https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v1

Study finds community presence in one California county to be 50-85x known cases.

That's a lot.

Making the mortality rate somewhere close to that of the flu. Interesting

Um...

"Dr. John Brownstein, an epidemiologist at Boston Children's Hospital and an ABC News contributor, cautioned that the results for the California county are not necessarily representative of the U.S. population and noted the use of online ads to find participants could skew the candidate pool."

To mean anything it needs to be random, not from people who respond to an ad.

Wow. That reads like a legit study, even thought it's just in pre-publication.

Cut that number in half and it'd still be an incredible number. Cut it by 75% and it'd still be a game-changing number.

As someone who's long thought that there were far more asymptomatic cases than were being captured, that type of number would still greatly exceed my expectations.

PJYoung said:

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To mean anything it needs to be random, not from people who respond to an ad.

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LMAO... I agree that it could slant things but you are way out of bounds to suggest that this completely invalidates the results. You don't throw the baby out with the bath water.

how do we think surveys are solicited these days? random selection from a large pool of interested parties - interest triggered by communication via 'advertising'.

do we think we do random surveys using paratroopers with clipboards and random parachute drops into neighborhoods from 60K feet to ensure 'random distribution' of people in a populated area?

PJYoung said:

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To mean anything it needs to be random, not from people who respond to an ad.

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Man, you're really quick to throw water on it as completely useless information. They did attempt to normalize it across geographic and demographic lines.

Let's assume that their method of obtaining participants skews the results a significant amount. I think that's probably a safe assumption. If it doubled, tripled, or even quadrupled the prevalence, it's still a huge number.

early indicators seem to be building that spread is vast. Teddy Roosevelt asymptomatic rate, cruise ship asymptomatic rate, pregnant mother survey (small sample) in MA asymptomatic rate, now this.

i wish we could get random antibody sampling underway at scale - this to me is more important at this point than actual testing. we lack the most basic information on this bug and are making decisions in the dark, three months into the crisis.

I genuinely enjoy this board. So quick to downplay any good news.

At 50x the number is 35 million or roughly 10% of the population

At 20x total infections is 15, million or less than 5% of the population both are a long way from herd immunity

marloag said:

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Making the mortality rate somewhere close to that of the flu. Interesting

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Ouch.

That's not the way these OPs are supposed to work!

Been telling y'all this since the beginning

I have zero doubt that there are more people infected than than the numbers indicate. But the experience in NY says it isn't remotely like the flu numbers wise, and doesn't seem mathematically possible to have that high a multiple given the deaths we see in hard hit places. An average flu season kills 32k or so, NY may get to that by itself or at least get close, with social distancing in place. For comparison, an average flu season in NY should kill around 2-3k people, a bad flu season 6-7k or so. This isn't that. They will find the real numbers eventually, my personal guess based on everything is that it will be just under 1 percent fatal. Way worse than the flu at .1 percent and more contagious so a higher percentage of people are infected, with asymptomatic carriers doing the transmission damage, which will explain some of the discrepancies. But some of the prelim numbers on asymptomatic don't seem to line up to reality on the ground.
Jmo,

Beat the Hell said:

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Been telling y'all this since the beginning

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Your lick thumb, hold up in air opinion doesn't quite hold the weight of a scientific study.

Science has let us down, my friend.

So maybe I was right?

Seriously this makes sense with the California numbers.

Everybody has said mortality rate would be less than case fatality rate, and everyone has known that the number of people that have had the disease is greater, probably far greater, than those that actually took a test and were positive. EVERYONE knew that. No one could pinpoint to what degree without a study. To say you knew what it would be based on a gut feel is hilarious to me. Guessed and were right? OK. And it's still not settled, this is one study, but OK.

marloag said:

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Making the mortality rate somewhere close to that of the flu. Interesting

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We can look to NY to see this clearing isn't like the flu.

We can look to NY? Because that is like the rest of the country? It's not unique. At. All.

Complete Idiot said:

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oragator said:

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I have zero doubt that there are more people infected than than the numbers indicate. But the experience in NY says it isn't remotely like the flu numbers wise, and doesn't seem mathematically possible to have that high a multiple given the deaths we see in hard hit places. An average flu season kills 32k or so, NY may get to that by itself or at least get close, with social distancing in place. For comparison, an average flu season in NY should kill around 2-3k people, a bad flu season 6-7k or so. This isn't that. They will find the real numbers eventually, my personal guess based on everything is that it will be just under 1 percent fatal. Way worse than the flu at .1 percent and more contagious so a higher percentage of people are infected, with asymptomatic carriers doing the transmission damage, which will explain some of the discrepancies. But some of the prelim numbers on asymptomatic don't seem to line up to reality on the ground.
Jmo,

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I would agree, makes me question the accuracy of the antibody test used in this study - except the study includes the results of testing they did on Covid positive and negative subjects to gauge accuracy of antibody test.

