I meant more along the lines of painting graffiti on walls

Still vandalism (I guess "vandalism" must count as a racist term, but until someone claims to be a descendant of the Vandals and speaks up, I'll stick to that term).  There have been protests over here as well (I remain somewhat skeptical of importing problems and fights belonging to other countries, though, dealing with own problems is more appropriate), and there has been grafitti, mostly in the form of writing "racist" on statues of people who lived centuries ago.  For instance, Carl von Linne has become a target, apparently becoming a racist because he in his great classification of all living things also classified humans by skin colour.  The trouble with protests is that they attract idiots and people looking for excuses to act like idiots.

I meant more along the lines of painting graffiti on walls

Still vandalism (I guess "vandalism" must count as a racist term, but until someone claims to be a descendant of the Vandals and speaks up, I'll stick to that term).  There have been protests over here as well (I remain somewhat skeptical of importing problems and fights belonging to other countries, though, dealing with own problems is more appropriate), and there has been grafitti, mostly in the form of writing "racist" on statues of people who lived centuries ago.  For instance, Carl von Linne has become a target, apparently becoming a racist because he in his great classification of all living things also classified humans by skin colour.  The trouble with protests is that they attract idiots and people looking for excuses to act like idiots.

Yes, I see statues of slave traders are being torn down.  In the UK also.  That is a symbolic gesture as you can't change history, but I believe people are sick and tired of honoring those who did so much harm.  I want the name of the FBI building changed because J Edgar Hoover was a noted racist and homophobe (he wiretapped MLK and blackmailed him, just like he did with some presidents) and I believe that would be a good change, because although you cant change history, you can at least stop honoring people who don't deserve it.
I didn't know that about Linne.....classification wouldn't concern me so much, the US had their own people back then who were classifying intelligence on the basis of the shape of the head!  On top of that Hitler got his inspiration from what was going on here at the time.  If we are going to go down that road we should also go after psychologists who considered homosexuality a mental disorder.  That happened as late as the 70s.  Or after the ones who helped the American military torture people during their "war on terrorism" that also resulted in the so-called "patriot act" that started police militarization and the surveillance state during the 2000s.  Or the psychs who were testing torture drugs on mental patients as late as the 80s.   I see the UK has problems with this also, as they usually lockstep with the US on these issues.
I can go on and on lol.  Back in the 40s and 50s a pharma company (now Bristol Squibb Myers) along with the US govt and Johns Hopkins Hospital was intentionally infecting 774 Guatemalans with syphilis via needles and then testing drugs on them (or giving them a placebo)....a 1 billion dollar lawsuit and an official apology from the President was the result.  And what about Johnson and Johnson that were covering up the connection between talcum powder and ovarian cancer- corporate malfeasance (some of it racist or sexist) goes on and on.  At least in that case people stopped using it and the company had to withdraw it from the market.  What about the Flint lead water crisis that seems to have been more widespread than initially thought?  Lawsuits and not using these products are the only solutions.  The US and Brits were testing nukes on indigenous people after WW2 that is also a form of racism, and there are high cancer rates on those islands to this day.  All you can really do is sue them, but you cant change history.  Another one I remember is a surgery tool was renamed after it was found out the doctor it was named for operated on slaves against their will and without anesthesia, to demonstrate to his fellow (white) doctors who were part of the audience.

Yes, I see statues of slave traders are being torn down.  In the UK also.  That is a symbolic gesture as you can't change history, but I believe people are sick and tired of honoring those who did so much harm.

It's nothing new that extremists seek to erase history that they don't like or get offended by, either themselves or behalf of others.  Taliban blew up statues.  The Nazis destroyed books and art by "wrong" people.  These extremists tear down statues because they don't understand history, and history repeats.  Young people are particularly vulnerable to such revolutionary thinking.  To this also belongs the "decolonalisation" of science and knowledge beginning to get foothold amongst university communities around the world.  This is so similar to the kind of thinking and action amongst students of German universities in the 1930's.  The world has seen these things before, but keeps forgetting.

