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Stanford study: More than 48K Santa Clara County residents have likely been infected by coronavirus

Survey of blood samples suggests between 2.49% and 4.16% of county residents may have coronavirus antibodies

The number of coronavirus infections in Santa Clara County could be between 50 and 80 times higher than the officially confirmed count, preliminary results from a community-based study by a team of Stanford University researchers indicates.

The prevalence study, led by Stanford Assistant Professor Eran Bendavid, has not been formally published and is still undergoing peer reviews. It has, however, been published on the preprint server medRxiv. As such, it is effectively a first draft, subject to change based on input before formal publication.

That said, the early findings indicate that between 48,000 and 81,000 residents in Santa Clara County were infected as of April 1, back when the official count was 956. The estimate is based on 3,330 blood samples that were taken from volunteers in Mountain View, Los Gatos and San Jose on April 3 and April 4 and tested for antibodies to SARS-CoV-2 .

When adjusted for Santa Clara County's population and demographics, the number of positive results suggests that between 2.49% and 4.16% of the county's 1.93 million residents have had COVID-19.

The study's results "represent the first large-scale community-based prevalence study in a major U.S. county completed during a rapidly changing pandemic, and with newly available test kits," the authors wrote.

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The most important implication, the preprint notes, is that "the number of infections is much greater than the reported number of cases."

"The population prevalence of SARS-CoV-2 antibodies in Santa Clara County implies that the infection is much more widespread than indicated by the number of confirmed cases," the researchers concluded. "Population prevalence estimates can now be used to calibrate epidemic and mortality projections."

Jay Bhattacharya, a professor of medicine at Stanford University and one of the study's authors, said the goal of the study is to understand how widespread the disease is.

"To do that, we need to understand how many people are infected," Bhattacharya told this new organization on April 4, as the second day of tests was kicking off. "The current test people use to check whether they have the condition – the PCR (polymerase chain reaction) test – it just checks whether you currently have the virus in you. It doesn't check whether you had it and recovered. An antibody test does both."

Participants in the prevalence study were targeted through Facebook ads, with the goal of getting a representative sample of the county by demographic and geographic characteristics, the study states. Because the sampling strategy relied on people who have access to Facebook and a car, there was an overrepresentation of white women between 19 and 64, as well as an under-representation of Hispanic and Asian populations, relative to the community, according to the study. The study attempted to compensate for that by weighting the results for race, sex and ZIP code so that they better reflect the countywide population.

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The group's analysis indicated 50 blood samples from the study, or 1.5% of the total, tested positive for either immunoglobulin M (IgM), the antibody that the body produces when the infection occurs and that disappears after several weeks, or immunoglobulin G (IgG), the antibody that appears later, stays longer and provides the basis for immunity.

After weighting to match the county population by race, sex and ZIP code, the prevalence rate was adjusted to 2.81%, according to the study. Other factors, including uncertainties relating to the sensitivity of the tests that were used, contributed to the range of up to 4.16%.

County, state and federal health experts have consistently acknowledged that the number of COVID-19 cases is far higher than the official statistics show, a problem they attribute largely to the lack of widespread testing. Even though California is looking to greatly ramp up serological (blood) testing and to establish new community-testing sites, the state continues to experience both a shortage of tests and a backlog in processing tests.

As of April 15, more than 246,400 tests had been conducted in California. In Santa Clara County, there were 17,774 tests completed as of April 17, with 10.52% testing positive for the coronavirus.

The new study suggests that the undercounting of COVID-19 infections — the extent to which they vary from official case numbers — is far greater than has been assumed.

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"The under-ascertainment of infections is central for better estimation of the fatality rate from COVID-19," the study states. "Many estimates of fatality rate use a ratio of deaths to lagged cases (because of duration from case confirmation to death), with an infections-to-cases ratio in the 1-to-5-fold range as an estimate of underascertainment. Our study suggests that adjustments for under-ascertainment may need to be much higher."

The Stanford study suggests that the undercounting of cases can also be attributed to a lack of widespread testing and reliance on PCR for case identification, which misses "convalescent" cases (those who have already recovered from the infection). The official count also doesn't capture asymptomatic or lightly symptomatic infections that go undetected, the study states.

The range of results also reflects uncertainty in both test sensitivity (how good it is at correctly identifying COVID-19 antibodies) and test specificity (how likely it is to produce a false positive). Researchers relied on tests manufactured by the Minnesota-based company Premier Biotech, rather than the newly developed serological test by Stanford, which has been used to test health care workers.

Bendavid told this news organization earlier this week that the tests were chosen because they are very easy to use (they produce a line reading similar to a pregnancy test) and produce results within 15 minutes. They are, however, less precise than laboratory-based tests and give you an underestimate of how many people have coronavirus – a shortcoming that was factored in the study.

To determine their accuracy, the research team used the kits it received from Premier Biotech to test blood samples from Stanford Hospital patients that were shown to be positive through a DNA test, as well as samples that were known to be negative because they were taken before the pandemic. These results led researchers to conclude that the sensitivity is about 91.8%, a rate that was factored in to produce the final range.

The authors acknowledge the study's other limitations. While they factored in sex, race and ZIP code, the survey does not account for age imbalances or a potential bias favoring individuals who were in good health and, therefore, able to volunteer. The effect of such biases, the study notes, is hard to ascertain.

Bendavid and Bhattacharya had both argued in the past that the COVID-19 fatality rate is far lower than many experts had assumed. That's because the number of actual infections far exceeds the official case counts.

"If the number of actual infections is much larger than the number of cases – orders of magnitude larger – then the true fatality rate is much lower as well. That's not only plausible but likely based on what we know so far," Bendavid and Bhattacharya wrote in a Wall Street Journal opinion piece on March 24.

As of April 10, the study notes, 50 people in Santa Clara County had died of COVID-19 in the county, with an average increase of 6% daily in the number of deaths. Given the trajectory, the study estimates that the county will see about 100 deaths by April 22.

Given the study's estimate of 48,000 to 81,000 infections in early April — and a three-week lag from infection to death — the 100 deaths suggest that the infection fatality rate is between 0.12% and 0.2%.

That's a far contrast from the county's mortality rate based on official cases and deaths as of April 17 — 3.9%.

The study states that the new data "should allow for better modeling of this pandemic and its progression under various scenarios of non-pharmaceutical interventions."

"While our study was limited to Santa Clara County, it demonstrates the feasibility of seroprevalence surveys of population samples now, and in the future, to inform our understanding of this pandemic's progression, project estimates of community vulnerability, and monitor infection fatality rates in different populations over time," the study states.

Related content:

Los Angeles study backs Stanford researchers' conclusion about high prevalence of COVID-19

Find comprehensive coverage on the Midpeninsula's response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.

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Gennady Sheyner
 
Gennady Sheyner covers the City Hall beat in Palo Alto as well as regional politics, with a special focus on housing and transportation. Before joining the Palo Alto Weekly/PaloAltoOnline.com in 2008, he covered breaking news and local politics for the Waterbury Republican-American, a daily newspaper in Connecticut. Read more >>

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Stanford study: More than 48K Santa Clara County residents have likely been infected by coronavirus

Survey of blood samples suggests between 2.49% and 4.16% of county residents may have coronavirus antibodies

The number of coronavirus infections in Santa Clara County could be between 50 and 80 times higher than the officially confirmed count, preliminary results from a community-based study by a team of Stanford University researchers indicates.

The prevalence study, led by Stanford Assistant Professor Eran Bendavid, has not been formally published and is still undergoing peer reviews. It has, however, been published on the preprint server medRxiv. As such, it is effectively a first draft, subject to change based on input before formal publication.

That said, the early findings indicate that between 48,000 and 81,000 residents in Santa Clara County were infected as of April 1, back when the official count was 956. The estimate is based on 3,330 blood samples that were taken from volunteers in Mountain View, Los Gatos and San Jose on April 3 and April 4 and tested for antibodies to SARS-CoV-2 .

When adjusted for Santa Clara County's population and demographics, the number of positive results suggests that between 2.49% and 4.16% of the county's 1.93 million residents have had COVID-19.