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They have some heavy hitters helping lead this study, including John Ioannidis and Jay Bhattacharya. Unlikely to get bad results from these guys.

Complete Idiot said:

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Everybody has said mortality rate would be less than case fatality rate, and everyone has known that the number of people that have had the disease is greater, probably far greater, than those that actually took a test and were positive. EVERYONE knew that. No one could pinpoint to what degree without a study. To say you knew what it would be based on a gut feel is hilarious to me. Guessed and were right? OK. And it's still not settled, this is one study, but OK.

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Fair enough. We shall see.

And it was not a "gut" feeling. I have been doing this for over 40 years. The numbers from California and Washington never made sense. And sure, I could be wrong and stated that from the get go. But I just mentioned a possibility that seems to be more and more likely and got blasted on here.

And it sounds like good news

Sq 17 said:

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At 50x the number is 35 million or roughly 10% of the population

At 20x total infections is 15, million or less than 5% of the population both are a long way from herd immunity

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I think you're missing several key points if you don't think these results would be absolutely game-changers IF they are representative of the larger population.

First, it would mean the virus is exponentially less deadly and less serious than originally thought. It really would be more akin to the flu. We could combat it with many less restrictions than we currently are. It would change everything we assumed we know about the virus and how much of a danger it is.

Second, it would represent substantial progress toward herd immunity. The people who were infected early, which logic would suggest would be those more likely to be more active spreaders, would now be out of the transmission game. And we haven't even played the card of sending kids back to school yet, which is a quick way to build another 10+% of immunity. Significant increases in immunity make everything else easier in combatting this, well before you get to the point of herd immunity.

The combination of much greater infection rate and much lower severity of infection would be about the biggest news we could get next to a vaccine magically appearing or a guaranteed prophylactic treatment that was cheap and widely available.

Honestly, I feel like it's a little too good to be true at this point. But it has me intrigued and excited.

Complete Idiot said:

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Yes, please read the PDF which can be downloaded from the link provided.

The study seems fairly sound and it is great news to read the actual cases could be 50-85 times higher than the amount you actually tested positive (in that county). Documents the limitations and states assumptions.

The study does note that it still represents a very small portion of the population (see below), but definitely the CFR would change as a result of this find (study suggests 0.12-0.2%). All great news and I hope new and larger studies continue to confirm.

We conclude that based on seroprevalence sampling of a large regional population, the prevalence of SARS-CoV-2 antibodies in Santa Clara County was between 2.49% and 4.16% by early April. While this prevalence may be far smaller than the theoretical final size of the epidemic,27 it suggests that the number of infections is 50-85-fold larger than the number of cases currently detected in Santa Clara County. These 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. It is also an important tool for reducing uncertainty about the state of the epidemic, which may have important public benefits.

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If that 0.12-0.2% is correct. The people pulling for this shut down in the government need their asses beat and to be out of a job.

oragator said:

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I have zero doubt that there are more people infected than than the numbers indicate. But the experience in NY says it isn't remotely like the flu numbers wise, and doesn't seem mathematically possible to have that high a multiple given the deaths we see in hard hit places. An average flu season kills 32k or so, NY may get to that by itself or at least get close, with social distancing in place. For comparison, an average flu season in NY should kill around 2-3k people, a bad flu season 6-7k or so. This isn't that. They will find the real numbers eventually, my personal guess based on everything is that it will be just under 1 percent fatal. Way worse than the flu at .1 percent and more contagious so a higher percentage of people are infected, with asymptomatic carriers doing the transmission damage, which will explain some of the discrepancies. But some of the prelim numbers on asymptomatic don't seem to line up to reality on the ground.
Jmo,

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Keep in mind, we don't test everyone for the flu and that test is only 70% accurate. The flu numbers you see and hear about are estimated.

dermdoc said:

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Complete Idiot said:

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Everybody has said mortality rate would be less than case fatality rate, and everyone has known that the number of people that have had the disease is greater, probably far greater, than those that actually took a test and were positive. EVERYONE knew that. No one could pinpoint to what degree without a study. To say you knew what it would be based on a gut feel is hilarious to me. Guessed and were right? OK. And it's still not settled, this is one study, but OK.

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Fair enough. We shall see.

And it was not a "gut" feeling. I have been doing this for over 40 years. The numbers from California and Washington never made sense. And sure, I could be wrong and stated that from the get go. But I just mentioned a possibility that seems to be more and more likely and got blasted on here.

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You were also steadfast in a lot of your opinions 30 days ago that now look laughably incorrect.

So I wouldn't be so quick to pat yourself on the back.