Yes, I see statues of slave traders are being torn down.  In the UK also.  That is a symbolic gesture as you can't change history, but I believe people are sick and tired of honoring those who did so much harm.

It's nothing new that extremists seek to erase history that they don't like or get offended by, either themselves or behalf of others.  Taliban blew up statues.  The Nazis destroyed books and art by "wrong" people.  These extremists tear down statues because they don't understand history, and history repeats.  Young people are particularly vulnerable to such revolutionary thinking.  To this also belongs the "decolonalisation" of science and knowledge beginning to get foothold amongst university communities around the world.  This is so similar to the kind of thinking and action amongst students of German universities in the 1930's.  The world has seen these things before, but keeps forgetting.

The problem is, when such history gets "erased" from memory, it increases the likelihood of it being repeated (this is my slight modification of the famous quote.....I think it applies to what is going on right now.)  We had a similar thing going on post 9/11 when the Patriot Act sought to monitor and control what people were reading.....as a more isolated example, there is a school in Tennessee that banned the Harry Potter books because of their use of "real" witchcraft spells.  The real problem is that it's a slippery slope philosophy that has no limit and ultimately repeats the problems it was seeking to eliminate.  "Erasing" history does not eliminate it, it increases the chances of it being repeated.  How's that for revolutionary thinking

Getting back to the pandemic, I think one of its more useful purposes (besides lowering pollution levels and exposing bad healthcare systems) was exposing extremist right wing nationalist governments such as the one in the US, Brazil and even the UK.  Bolsanaro, whom we all know was an antiscience nationalist bent on burning down the Amazon (for which the UN should have been given the power to intervene militarily, since the Amazon is of global importance) has shot himself in the foot with his poor response to the pandemic.  I was hoping for him to be a casualty to the pandemic, but that wont even be necessary as his own people will probably remove him.  Looking at nations like New Zealand and others with progressive leaders of that type to lead us into the future, and for Darwinism to take care of the right wing nationalists who are relics of the previous century.

COVID-19: Straight Answers from Top Epidemiologist Who Predicted the Pandemic

My dad linked me to this article earlier and I finally got around to reading it. Very good interview, and quite sobering...

COVID-19: Straight Answers from Top Epidemiologist Who Predicted the Pandemic

My dad linked me to this article earlier and I finally got around to reading it. Very good interview, and quite sobering...

Looks like rather than a second wave, there's a second rise going on during the first wave.....the US South and West is experiencing this now.  There's also a lockdown of Beijing!  Sadly, Cuomo isn't doing any more of these daily press conferences after today, but he did mention NYC is probably going into Phase 2 on Monday.  The infection rate is under 1%!  Upstate NY which has gone into Phase 3, has seen a rising infection rate, now at 3%....so maybe we should pause again at Phase 2 and not go beyond that until we have a vaccine.  That means businesses will have to remain at 50% capacity and no indoor dining, etc.  Hair salons will also be at 50% capacity, so it's a good place to be at, I dont think any business should be at full capacity until we have a vaccine.  He also said he might ask travelers from states like Florida, Texas and Arizona to go into self-quarantine for 14 days if they come here...... my, now the tables have turned.  The infection rate in Orlando is now 12%!

How the Virus Won

An excellent New York Times data visualization of how the epidemic spread through the US, and the missteps we made along the way. (A free account may be required to view, all that's needed is a valid email.)

Looks like rather than a second wave, there's a second rise going on during the first wave.....the US South and West is experiencing this now. 

Yes, it is simply a continuation of the first wave, due to lock-downs ending too quickly in many states, particularly as you say in the south and west. An important cause was the reopening of bars and restaurants where large numbers of people were allowed to gather indoors without masks. Many also made the mistake of interpreting reopening to mean "everything is okay now, you can relax and resume business as usual", which of course causes a rebound. We're especially seeing a shift in the demographics of new cases -- it is mostly the younger people who perceive less risk to themselves, not thinking of their obligation to society to help reduce the spread to the more vulnerable.