The study's results "represent the first large-scale community-based prevalence study in a major U.S. county completed during a rapidly changing pandemic, and with newly available test kits," the authors wrote.

The most important implication, the preprint notes, is that "the number of infections is much greater than the reported number of cases."

"The population prevalence of SARS-CoV-2 antibodies in Santa Clara County implies that the infection is much more widespread than indicated by the number of confirmed cases," the researchers concluded. "Population prevalence estimates can now be used to calibrate epidemic and mortality projections."

Jay Bhattacharya, a professor of medicine at Stanford University and one of the study's authors, said the goal of the study is to understand how widespread the disease is.

"To do that, we need to understand how many people are infected," Bhattacharya told this new organization on April 4, as the second day of tests was kicking off. "The current test people use to check whether they have the condition – the PCR (polymerase chain reaction) test – it just checks whether you currently have the virus in you. It doesn't check whether you had it and recovered. An antibody test does both."

Participants in the prevalence study were targeted through Facebook ads, with the goal of getting a representative sample of the county by demographic and geographic characteristics, the study states. Because the sampling strategy relied on people who have access to Facebook and a car, there was an overrepresentation of white women between 19 and 64, as well as an under-representation of Hispanic and Asian populations, relative to the community, according to the study. The study attempted to compensate for that by weighting the results for race, sex and ZIP code so that they better reflect the countywide population.

The group's analysis indicated 50 blood samples from the study, or 1.5% of the total, tested positive for either immunoglobulin M (IgM), the antibody that the body produces when the infection occurs and that disappears after several weeks, or immunoglobulin G (IgG), the antibody that appears later, stays longer and provides the basis for immunity.

After weighting to match the county population by race, sex and ZIP code, the prevalence rate was adjusted to 2.81%, according to the study. Other factors, including uncertainties relating to the sensitivity of the tests that were used, contributed to the range of up to 4.16%.

County, state and federal health experts have consistently acknowledged that the number of COVID-19 cases is far higher than the official statistics show, a problem they attribute largely to the lack of widespread testing. Even though California is looking to greatly ramp up serological (blood) testing and to establish new community-testing sites, the state continues to experience both a shortage of tests and a backlog in processing tests.

As of April 15, more than 246,400 tests had been conducted in California. In Santa Clara County, there were 17,774 tests completed as of April 17, with 10.52% testing positive for the coronavirus.

The new study suggests that the undercounting of COVID-19 infections — the extent to which they vary from official case numbers — is far greater than has been assumed.

"The under-ascertainment of infections is central for better estimation of the fatality rate from COVID-19," the study states. "Many estimates of fatality rate use a ratio of deaths to lagged cases (because of duration from case confirmation to death), with an infections-to-cases ratio in the 1-to-5-fold range as an estimate of underascertainment. Our study suggests that adjustments for under-ascertainment may need to be much higher."

The Stanford study suggests that the undercounting of cases can also be attributed to a lack of widespread testing and reliance on PCR for case identification, which misses "convalescent" cases (those who have already recovered from the infection). The official count also doesn't capture asymptomatic or lightly symptomatic infections that go undetected, the study states.

The range of results also reflects uncertainty in both test sensitivity (how good it is at correctly identifying COVID-19 antibodies) and test specificity (how likely it is to produce a false positive). Researchers relied on tests manufactured by the Minnesota-based company Premier Biotech, rather than the newly developed serological test by Stanford, which has been used to test health care workers.

Bendavid told this news organization earlier this week that the tests were chosen because they are very easy to use (they produce a line reading similar to a pregnancy test) and produce results within 15 minutes. They are, however, less precise than laboratory-based tests and give you an underestimate of how many people have coronavirus – a shortcoming that was factored in the study.

To determine their accuracy, the research team used the kits it received from Premier Biotech to test blood samples from Stanford Hospital patients that were shown to be positive through a DNA test, as well as samples that were known to be negative because they were taken before the pandemic. These results led researchers to conclude that the sensitivity is about 91.8%, a rate that was factored in to produce the final range.

The authors acknowledge the study's other limitations. While they factored in sex, race and ZIP code, the survey does not account for age imbalances or a potential bias favoring individuals who were in good health and, therefore, able to volunteer. The effect of such biases, the study notes, is hard to ascertain.

Bendavid and Bhattacharya had both argued in the past that the COVID-19 fatality rate is far lower than many experts had assumed. That's because the number of actual infections far exceeds the official case counts.

"If the number of actual infections is much larger than the number of cases – orders of magnitude larger – then the true fatality rate is much lower as well. That's not only plausible but likely based on what we know so far," Bendavid and Bhattacharya wrote in a Wall Street Journal opinion piece on March 24.

As of April 10, the study notes, 50 people in Santa Clara County had died of COVID-19 in the county, with an average increase of 6% daily in the number of deaths. Given the trajectory, the study estimates that the county will see about 100 deaths by April 22.

Given the study's estimate of 48,000 to 81,000 infections in early April — and a three-week lag from infection to death — the 100 deaths suggest that the infection fatality rate is between 0.12% and 0.2%.

That's a far contrast from the county's mortality rate based on official cases and deaths as of April 17 — 3.9%.

The study states that the new data "should allow for better modeling of this pandemic and its progression under various scenarios of non-pharmaceutical interventions."

"While our study was limited to Santa Clara County, it demonstrates the feasibility of seroprevalence surveys of population samples now, and in the future, to inform our understanding of this pandemic's progression, project estimates of community vulnerability, and monitor infection fatality rates in different populations over time," the study states.

Related content:

Los Angeles study backs Stanford researchers' conclusion about high prevalence of COVID-19

Find comprehensive coverage on the Midpeninsula's response to the new coronavirus by Palo Alto Online, the Mountain View Voice and the Almanac here.

Comments

Bill Glazier
Old Palo Alto
on Apr 17, 2020 at 6:03 pm
Bill Glazier, Old Palo Alto
on Apr 17, 2020 at 6:03 pm

Well, even if between 2-4% of Santa Clara County has already been infected, and perhaps now has some form of immunity, that still leaves 96-98% of the population of the county that has NOT been infected and has no immunity. I do not think this is anywhere close to herd immunity. This might be helpful to give individuals a sense of weather they might feel comfortable returning to a work-like setting, however.


non-random sample
Barron Park
on Apr 17, 2020 at 6:04 pm
non-random sample, Barron Park
on Apr 17, 2020 at 6:04 pm

While the researchers are likely correct that the number of infected cases is larger than previously thought, their sample (people who chose to be tested) is non-random and likely includes a greater proportion of people who were infected than had they randomly selected persons to test.


Mitchell Johns
another community
on Apr 17, 2020 at 7:58 pm
Mitchell Johns, another community
on Apr 17, 2020 at 7:58 pm

While the 3300 tests taken were statistically inferred to the county's population, it brings up a speculative suspicion that this coronavirus (Covid-19)or a related 'derivative' has been around for longer than we thought. For any validity with this suspicion is the assumption that the antibody test used was 'factored in' appropriately to prevent false positives. If a considerable population was exposed much earlier to this virus than January 2020, then does this give immunity partially or wholly to those who tested positive? Again all this is speculative, and we must wait to hear from the researchers who performed the study.


Michelle mentod
Palo Alto Hills
on Apr 17, 2020 at 9:47 pm
Michelle mentod, Palo Alto Hills
on Apr 17, 2020 at 9:47 pm
Nayeli
Midtown
on Apr 17, 2020 at 10:17 pm
Nayeli, Midtown
on Apr 17, 2020 at 10:17 pm

Interesting. I suspect that the same would be true around the world. The official "confirmed cases" are always going to be lower for any communicable disease. This is particularly true of coronaviruses like SARS, MERS and COVID-19 that spread so quickly from person-to-person.

I wonder what the actual number of infections are in places like Italy, Spain, Iran and, of course, China. I also wonder how it compares with the rate of injection and mortality from things like influenza strains. In the 2017-2018 flu season, roughly 45 Million Americans contracted the flu and about 61,000 died from it. Last year, the number of deaths was estimated to have dropped to just over 34,000.

