years ago

Clarifying this - would we stop the economy to stop Alzheimers *for one year*.

Coronavirus: Let's Move On
5 years ago

Which matters. Take New York state. It was by far the hardest hit place in the US and one of the hardest hit in the world. At the end of the 'first wave' 13.9% of the state population had been infected. Since then, infections (and deaths) have fallen massively.

New York State appears to have reached some sort of rolling immunity (immunity getting topped up by additional exposures resulting in actual herd immunity even as individual immunity lapses).

In this process 32,000 people died and something like 400,000 were diagnosed. Using the 20% morbidity number, something like 80,000 were affected with the long-term effects of the virus.

Since this 'first wave', as evidenced by the charts I posted, the US and world have actually gotten far more effective at treating cases. The cause could be a less virulent virus, wider testing catching weaker cases or better treatment. From a friend I have who works in a corona ward here people are coming in healthier and are being treated far more effectively. This would suggest that both deaths and ill effects are being moderated.

Deaths per case have fallen dramatically. If either a weaker virus or better treatment are to blame this would suggest morbidity has also fallen.

New York had a serological death rate of about 1.2% (32,000/(13.9% * 19,450,000). If current trends hold, that might fall closer to 0.25%. So the next place could suffer 1/5th the deaths and morbidity and achieve the same herd immunity.

Texas has 30 million people (1.3X New York State), so that suggests 8,320 deaths to achieve the same result.

That is, of course, a terrible result. It is also 0.03% of the population. It would be the 7th leading cause of death - right behind Alzheimers.

If we could stop the economy to stop Alzheimers would we? What if the economic shock damaged our ability to treat heart disease, cancer, stroke... I know in Melbourne (Oz) you can't be treated by a physio after a stroke, because they won't see you in person. Would you decide to do that?

And what if all your open-ended efforts are really for naught - because even if you eradicate the virus in Texas it will come across the Mexican border from places that lack the depth of resources we have - places that can't shut down?

At what point do you say: this is awful, we have no good choices, but our choices are a whole lot better than New York's were and we can afford to move on?

This is meant as a serious question. There are no obvious answers, but the debate is certainly worth having.

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