States in the northeast on the other hand have had remarkable success in gaining control of the virus. They enforced sufficiently strict lock-downs for a long enough time to reverse the curve and reduce the number of new infections to more manageable levels. Just as importantly, as they were doing this, they planned ahead to increase both their testing and contact tracing efforts, so that once they were ready to begin phased reopening, they could track all new cases and their contacts. We know that contact tracing is one of the most powerful tools we have against the spread of a virus, and now the northeast states are able to make this work for them. Not so much in the southern states, where the rates of new infections are now so high that cases are vastly under-counted, and their contacts under-tracked. Being in that position is a desperate struggle.

Many have wondered about the impact of the protests. What we are seeing is that the surges in the US are not well correlated to the protests. Contact tracing is showing us that most transmissions are happening in crowded indoor environments and without mask usage. Transmission is much lower for people outdoors and with masks. Another aspect is that while many people attended these protests, they actually led to more people staying home.

How the Virus Won

An excellent New York Times data visualization of how the epidemic spread through the US, and the missteps we made along the way. (A free account may be required to view, all that's needed is a valid email.)

Looks like rather than a second wave, there's a second rise going on during the first wave.....the US South and West is experiencing this now. 

Yes, it is simply a continuation of the first wave, due to lock-downs ending too quickly in many states, particularly as you say in the south and west. An important cause was the reopening of bars and restaurants where large numbers of people were allowed to gather indoors without masks. Many also made the mistake of interpreting reopening to mean "everything is okay now, you can relax and resume business as usual", which of course causes a rebound. We're especially seeing a shift in the demographics of new cases -- it is mostly the younger people who perceive less risk to themselves, not thinking of their obligation to society to help reduce the spread to the more vulnerable.

States in the northeast on the other hand have had remarkable success in gaining control of the virus. They enforced sufficiently strict lock-downs for a long enough time to reverse the curve and reduce the number of new infections to more manageable levels. Just as importantly, as they were doing this, they planned ahead to increase both their testing and contact tracing efforts, so that once they were ready to begin phased reopening, they could track all new cases and their contacts. We know that contact tracing is one of the most powerful tools we have against the spread of a virus, and now the northeast states are able to make this work for them. Not so much in the southern states, where the rates of new infections are now so high that cases are vastly under-counted, and their contacts under-tracked. Being in that position is a desperate struggle.

Many have wondered about the impact of the protests. What we are seeing is that the surges in the US are not well correlated to the protests. Contact tracing is showing us that most transmissions are happening in crowded indoor environments and without mask usage. Transmission is much lower for people outdoors and with masks. Another aspect is that while many people attended these protests, they actually led to more people staying home.

Wat, you can see this in NY also, where there were/are many protests still going on and it's been more than two weeks since they started and still no surge.  Two reasons why may be more mask wearing and also that they are outdoor events.  Large indoor gatherings, especially with no mask wearing, seem to be closely linked to the states where there are surges.  For some reason, mask-wearing seems to have become a political issue.  I think we are (in a way) seeing climate change policy on an accelerated time scale, and the states that are doing worse in the pandemic are the same ones that are resistant to climate change policy.  It, like mask-wearing, has wrongly become a political issue, where issues that involve science should always be done regardless of politics.

Also of note is that the nations doing worst (new cases per million people) are the nations with authoritarian rulers 1) Brazil 2) US 3) Russia 4) India.

Compare this to nations like Germany, Italy (the former epicenter), and New Zealand, who have all opened up.  All of Europe seems to be in pretty good shape now.

you need to do enough testing to get below 5% for 14 days in a row to be properly managing this pandemic.

Unlike what the science denier in chief says, more testing = a lower infection rate because when you're testing more you're testing more people who are not infected.  With less testing, more than likely most of the people being tested already have it (that's why they are being tested- because they either have the symptoms or were around someone else who has already tested positive.)

As someone who has been following the testing and contact tracing effort in the US very closely, and with growing alarm at how quickly it has fallen apart in many states, I think this rings true.