Web Link

At this point, over 33,000 people in the U.S. have died from COVID-19. More than a third of all deaths were in New York City. Out of the total of 661,712 confirmed cases in the United States and its territories, 229,642 are in New York.

Web Link

Web Link

This causes me to wonder why. As of today, Santa Clara County has had a total of 1,870 confirmed cases and a total of 73 deaths. Of the 73 deaths, 86% (about 63) were "deaths by comorbidities" (deaths from two or more causes).

Web Link

I think that Santa Clara County is doing something right. The same is true of other surrounding counties in the Bay Area. At the same time, it makes me wonder why New York City (and the greater NYC area) has been hit so hard.


Alicia
another community
on Apr 17, 2020 at 10:17 pm
Alicia, another community
on Apr 17, 2020 at 10:17 pm

It's too bad doctors are STILL telling patients no need to get tested if you have no symptoms. Or they suggest they wait as there specific medical provider is Sutter Health is setting testing up and it would be better for them to wait and get tested through them ?? That sounds like it just about money! That's what my Aunt's doctor told her when she qualified for FREE testing of Covid-19.


Stanford should do better
Mountain View
on Apr 17, 2020 at 10:22 pm
Stanford should do better, Mountain View
on Apr 17, 2020 at 10:22 pm

[Portion removed.] Those who wish to diminish the dangers of COVID-19 are going to latch on to this "study," which was not a random sample, but rather a self-selected group.

Already people are saying the nation has overreacted by using this study to suggest COVID19 is no more dangerous than the flu. Look at real data from NYC on the death rates last year and now, and it's clear this is not just a flu. Web Link at the overcrowded hospitals in hot zones. Look at those who lost someone. These [portion removed] studies add to their injury and imperil all the wider community.


Online name
another community
on Apr 17, 2020 at 11:05 pm
Online name, another community
on Apr 17, 2020 at 11:05 pm

Either way, we will still practice social distancing, however, we also need to get back to work.


Resident
Another Palo Alto neighborhood
on Apr 17, 2020 at 11:13 pm
Resident, Another Palo Alto neighborhood
on Apr 17, 2020 at 11:13 pm

Many of us were saying this long before the shelter in place order. Many people who were sick in February and early March were not tested and presumably many of those were sick with Covid but with mild symptoms. I remember all the news about sports stars and celebrities being publicized that they had been tested positive with mild symptoms. How did they manage to get tested when the general public was not able to get a test?


Jack
Midtown
on Apr 18, 2020 at 12:12 am
Jack, Midtown
on Apr 18, 2020 at 12:12 am

[Post removed due to inaccurate information.]


Michael
another community
on Apr 18, 2020 at 12:18 am
Michael, another community
on Apr 18, 2020 at 12:18 am

New York City has a population of 8.399 million in 2018 according to Google. Currently (according to John Hopkins tracker) there are 13,203 deaths attributed to COVID-19 in NYC. If you assume the infection fatality rate that the Stanford folks are putting forward of 0.12 - 0.2 % in NYC and assume *EVERYONE* in NYC was infected then you'd get that there should be between 10,079 - 16,798. Given not everyone was infected in NYC, and given that there are more deaths in NYC every day (but not more people) it looks like the infection fatality rate in NYC is much higher than this number. Some of that may be health system overwhelmed but a reasonable assumption is that some of it is the base infection fatality rate is much higher than this first draft of unpeer reviewed study suggests.


Bob
Downtown North
on Apr 18, 2020 at 12:19 am
Bob, Downtown North
on Apr 18, 2020 at 12:19 am

If the 48K number of infections is correct and the number of deaths, 73, as of April 17, 2020, is correct than the death rate is: 0.0015 percent which is significantly less than the 0.0390 percent what is being advertised from public health officials and the media.
Web Link


We Still Do Not Know About Immunity
another community
on Apr 18, 2020 at 1:00 am
We Still Do Not Know About Immunity, another community
on Apr 18, 2020 at 1:00 am

Do those with the antibodies have immunity to the SARS-CoV2 virus? If so, for how long does that immunity last?

Also, is it possible for common cold coronaviruses to elicit the same immunoglobulin M and G antibodies as were detected in these tests? Or does this test detect a variant of these antibodies that is specific only to SARS-CoV2 exposure?


Anonymous
another community
on Apr 18, 2020 at 3:12 am
Anonymous, another community
on Apr 18, 2020 at 3:12 am

[Portion removed.]

The participants were basically self selected volunteers that likely had covid like symptoms at some point and wanted to see if they did in fact have covid. So they had more people in the sample group that were symptomatic than the average population. And were therefore more likely to find positive cases.

They also left out some important details, and scaled their findings up (the true percentage of antibody positive results was only 1.5%).

Bottom line: I am frustrated that the worldwide media is highlighting this study and now claiming that we may have 50x-85x more cases than confirmed. That number is way too high. [Portion removed.]


AndypSr
another community
on Apr 18, 2020 at 5:08 am
AndypSr, another community
on Apr 18, 2020 at 5:08 am

These preliminary data point to the medical judgement that in order to determine the effects of a pandemic infection you must know the prevalence of the infection. Regardless of the bias inserted by the structure of the study one must accept that the death rate relative to a prevalence of the disease is less than the raw data reported on a regular basis. [Portion removed.]


JM
Charleston Meadows
on Apr 18, 2020 at 7:12 am
JM, Charleston Meadows
on Apr 18, 2020 at 7:12 am

I'm wondering why such an important study has not been conducted by authorities such as CDC? If some researchers in Stanford have enough resources to do it on thousands of people, CDC sure has more resources to do it more correctly. Even more curiously is no authorities around the world has published any prevalence study using antibody tests, AFAIK. Not even China. Why? Is it because they worried such study will only encourage to ignore the instructions from health authorities?


Don B
another community
on Apr 18, 2020 at 7:13 am
Don B, another community
on Apr 18, 2020 at 7:13 am

Using your postulated rate of infection for Santa Clara county on New York state (population 19,000,000) yields a likely number of infections of(.028 x 19,000,000 = 532,000. This is only a little more than double the reported cases of 234,000 as of April 18. Not orders of magnitude. Any explanation?


NYer
Barron Park
on Apr 18, 2020 at 8:27 am
NYer, Barron Park
on Apr 18, 2020 at 8:27 am

A friend who is an ObGyn at a large hospital system in NYC said they are testing every pregnant woman coming in for a checkup and the infection rate of that population is 15-20%. FWIW since that population also is not random but it seems everyone can agree the actual infection rate is higher than what is being reported. It is truly bizaare that neither the CDC nor any medical/health/scientific organizations are conducting larger randomized studies of the infection rate.


scientific critical thinking
Midtown
on Apr 18, 2020 at 9:07 am
scientific critical thinking, Midtown
on Apr 18, 2020 at 9:07 am

The publicity that this pre-peer-reviewed research received felt a bit strange. Is the agenda behind this to support the researchers earlier assertions that the mortality rate was NOT that high? Does that make any difference given what we know so far about the contagion?

The Test Kit Performance section in the paper talks about how they compensated for false positives etc. but here's from CDC/FDA about
antibody tests: "False positive results for IgM and IgG antibodies may occur due to cross-reactivity from pre-existing antibodies or other possible causes. At this time, it is unknown for how long IgM or IgG antibodies may persist following infection."

Some additional data about the samples/specimens:
1) How many of the participants had taken the flu shot?
2) Did any of those tested positive recall having any symptoms?

We need researchers in Stanford and other wellfunded organizations to conduct research and meaningful and impactful reports. Other than possibly recomputing mortality rate of COVID19, I do not find any value in the preliminary report that is being circulated.


Numbers
College Terrace
on Apr 18, 2020 at 9:07 am
Numbers, College Terrace
on Apr 18, 2020 at 9:07 am

@ Bob: “If the 48K number of infections is correct and the number of deaths, 73, as of April 17, 2020, is correct than the death rate is: 0.0015 percent which is significantly less than the 0.0390 percent what is being advertised from public health officials and the media. “

Your logic notwithstanding, even your math is wrong by a factor of 100. Armchair epidemiologists and statisticians are not helpful.


Anon
Another Palo Alto neighborhood
on Apr 18, 2020 at 9:20 am
Anon, Another Palo Alto neighborhood
on Apr 18, 2020 at 9:20 am

Posted by Online name, a resident of another community

>> Either way, we will still practice social distancing,

Agreed.

>> however, we also need to get back to work.

When it makes sense and is safe to do so. As in, adequate protective gear for people who are at high risk, or, are at risk of communicating disease to others.

I question whether it will make sense any time soon for bars, restaurants, theatres, amusement parks, and any other crowded venues that depend upon the crowding either for the economics of it, or, for the fun of it. For such activities, I think we have to wait until we have an effective vaccine.



wgdesign
Greenmeadow
on Apr 18, 2020 at 9:31 am
wgdesign, Greenmeadow
on Apr 18, 2020 at 9:31 am

In NYC several issues regarding testing and stat avgs. In midtown areas random sampling by test is around 38% positive, 1.5 miles away at Elmhurst, JFK, Queens we see a 77% positive test rate. Morbidity is a final test per diagnosis. We are looking at the positive test result to hospitalizations,by zipcode, to death by test in hospital, and now possible infection, death certificates are a bit difficult to comply as many people are death in homes, or in a "care" facility. I would not recommend a simple facile answer to this issue. A possible scenario with the Bay Area, is you are out of the firing line and NYC has had a much larger incubation time, because of world travel JFK airport, and cross cultural exposure much earlier then the Bay Area, with a depreciation, of virus incubation alerts: time lag exposure rate. (Grew up in Greenmeadow, now in NYC)


Jim
another community
on Apr 18, 2020 at 9:38 am
Jim, another community
on Apr 18, 2020 at 9:38 am

If the virus had been here earlier than previously thought and at a much higher rate than previously thought, there would certainly have been fatalities associated with these infections. Does this mean that these fatalities were not properly attributed to the virus and therefore not included in the overall count? Would this not change the overall fatality rate back upward? Seems odd not to see any discussion regarding this.


Shut it down
East Palo Alto
on Apr 18, 2020 at 9:45 am
Shut it down, East Palo Alto
on Apr 18, 2020 at 9:45 am

Nayili: New York City is a disaster because they didn't socially distant and shut down as fast as California did.

Open things up, let her rip skip, and as soon as people get comfortable being out and offices and bars and restaurants... 4 weeks later we will look like New York City.

It's math that's been proven around the world.

Trump was notified all through January by his intelligence services that this was coming, and he did next to nothing. Worse, he told us it wasn't a problem through the entire month of February.

Even worse, he kept shipping medical supplies overseas during the month of February.

Even worse than that, he did not use his authority to ramp up needed supplies.


Nick
Los Altos
on Apr 18, 2020 at 9:52 am
Nick, Los Altos
on Apr 18, 2020 at 9:52 am

[Portion removed.] I know no one who has been given a test, but I know numerous people who have been sick & symptomatic and believe they had Coronavirus. The only person who died in my county was denied a test repeatedly, showing just how tight they have been with testing. The "official numbers" are limited by the number of available tests and are inaccurate.

[Portion removed.]


Me 2
Old Palo Alto
on Apr 18, 2020 at 10:20 am
Me 2, Old Palo Alto
on Apr 18, 2020 at 10:20 am

The criticism of the study is disconcerting, yet not surprising. This is how science works. People publish papers. They're peer-reviewed (which this has not been yet) to get critical feedback and then better studies are done.

You have to start somewhere. That's science. It's never infallible - it's a *process* not a result.

[Portion removed.]


because why
another community
on Apr 18, 2020 at 10:32 am
because why, another community
on Apr 18, 2020 at 10:32 am

knowledge is power. as more and more broadbased nationwide antibody testing is completed, the more power it will give to the people to decide proper and sustainable safety measures at the ballot box. so i say go ahead and err on the side of caution, but do so with as clear a picture as antibody testing will allow. the people who decide safety protocols for the public should be pushing for all knowledge available minute by minute to justify removing social controls. so i say cheers to Stanford for their efforts to get the ball rolling by bringing national and global attention to the potential of this vitally important data mine.


David Duemler
another community
on Apr 18, 2020 at 10:51 am
David Duemler, another community
on Apr 18, 2020 at 10:51 am

If a high percentage of those who tested positive for antibodies were asymptomatic, then the potential distortion due to symptomatic people being more likely to take part is relatively small. The researchers presumably have this data, and I wish they would share.


Pasha
College Terrace
on Apr 18, 2020 at 10:57 am
Pasha, College Terrace
on Apr 18, 2020 at 10:57 am
D.J. Rainer
Professorville
on Apr 18, 2020 at 11:03 am
D.J. Rainer, Professorville
on Apr 18, 2020 at 11:03 am
Pasha
College Terrace
on Apr 18, 2020 at 11:07 am
Pasha, College Terrace
on Apr 18, 2020 at 11:07 am
D.H.
Los Altos
on Apr 18, 2020 at 11:24 am
D.H., Los Altos
on Apr 18, 2020 at 11:24 am

Curious that if so many has been infected, why no clear reports in these early days of serious pneumonia or ventilator use until recent outbreak. if the anti-body test has a 3% false positives it would account for most of these cases.


Patrick Staley
another community
on Apr 18, 2020 at 11:28 am
Patrick Staley, another community
on Apr 18, 2020 at 11:28 am

This article conflates the term "mortality" with "fatality". The stuff about using influenza mortality for comparison is very misleading.


D.J. Rainer
Professorville
on Apr 18, 2020 at 11:33 am
D.J. Rainer, Professorville
on Apr 18, 2020 at 11:33 am
@nick
Mountain View
on Apr 18, 2020 at 11:36 am
@nick, Mountain View
on Apr 18, 2020 at 11:36 am

When people say the death rates are skewed by over labeling deaths as COVID19 related, just look to see how many more people are dying in NYC these last 30 days than any other 30 days in modern history of NYC including 9/11, what else explains that jump if not COVID19 being very deadly to a small but still important subset of people?
Please read the NY Times report of the data:
Web Link

I know people who died in NYC these last 30 days, and hearing people say it wasn't COVID19 is like hearing people say 9/11 didn't happen. To say that their deaths were overblown, far more Americans have died from COVID19 than American fatalities from 9/11, Afghanistan, and Iraq combined, yet somehow now, it's become politically acceptable to write off COVID19 victims.


scientific critical thinking
Midtown
on Apr 18, 2020 at 12:16 pm
scientific critical thinking, Midtown
on Apr 18, 2020 at 12:16 pm

To all those who think mortality or fatality rates of COVID19 must be the deciding factor for mitigation strategies, as the Stanford researchers seem to be highlight it, read this article and join that dubious Dr-Phil-Dr-Oz-Dr-Minsky club:
Web Link

Sensationalizing media should not be justification for researchers to publish high-school caliber research reports without first asking
themselves all the critical, analytical questions that others would ask.
Science that can't withstand questioning is belief.


BRIJ BHAMBI
another community
on Apr 18, 2020 at 12:33 pm
BRIJ BHAMBI, another community
on Apr 18, 2020 at 12:33 pm

Authors tweaked total infection rate from 1.5% to >4% to account for sensitivity issues with test and additional demographic factors. I wonder how does low pretest probability(96% did not have infection by study numbers)and false positive test rate impact the overall conclusions. False positive rates may meaningfully alter any conclusions and may encourage complacency.


Molly
Another Palo Alto neighborhood
on Apr 18, 2020 at 1:25 pm
Molly, Another Palo Alto neighborhood
on Apr 18, 2020 at 1:25 pm

Testing is useless - it is backward looking. We know the best way not to get the virus is wear a mask and wash/sanitize your hands, and stay 3-6 ft away from others when out. Require those things and open up doctors offices, orthos,etc, and other businesses ASAP....stop prolonging the inevitable. And if you don’t want to leave your house, don’t. We still have free choice.