Rockefeller Foundation National Testing and Tracing Plan 

But how did the US come to this point?  Even 3 million tests per week is a lot, it's 1% of the population every week!  Over here in Norway, things seemed out of control in mid-March, but fairly quickly settled, and testing has been mostly well under 0.1% of the population per week, no face masks, but there was a partial shutdown for a couple of months (schools, restaurants, dentists, but regular stores and malls stayed open - for most people the only things different were cancelled vacations abroad and more work from home).  Population density is likely one critical factor.  The US has many big, crammed cities, Norway does not.  Yet, most of the US is sparsely populated, but many of these areas have been hit (the total US population density is just a little above twice that of Norway).  So there must be more.

But how did the US come to this point?

I think a good way to see what happened in the US is to derive the value of R (the average number of people an infected person transmits the virus to) as a function of time for the US, and compare to other countries. Here's the curve (dashed purple) for the US, as of the 18th:



About four months ago states began shutting down across the US, and we see the effect of this as well as people being more cautious in the plummeting value of R. Initially the value of R was about 2 (each person infecting about 2 more people on average), and our actions dropped it down to about 0.95 at the minimum. We managed to hold R below 1 for about two more months, during which the number of new infections decreased exponentially. This period of decline is deceptive if we look at the cases:



Because of the slow decline of this curve, many people thought our shutdowns were only barely working, and that they would need to be held for so long to drop the infections back down that the economic harm was simply not worth it. But this curve is an illusion. It only shows what we could test. The reality of what was happening shows through more clearly in the deaths, but with a lag:



The deaths are telling us that the first peak was much higher than what we would think from looking at the official cases. If the mortality rate is around 1%, then back in late March and early April, hundreds of thousands of people were being infected every day! Our testing capability was completely overwhelmed, and most of those infections were not detected. Another clue to this is that the percent of tests coming back positive exploded to more than 40% in hard hit areas like New York. When testing is keeping up with infections, the percent positivity is typically only a few percent.

Ok, so the US had a substantial explosion of cases early on, which overwhelmed our testing capability. The lockdowns then started decreasing the number of new infections to more manageable levels, but it didn't really look like it because at the same time our capacity was increasing and we were catching more cases. We were "applying the hammer", and it was working, but we didn't apply it for long enough, at least not everywhere.

Facing growing pressure from the public and the federal government to relax the lockdowns, many states across the south and west proceeded to do so -- far too quickly. Their re-openings pushed R back above 1, and there the exponential growth resumed (some states never really even declined). New cases exploded out of control, hospitalizations rose, deaths increased, and now it's déjà vu. Even with our expanded testing capacity that we have now compared to April, these states' capabilities are still totally overwhelmed. Some lines for testing take 8 hours or more. Return times on those tests sometimes take more than a week. It's absurd, it's insane, and it renders the contact tracing efforts there completely useless.

States in the northeast on the other hand ignored that pressure, followed the science and data, and phased their re-openings slowly and carefully enough to avoid a second surge. Now they are the states with the most control over the virus. They have a low enough number of infections, and sufficient testing and tracing, to manage things without having to roll back to stricter measures.


How does Norway compare? Here's what R(t) looks like there:



The initial value of R in Norway was lower than in the US: about 1.4 instead of 2. Perhaps this reflects a difference in normal social interactions. Norway's lockdown also reduced R to lower levels than in the US: about 0.8 instead of 0.95. Norway experienced faster exponential decay in new infections.

So Norway had a slower rise to a lower peak, followed by faster decline than the US. Norway needed a smaller hammer, and the effect of it was more apparent. I think that's one big part to understanding why Norway did better. It does look like Norway had a brief skirmish with R>1 about two months ago, though that could just be a weird blip in the deaths or the virus happening to find more vulnerable people. Either way, it never really spiraled out of control.


I think the best lesson we have learned from all of this is that the most effective strategy for fighting a pandemic (once it's already spreading within your borders) really is to hit hard and fast with lockdown. If you go for hard lockdown, then although it is painful, it lets you regain control of the situation, especially if you use that time to expand your testing and tracing capability. Then you can relax measures and use the testing and tracing to keep things in check. Whereas if you only take half-measures or focus on trying to reopen things sooner for the sake of the economy, then you paradoxically end up doing more damage. Not only does this cause a resurgence with more sickness and death, but if infections end up rising to the point that it overwhelms your testing and tracing capability, then you might never be able to get control back without resorting to lockdowns again. You end up with more severe disruptions to society for even longer.