Jen
Another Palo Alto neighborhood
on Apr 18, 2020 at 1:34 pm
Jen, Another Palo Alto neighborhood
on Apr 18, 2020 at 1:34 pm

Yes, most counties in Bay Area now require a mask in public...best move yet....and the only one that really offers any protection. I do double, mask then scarf over it. My kids wear a bandana over their mask. We all feel safe when out and about. Testing for antibodies, sounds good in theory, but I still won’t relax this mask requirement in my family.


JohnF
Los Altos Hills
on Apr 18, 2020 at 3:27 pm
JohnF, Los Altos Hills
on Apr 18, 2020 at 3:27 pm

This study needs to be repeated with a randomly selected group of subjects. Self selection builds in an inherent bias.


YP
Crescent Park
on Apr 18, 2020 at 4:14 pm
YP, Crescent Park
on Apr 18, 2020 at 4:14 pm

Meanwhile 22 million people unemployed. What's the right solution for NYC and it's density not right for rest of country. NYC/New Jersey/Connecticut represent about 50% of fatalities. Now our Governor now wants to form an 80 person council co-chaired by Tom Steyer to figure out how we reopen California. Wonder how long that will take to reach consensus?

Web Link

I really feel sorry for small businesses and those recently unemployed in California. You are now facing a double whammy, the Corona Virus and Newsom's anti-business administration. Good luck!!


Resident
Old Palo Alto
on Apr 18, 2020 at 4:50 pm
Resident, Old Palo Alto
on Apr 18, 2020 at 4:50 pm

We have the best community colleges in state right here.
With 57.8% of the voters voting in favor of measure G, they now have an additional 898 million dollars to spend on programs.
Small business owners and service employees should consider going back to school and start new careers.
It is never too late to go back to school.
Often the hardest times result in the most creative and brightest ideas in history.


Bob
Downtown North
on Apr 18, 2020 at 5:29 pm
Bob, Downtown North
on Apr 18, 2020 at 5:29 pm

@Numbers, 73÷48,000 = 0.0015... If that's wrong than provide your calculation.


Molly
University South
on Apr 18, 2020 at 8:03 pm
Molly, University South
on Apr 18, 2020 at 8:03 pm

Your comment is completely irresponsible and wrong. You need to test 3-5x as many people as are being tested now and then trace all of the contacts of the positives and test them. All of the positives need to be isolated strictly and not on some loose honor system.

Your advice to open up business before that would lead to a horror show.


Harry Merkin
Ventura
on Apr 18, 2020 at 8:51 pm
Harry Merkin, Ventura
on Apr 18, 2020 at 8:51 pm

"I think that Santa Clara County is doing something right. The same is true of other surrounding counties in the Bay Area. At the same time, it makes me wonder why New York City (and the greater NYC area) has been hit so hard."

That should be no surprise. Dwelling densities in the NYC area are much higher than here, and their people-concentrating transit systems are heavily used. That makes a really big petri dish to share viruses.


C. Walters
Barron Park
on Apr 18, 2020 at 10:07 pm
C. Walters, Barron Park
on Apr 18, 2020 at 10:07 pm

@Bob
73/48,000= 0.0015
= 0.15%



Online name
Mountain View
on Apr 18, 2020 at 11:07 pm
Online name, Mountain View
on Apr 18, 2020 at 11:07 pm

The real horror show is shopping at the big box stores, this is far worse then opening up some businesses.


Donald Steiny
Professorville
on Apr 18, 2020 at 11:12 pm
Donald Steiny, Professorville
on Apr 18, 2020 at 11:12 pm

If you assume the percentage is correct, then to have the number of deaths they have in NYC, everyone in the city already has it.


Perpetual Motion Squirrel
Mayfield
on Apr 19, 2020 at 12:48 am
Perpetual Motion Squirrel, Mayfield
on Apr 19, 2020 at 12:48 am

@Resident,

"Small business owners and service employees should consider going back to school and start new careers. It is never too late to go back to school."

I generally agree with your comment, it is never too late to go back to school. However, I have to say that you appear to have very narrow-minded/oversimplistic view of small business. Are you suggesting that small business owners lack or do not have enough higher education to run business?

I know some "small business" owners who hold higher education degrees and run companies with ~200 employees.

Many small business owners are currently facing difficulties due to COVID-19 pandemic not because they lack education.


Scott Krause
Barron Park
on Apr 19, 2020 at 10:25 am
Scott Krause, Barron Park
on Apr 19, 2020 at 10:25 am

How specific is the antibody test? Will it give a false positive when someone has been exposed to a common cold coronavirus, or even canine coronavirus? And if that answer is yes, or maybe, would exposure to these viruses cause at least partial immunity to the COVID-19 virus, and may be the reason some people remain asyptomatic?


Anon
Another Palo Alto neighborhood
on Apr 19, 2020 at 11:59 am
Anon, Another Palo Alto neighborhood
on Apr 19, 2020 at 11:59 am

I'm not sure why some people are drawing the conclusions from this that they are. What it tells me is that there are "a lot" of people out there who either are delayed in developing symptoms or are asymptomatic. A lot of people can be contagious without their knowing it, or, someone else knowing it. What this tells me is that we need to ramp up testing, including do some real, statistically valid random testing, to get solid estimates. Testing capability is still way too scarce. I think we should get to the point where every single person can be tested for COVID-19, and, later, can be tested for antibodies.

Because so many people may be asymptomatic but contagious, we need to continue with the current social distancing policies until we can get enough testing done to accurately estimate risk.


Randal
another community
on Apr 19, 2020 at 12:17 pm
Randal, another community
on Apr 19, 2020 at 12:17 pm

This paper is likely vastly overestimating the level of infection in the SC area. My suspicion is that the test lacks specificity for SARS-CoV2 and is detecting antibodies against other, commonly acquired, coronaviruses.This would inflate the numbers dramatically. I can believe that the number of actual infections is 10X the test-confirmed cases, but 80X? No way.


Woodworker
another community
on Apr 19, 2020 at 12:17 pm
Woodworker, another community
on Apr 19, 2020 at 12:17 pm

@C.Walters .15 and .0015 are very different amounts


Helen
Downtown North
on Apr 19, 2020 at 4:36 pm
Helen, Downtown North
on Apr 19, 2020 at 4:36 pm

Basic Math my friend.
Learn your Percentages.


Betty
another community
on Apr 19, 2020 at 5:08 pm
Betty, another community
on Apr 19, 2020 at 5:08 pm

I'm pretty sure I had this back in Jan/Feb. I had what I thought was a cold, had a bit of a cough and some flem. The flem was different than any flem I ever had before, it was real sticky. My lungs hurt on occasion and the cough was pretty much a dry one with the occasion flem. I do remember thinking that I had never had a cold like this one before. I never got ill enough to go the doctor, but had me concerned enough to quit smoking as my mom is on oxygen therapy for late term COPD. I also work at the local welfare office which we just closed to the public on Thursday. I am an essential worker and handle every piece of paper that comes across the front desk and every piece of mail. Point is I think I would be dead if it was all that dangerous to the person with average health.


Microbiologist
another community
on Apr 19, 2020 at 6:28 pm
Microbiologist, another community
on Apr 19, 2020 at 6:28 pm

The question remains, "How did this happen" ? and "Why the west coast"?

For years, there have been reports linking particulate pollution in California, Oregon, Washington St. to pollution coming from China.
If dust can travel that distance, virus can make the trip much more easily.

Thank you to the Palo Alto News for leaving this conversation open.


Anon
Another Palo Alto neighborhood
on Apr 19, 2020 at 7:00 pm
Anon, Another Palo Alto neighborhood
on Apr 19, 2020 at 7:00 pm

Posted by Microbiologist, a resident of another community

Where did you study, Microbiologist?

>> The question remains, "How did this happen" ? and "Why the west coast"?

Are you asking why the West Coast is so much better off than New York? Good question. IIRC, the Bay Area was shutting down at the same time that NYC was saying, "Since I’m encouraging New Yorkers to go on with your lives + get out on the town despite Coronavirus". Web Link

>> If dust can travel that distance, virus can make the trip much more easily.

Do you have links to the evidence for what you are talking about? I'm guessing that you may be confusing this with types of Influenza that can infect both birds and people. e.g. Web Link


Family Friendly
Old Palo Alto
on Apr 20, 2020 at 9:31 am
Family Friendly, Old Palo Alto
on Apr 20, 2020 at 9:31 am

Interesting article in the SJM, quoting reactions from various renowned statisticians across the world: Web Link

Net net is a pretty big embarrassment for Stanford. Someone should be internally reviewing papers before they're published -- even the non-peer-reviewed ones.


Questions
Another Palo Alto neighborhood
on Apr 20, 2020 at 9:31 am
Questions , Another Palo Alto neighborhood
on Apr 20, 2020 at 9:31 am

I think this study is more useful if it traces the professions, exposures, and other contacts, To see who is most likely to have been infected and where undetected hotspots were. I don’t think there is any way to judge infection or mortality rates from this,, It was conducted simply too far into the pandemic to judge that. If everyone recalls, many large events were canceled out of an abundance of caution. Remember cancellations of Lunar new year events? That kind of behavioral modification went back all the way to early February and January. I don’t think you can get an accurate measure of ordinary prevalence and ordinary mortality months after people started modifying their behavior.

And yes there is a greater density in New York City and more people tend to ride public transit and go shoulder to shoulder with other people and all kinds of situations. But whether that’s the case or not, you don’t get a realistic infection rate and mortality rate unless the test is done before any behavioral changes on a large scale have been at play. And then, do you have the factor of how seriously or well various localities took those behavioral changes. Because we already know that countries like South Korea and Taiwan taking those very serious and early steps reduced infections. I really don’t see how it’s possible to even factor in the strength of the underlying healthcare system, which may have helped countries like Germany and Sweden to reduce the impact of the epidemic.

How detailed it was the survey? I don’t think using having a car is the greatest proxy for socioeconomic Statusmenü our area.


Questions
Another Palo Alto neighborhood
on Apr 20, 2020 at 9:33 am
Questions , Another Palo Alto neighborhood
on Apr 20, 2020 at 9:33 am

Oh that’s hilarious. I’m using voice recognition to type this I meant to say in our area not in new our area LOL.


C
Palo Verde
on Apr 20, 2020 at 11:53 am
C, Palo Verde
on Apr 20, 2020 at 11:53 am

One issue I have with the discussion of the virus is that it's the fatality that's being emphasized.

> we also need to get back to work.

See, statements like these, imo, brush off everything else about the infection other than fatality. At the moment, any information of non-fatal yet otherwise debilitating effects of the virus are, at best, anecdotal. You cannot go back to work when you can't get out of bed. And it's unethical for an employer to let you go back to work when you can spread a highly contagious virus that will infect others.

Even while this study is saying that the virus is highly contagious, we're only focusing on the lethality. IMO, That's wrong. At least until an effective treatment, such as a vaccine, is found, this is not just the flu, bro. (Or, more precisely, it's not like the common cold, which many people who catch it mistake for the flu.)

If the virus was *not* contagious, I wouldn't be worrying so much about it. But it is, and working and socializing increases not only the chances of your catching it, but the load (amount) of not only the virus, but other possible infections that the virus may compound. The virus attacks the immune system, and is known to be more lethal in those with existing conditions, thus suggesting that the virus may increase the severity of a co-infection.

We don't know the long-term effects from those who have recovered from the virus, nor the duration of the antibodies generated from them. After all, the virus has only been around four months. But I read this morning about how children are showing inflammation of the skin on their extremities, further suggesting that we don't know the virus well.

CoVid may not have any noticeable non-lethal short-term effects (compare it to polio which left children paralyzed), but, if it has long-term effects on our immune system and increases the chances of other organ failure, such as cardiac arrest, then CoVid may mean we'll live shorter lives.


Robert
Los Altos
on Apr 20, 2020 at 12:00 pm
Robert, Los Altos
on Apr 20, 2020 at 12:00 pm

GREAT study. Still, given the gross sample bias introduced by Facebook advertising and attempts to "clean up" the data by weighting the data demographically, I would take that 48,000 and round it up to "approximately 50,000" with only one significant figure --- and then doubt that figure.

Still, approx 50,000 is a heck of a lot more than the 20000 confirmed cases in SCC and this study highlights a very serious danger to people of above average vulnerability to this disease. There probably probably are a lot of people who asymptomatic carriers as well as carriers with only mild symptoms --- like feeling rotten and thinking it's allergies or maybe just a "minor flu bug". So, it will be highly advisable to self-protect by physical distancing, wearing proper gear (mask, eye protection, and gloves, and clothing), and sheltering in place just as before. Until there is a huge increase in accurate, rapid, and inexpensive testing, along with at least two effective oral antivirals with minimal side effects that can be taken at home, then it's better to stay the course. Note: Neither remdesivir nor oxyhydroquinone are suitable for home use by people not medically trained. More suitable drugs are in the pipeline being tested.


Robert
Los Altos
on Apr 20, 2020 at 12:02 pm
Robert, Los Altos
on Apr 20, 2020 at 12:02 pm

Excuse me. I meant 2,000 verified cases, not 20,000 in SCC as of this writing.


Joyce
Stanford
on Apr 20, 2020 at 12:18 pm
Joyce, Stanford
on Apr 20, 2020 at 12:18 pm

There is a lot of twitter pointing out problems with the Stanford study.

Also, Prof. Andrew Gelman, professor of statistics and political science and director of the Applied Statistics Center at Columbia University, summarizes his critique of the Stanford study, with this comment:

"I think the authors of the above-linked paper owe us all an apology. We wasted time and effort discussing this paper whose main selling point was some numbers that were essentially the product of a statistical error.

I’m serious about the apology. Everyone makes mistakes. I don’t think the authors need to apologize just because they screwed up. I think they need to apologize because these were avoidable screw-ups. They’re the kind of screw-ups that happen if you want to leap out with an exciting finding and you don’t look too carefully at what you might have done wrong."

see Web Link


Gale Johnson
Adobe-Meadow
on Apr 20, 2020 at 12:27 pm
Gale Johnson, Adobe-Meadow
on Apr 20, 2020 at 12:27 pm

@Resident re who got tested...it's because of who they are...celebrities and sports stars. Didn't you know they are special people in our lives??? Wink! wink! Neither did I, and the fact is they are not special as far as the virus is concerned. Virus speaking.."Take all your awards, trophies, and ribbons to your graves...I might be the real winner in this competition".


scientific critical thinking
Midtown
on Apr 20, 2020 at 1:14 pm
scientific critical thinking, Midtown
on Apr 20, 2020 at 1:14 pm

The mercury news and twitter appear to suggest that I was right about "high-school caliber research report"ing by Stanford - no offense to high school students who do more with less in terms of resources, time, etc.

Their agenda was to find something to back up their earlier assertions of mortality rate, which was a hunch to begin with and not based on data. The report and the study is not only flawed but useless as it does not have anything actionable that may suggest correcting course going forward.

Do something useful, valuable not just a show like Dr-Phil-Dr-Oz-Dr-Minky.


Tom from Midtown
Midtown
on Apr 20, 2020 at 1:59 pm
Tom from Midtown, Midtown
on Apr 20, 2020 at 1:59 pm

I think it's a mistake to apply the same standards to the Stanford study as most lay readers do to "scientific research". Note that the Online very responsibly states in the second paragraph that the study "has not been formally published and is still undergoing peer reviews. It has, however, been published on the preprint server medRxiv. As such, it is effectively a first draft, subject to change based on input before formal publication." I think the appropriate way to read the report is to hear the researchers saying, "hey, this looks like very interesting information that people, especially health professionals, will want to know about." In other words, this is news...it was meticulously gathered news, such as you might expect from an excellent NYT investigative team, but it's not (yet) intended to be taken as "science."

For this reason I respectfully disagree with Prof. Gelman. I think we owe the researchers our thanks; I think the only thing they owe us is to keep working. If many more people have been exposed to the virus than we thought (and this study provides data, not "proof") among other things it allows us to ask better, more pointed questions. Did the people who tested positive get the disease (just with mild or no symptoms), and are now immune? Or do they have antibodies because they're actually sick now and, even without symptoms, contagious for others?