Those later R numbers for Norway are significantly higher than what authorities here have been presenting. Early, however, R was assumed to be higher ( >2).  Yet with relatively modest measures it quickly dropped below 1.  One observation is that in Norway nearly half of the cases till date have been amongst people born outside Norway, mostly outside Europe, yet these people make up about 15% of the total population.  Unfortunately, it's become impossible to dig deeper into such numbers these days.  Let's just say that cultural differences might be a factor.  Norwegians culture has mandated social distancing for generations already (on the other hand, it's also considered somewhat rude to talk to others whilst covering your face, so face masks are very rarely used here).

Those later R numbers for Norway are significantly higher than what authorities here have been presenting. Early, however, R was assumed to be higher ( >2).  Yet with relatively modest measures it quickly dropped below 1. 

Indeed, our models and they data they are based on are very different, so I'm not surprised to see significant differences in the derived R(t) curves. I'm using a compartmental SIR model, while what they are doing is far more sophisticated and includes the population structure and movements from cell-phone data. The SIR model is differential equations which are fully deterministic, while theirs is stochastic (which is also nice for providing a natural way to estimate uncertainties). The lower number of deaths in Norway would also imply a greater uncertainty in my derived R(t) for Norway than for the US. Finally, the lag inherent to going by deaths means that my method is blind to changes in the last ~3 weeks, while their fitting to hospitalizations would involve a much smaller lag.

Still, the two methods return something qualitatively similar: R rapidly declining from something bigger than 1 to something smaller than 1, and then wavering a bit. (I do find it reassuring that both show a quick excursion of R>1, if not quite in the same way.) But one convenience of the simpler SIR model is that it can be quickly applied to any country and provide an apples to apples comparison for R(t). 

Probably the greatest flaw in my method is that I assume some underlying infection mortality rate and that it is the same in every country and constant over time. We've already seen that differences in population structure and risk factors will render that untrue, and different components of a population may have different exposure at different times. For instance, in the US the median age of hospitalizations has declined, probably not because of a change in the virus but because of a change in who is getting exposed. We can expect that to correspond to a decrease in the mortality rate, at least for the moment.

Let's just say that cultural differences might be a factor.  Norwegians culture has mandated social distancing for generations already (on the other hand, it's also considered somewhat rude to talk to others whilst covering your face, so face masks are very rarely used here).

Yeah, I think so. It seems to be what the slower initial spread in Norway than in the US suggests, that Norwegians don't have as many close interactions as we do. Or it could be because our largest and deadliest early outbreaks were in more densely populated areas. Maybe both are important. What you say about mask usage there is interesting. In the US I think the majority favor the mask usage, but it's also become a political issue and there is a very vocal push-back against mandating them. At least here in Washington State, we require them to be worn in all businesses, and most seem happy to comply.

the US is too densely populated Wat, that plus we have a very unhealthy lifestyle with regards to food and air pollution levels.

also it doesn't help when people in positions of power say that "we cant let science get in the way of the economy"

But how did the US come to this point?  Even 3 million tests per week is a lot, it's 1% of the population every week!  Over here in Norway, things seemed out of control in mid-March, but fairly quickly settled, and testing has been mostly well under 0.1% of the population per week, no face masks, but there was a partial shutdown for a couple of months (schools, restaurants, dentists, but regular stores and malls stayed open - for most people the only things different were cancelled vacations abroad and more work from home).  Population density is likely one critical factor.  The US has many big, crammed cities, Norway does not.  Yet, most of the US is sparsely populated, but many of these areas have been hit (the total US population density is just a little above twice that of Norway).  So there must be more.

the US is notoriously unhealthy, you noted this before.  Even the rural areas you mentioned dont have access to healthy unprocessed food.  This the pandemic occurred on top of a diabetes and obesity epidemic that was already present.