For those focusing on the "sketchy" nature of the research (lack of real randomness, etc.), it is worth noting that this is not the only report of findings like this. The Boston Globe reported a similar study in the Boston suburb of Chelsea last week, headlined "Nearly a third of 200 blood samples taken in Chelsea show exposure to coronavirus" Web Link Again, this is information that should be used to help draw conclusions, including the obvious one: more testing.


Pied Piper
Community Center
on Apr 20, 2020 at 2:24 pm
Pied Piper, Community Center
on Apr 20, 2020 at 2:24 pm

Publish garbage. Then don the fig leaf of "not yet peer reviewed" to justify not having used proper analysis on your data. How dumb is that.

Don't they have folks at Stanford that understand statistics, who can give them internal feedback before they embarrass themselves on a global stage?

Maybe that's why it's called the Leland Stanford JUNIOR University.


Another Bob
Community Center
on Apr 20, 2020 at 4:25 pm
Another Bob, Community Center
on Apr 20, 2020 at 4:25 pm

If you don't like the authors' conclusions, you can just look at the facts they present:

--The obtained a certain number of subjects by a certain recruiting method
--They ran the specified test
--They got certain test results.

Stop there! Then draw your own conclusions.


Hmmm
Another Palo Alto neighborhood
on Apr 20, 2020 at 7:57 pm
Hmmm, Another Palo Alto neighborhood
on Apr 20, 2020 at 7:57 pm

Lots of armchair quarterbacks disputing data from reputable universities, Harvard found similar community wide antibodies. Methinks some of you have an agenda.....to tank the economy maybe?


Illuminato
another community
on Apr 20, 2020 at 9:37 pm
Illuminato, another community
on Apr 20, 2020 at 9:37 pm

No one really has any idea about what's going on with this virus thing. Maybe it's deadly, maybe it isn't, maybe you have it, maybe you don't, maybe you are immune, maybe not, maybe it is really easy to catch, maybe not, wear gloves, no, wear a mask, etc. No one knows how long it will last or what comes next. Meanwhile, the Governor is totally in control of the situation. That's comforting.


JB Good
another community
on Apr 20, 2020 at 10:33 pm
JB Good, another community
on Apr 20, 2020 at 10:33 pm

Given that Stanford is I believe, a top 4 medical research facility in the US, I would suggest that their testing and hypotheses are very legitimate, contrary to some comments on this feed. As mentioned by another, more studies need to be done to get a better handle on the real numbers, but it does beg the question: Why do the so-called experts that speak publicly continue the fear mongering by stating such large numbers? Not to diminish any deaths due to any cause, but where are the targeted emotional stories about deaths from the flu or other causes? Never seen this kind of targeted detail of victims.


Resident
Palo Alto High School
on Apr 21, 2020 at 3:41 am
Resident, Palo Alto High School
on Apr 21, 2020 at 3:41 am

Wow! With that high a number, who would want to live, work, or send their kids to school here? Rentals will have to undergo a thorough disinfection. I guess diversity and money to travel has it's downfalls.


C
Palo Verde
on Apr 21, 2020 at 1:02 pm
C, Palo Verde
on Apr 21, 2020 at 1:02 pm

Article written by an ER doctor that anecdotally supports that the infection is more widespread than previously thought, but that it still needs to be taken seriously, at least at the hospital stage. The article does say that "most Covid-19 patients experience relatively mild symptoms and get over the illness in a week or two without treatment." The problem is that it's difficult to diagnose early enough if you will end up on a ventilator. "And once on ventilators, many die." Article then recommends using a pulse oximeter a common medical device, for earlier detection.

"Even patients without respiratory complaints had Covid pneumonia. The patient stabbed in the shoulder, whom we X-rayed because we worried he had a collapsed lung, actually had Covid pneumonia. In patients on whom we did CT scans because they were injured in falls, we coincidentally found Covid pneumonia. Elderly patients who had passed out for unknown reasons and a number of diabetic patients were found to have it. ...

To my amazement, most patients I saw said they had been sick for a week or so with fever, cough, upset stomach and fatigue, but they only became short of breath the day they came to the hospital. Their pneumonia had clearly been going on for days, but by the time they felt they had to go to the hospital, they were often already in critical condition. ...

Patients compensate for the low oxygen in their blood by breathing faster and deeper — and this happens without their realizing it. This silent hypoxia, and the patient’s physiological response to it, causes even more inflammation and more air sacs to collapse, and the pneumonia worsens until oxygen levels plummet. In effect, patients are injuring their own lungs by breathing harder and harder. Twenty percent of Covid pneumonia patients then go on to a second and deadlier phase of lung injury. Fluid builds up and the lungs become stiff, carbon dioxide rises, and patients develop acute respiratory failure.

Web Link


Anon
Another Palo Alto neighborhood
on Apr 21, 2020 at 2:12 pm
Anon, Another Palo Alto neighborhood
on Apr 21, 2020 at 2:12 pm

Posted by Hmmm, a resident of Another Palo Alto neighborhood

>> Methinks some of you have an agenda.....to tank the economy maybe?

My agenda is to avoid having myself and my family get COVID-19, and, if I/we do get it, to avoid passing it on to others. Unfortunately, the number of active cases in California is still growing exponentially, with a doubling time of roughly two weeks. Source: Web Link

Posted by Illuminato, a resident of another community

>> No one really has any idea about what's going on with this virus thing. Maybe it's deadly, maybe it isn't.

It is deadly. 18,611 deaths in New York. 42,094 (at least) deaths in the US. Same source as above. So, maybe you are wondering if the same people would have died of the flu, instead? Answer, "no". The excess mortality has been/is being studied in the UK. You can find a similar picture from a lot of different sources. The difference between now and the previous 5 years is very large: Web Link




CrescentParkAnon.
Crescent Park
on Apr 21, 2020 at 3:38 pm
CrescentParkAnon., Crescent Park
on Apr 21, 2020 at 3:38 pm

An article in the NYT today mentioned that the tests for COVID-19 are only about 70% accurate. I have no heard the accuracy of these tests discussed anywhere except in regard to the fact that no one has said anything about it. They do not seem to say where that accuracy number comes from or whether it is false positives or false negatives.

NYT OPINION:
The Infection That’s Silently Killing Coronavirus Patients
This is what I learned during 10 days of treating Covid pneumonia at Bellevue Hospital.
NYT: Web Link

excerpted -
> All persons with cough, fatigue and fevers should also have pulse oximeter
> monitoring even if they have not had virus testing, or even if their swab test
> was negative, because those tests are only about 70 percent accurate

We need more actual factual true information, and we need more detail. Particularly since this has gotten so political and it would not be unreasonable to fear that there are people out there in positions with the ability to make up or twist facts into pushing people to get back to work and ending up making things many times worse. Even folks from hoity-toity Stanford University.

Meanwhile I see a lot of stores coming in with their own new models of how to do business during this time, and perhaps for the foreseeable future. Calling in with what you need, and collecting and paying for it at curbside pickup.


Agreed
Mountain View
on Apr 21, 2020 at 4:25 pm
Agreed, Mountain View
on Apr 21, 2020 at 4:25 pm

@CrescentPark totally agreed that it’s gotten political. Many using positions to make up or twist facts; masks don’t help/do help, Trump is racist for shutting down travel from China/Trump didn’t shut down soon enough. And the astounding numbers of percentages that mean NOTHING, all conjecture.

It’s all political. On both sides.


Anon
Another Palo Alto neighborhood
on Apr 21, 2020 at 4:57 pm
Anon, Another Palo Alto neighborhood
on Apr 21, 2020 at 4:57 pm

Posted by Agreed, a resident of Mountain View

>> And the astounding numbers of percentages that mean NOTHING, all conjecture.

So, you think it is just "conjecture" that so many people have been dying so fast at the Brooklyn Hospital Center that they have had to stack the bodies into cold-storage trailers?

Web Link

>> It’s all political. On both sides.

Both sides of what? What is "all political"? It is a virus. A lot of people have been dying from it. Latest I know of is former Stanford President Donald Kennedy.

Web Link


CrescentParkAnon.
Crescent Park
on Apr 21, 2020 at 5:52 pm
CrescentParkAnon., Crescent Park
on Apr 21, 2020 at 5:52 pm

Agreed? -- It’s all political. On both sides.

Yes, it is political, and on both sides, but not equally by far. In fact the false equivalency would not be mentioned if it did not benefit Republicans by making them seem normalized. They are not. This is the most corrupt Republican administration in a long line of corrupt Republican administrations.

No, not equally. The Republicans are so far out front in terms of rigging, lying, flip-flopping and grandstanding it hardly makes sense to mention Democrats who mostly seem to be trying to figure out just how to deal with the massive Republican BS operations.


RN
Old Palo Alto
on Apr 21, 2020 at 8:58 pm
RN, Old Palo Alto
on Apr 21, 2020 at 8:58 pm

There has been a lot of fear generated re this virus, but a number of studies around the world, the medical facts and the info listed on the CDC website do not support those doing the fear mongering. The virus has yet to be isolated, but consistently (simple math) has shown the death rate to be well below the flu as well as the recent studies. The CDC recently changed reporting to include any related admission even if normally would not be diagnosed as covid (and even if patient was never tested). CDC site also states the PCR test not specific for covid, but for any virus or any bacteria. Note wearing a mask can harm immune function bc rebreathing. Healthier breathing fresh air. Fear also damages immune function. Protect the elderly and others live freely. Herd immunity has always been the best protection as our natural immune systems build strong cell mediated and humoral immunity. Please note if flu vaccinated, you will be covid positive. Poverty will kill far more than virus.


Mr C.
Downtown North
on Apr 22, 2020 at 10:34 am
Mr C., Downtown North
on Apr 22, 2020 at 10:34 am

To only focus on the SARS-CoV-2 and how virulent it is puts fear in people "rightly so". Having said that I believe the frustration in its comparison with the statistics and influenza is that the media or national leaders didn't react this way with the deaths influenza causes each year. It's not reported case by case, county by county. 2 seasons back 45 million people in the United states had influenza. Can you imagine the fear it would have caused. Of course you can- just look at us now. You should take all of it serious.
Fear and panic come from a primal part of our brain. Makes order reacting a good choice.
I am more troubled with reading the contempt people have for one another, when did we stop loving our neighbors. Really sad that this contemptuous behavior will long be with us well after the virus is gone. Remember one nation under God not every man for himself. Best of luck and health to everyone.


RDoyle
another community
on Apr 22, 2020 at 10:57 am
RDoyle, another community
on Apr 22, 2020 at 10:57 am

There are numerous reasons that the study's result of 50-85X asymptomatic number is implausible, the main being that false positive signals can easily swamp true rare signals. Here are two more: 1) If this were true, then it would be very rare to have multiple symptomatic people in the same household. When one person gets sick, it would result in at most a 2% chance of their partner becoming symptomatic. The couples I know that got sick, both got symptomatically sick, and the families I read reports of being sick, multiple family members in the house were sick. This could be studied. But I think this report is way off.

2) The data on my local health website in (suburban cook county, Illinois) tally the coronavirus cases, and categorize them as related to (1) travel — though nobody travels any more, (2) close contact with a known infected person, and (3) so-called community acquired, meaning they got it from an unknown source such as while out in public. If there really were 50–85X undetected asymptomatic cases, the 3rd category would have a much higher tally, at least 50X more than (2). It is the highest prevalence, but only by a factor of about 5.8 times more than category (2).


Anon
Another Palo Alto neighborhood
on Apr 22, 2020 at 1:08 pm
Anon, Another Palo Alto neighborhood
on Apr 22, 2020 at 1:08 pm

Posted by RN, a resident of Old Palo Alto

>> There has been a lot of fear generated re this virus, but a number of studies around the world, the medical facts and the info listed on the CDC website do not support those doing the fear mongering. The virus has yet to be isolated, but consistently (simple math) has shown the death rate to be well below the flu as well as the recent studies.

You can see the huge spike in deaths in NYC, only the beginning of which is here: Web Link

This article is more in-depth and looks at the excess deaths in England and Wales: Web Link

There is a large number of excess deaths due to coronavirus-- it is quite obvious in the graph in the second article. So, no, this isn't just like the flu.


Agreed
Mountain View
on Apr 22, 2020 at 1:56 pm
Agreed, Mountain View
on Apr 22, 2020 at 1:56 pm

@Anon no it’s not conjecture, NY was hit hard and there are reasons for that. And yep, people have died and a lot more are going to, no getting around it. But you can’t apply their numbers to everyone else which is what has been happening. Hospitals across California are EMPTY, healthcare workers getting laid off in droves.

And @CrescPark, want to comment on how Pelosi is working so diligently to solve issues? Hunkered down in her SF estate? Grandstanding? Because you don’t like what they’re saying it’s grandstanding yet when Cuomo does it’s OK?


Anon
Another Palo Alto neighborhood
on Apr 22, 2020 at 4:19 pm
Anon, Another Palo Alto neighborhood
on Apr 22, 2020 at 4:19 pm

Posted by Agreed, a resident of Mountain View

>> @Anon no it’s not conjecture, NY was hit hard and there are reasons for that.

And I thank Santa Clary County and some other Bay Area governments for trying to get ahead of it here. To a large extent, it worked. New York City did not stay ahead of it.

>> Hospitals across California are EMPTY, healthcare workers getting laid off in droves.

SCC county hospitals are not "empty". Web Link

However, as you know, non-emergency surgery was postponed. Now that it looks like the new infection rate is declining, and, more predictable, they are going to allow non-cosmetic surgery: Web Link

Though, I really wish that hospitals and clinics (like PAMF) were structured better to keep infectious respiratory diseases segregated from other patients. I hope what has been learned from coronavirus is turned into real changes in building layout and in care procedures.


Common sense
another community
on Apr 22, 2020 at 8:46 pm
Common sense, another community
on Apr 22, 2020 at 8:46 pm

two policies – between Lockdown and Non-Lockdown countries and states. The results seem crystal clear already: the Non-Lockdown countries and states have generally out-performed the Lockdown states by the metric of lower deaths per millions.

All of this should beg the question: why did governments from Lockdown states ignore the real science and opt instead for an experimental medieval-style universal-national quarantine approach. Is it possible that mass-panic and rushed Lockdown polices have actually contributed to more unnecessary deaths and collateral damage that could have otherwise been avoided by adopted a more cool, calm and intelligent science-based approach taken by Non-Lockdown countries like Sweden, Japan, Iceland, Belarus, South Korea and Taiwan? What’s more, the Non-Lockdown countries and states have achieved much more favorable results without having to ruin their economies and societies by voluntarily initiating a downward spiral that could end up being hundreds of millions of lives, families, businesses and communities in the process. Indeed, if this was an government IQ test, then clearly thus was an epic fail for panic-driven, reactionary Pro-Lockdown governments.


Scott
another community
on Apr 26, 2020 at 1:37 pm
Scott, another community
on Apr 26, 2020 at 1:37 pm

See below ... Bob posted Incorrectly on Apr 18, "death rate is: 0.0015 percent" ... but .0015 in this case is not a "percentage"(defined as a part of 100 aka Centum" ...it is "one part of 73 per 48K". He forgot or does not know to multiply .0015 x 100 = .15 percent. This allows you to express it as a part of 100 items/people. In other words .15 percent is "one 15th of one percent" ... still a fairly low death rate.


"Posted by Bob
a resident of Downtown North
on Apr 18, 2020 at 12:19 am
If the 48K number of infections is correct and the number of deaths, 73, as of April 17, 2020, is correct than the death rate is: 0.0015 percent which is significantly less than the 0.0390 percent what is being advertised from public health officials and the media.
Web Link


Big D
Menlo Park
on May 12, 2020 at 8:42 am
Big D, Menlo Park
on May 12, 2020 at 8:42 am

I am sure as soon as they finish divvying up the ten TRILLION dollars they are using this pandemic as an excuse to loot, then suddenly this sort of information will get widespread attention.
Until then, do not look for it in the mainstream press.


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