Airplane ownership CV19

[carusoam]

Six,

Thank you very much for sharing your first hand experience.

Sharing that important knowledge is a core MSer trait.

Thanks again and best regards,

-a-

[DXB]

10 hours ago, DonMuncy said:

One question I have not seen an answer to. When we speak of testing, are we talking about (1) Does the testee have the Corona virus infection, or (2) has he been infected previously. Or will one test tell us both answers. It would seem that prior infection would almost certainly provide some immunity. But would a negative test for an active infection give us any idea of whether any immunity exists now?

Active infection and history of infection require two separate types of tests - these are generally done with detecting viral RNA in the first case and serum antibody in the second.  

Both types of tests have imprecision, making interpretation particulary difficult in populations where the condition being tested is not very common. Then there are multiple flavors of both types of tests - for antibody tests the two varieties were described well by @bradp above.

A negative test for an active infection - does that indictate immunity?  That is a subtle question - as RNA goes down the antibody generally comes up.  The ability of RNA tests to detect infected people starts to decline right after symptom onset, except in the people who will get scary sick in the second week.  The antibody tests (particularly the IgM component) will identify some of those diagnoses in sick people missed by RNA, as will CT scans of the chest. 

Then there is the question of how reflective serum antibody is of immunity, and how much of that immunity is a direct result of the antibody - that answer is coming, but it may some time. The implications for vaccine development are profound.

[DXB]

11 hours ago, PT20J said:

It seems to me that that the debate about staying at home vs opening the economy is a false choice. It's self evident that we cannot bear this level of decrease in economic activity indefinitely, and also that we cannot afford to let the virus restart it's exponential growth. There seems to be widespread agreement that testing is one key component necessary for relaxing restrictions. The whole testing issue is very murky and has become highly politicized with state and federal leaders pointing fingers and making claims and counterclaims. It's not clear to me how to separate the signal from the noise. The answers to three simple questions would help, I think: What testing capability (including kits, labs and supplies) do we need to relax social distancing without undue risk of resurgence?; How close are we now in each State to meeting that criteria?;  When will any shortfalls be remedied?

Recently, dates were added to the IHME model for each state for when infections are projected to drop to 1% per 1-million of the population. This provides possible dates when social distancing could be safely relaxed assuming (according to the researchers) that testing, contact tracing, isolation and limiting gathering size are in place. No one is going to like those dates, but at least it is based on analysis of current data. https://covid19.healthdata.org/united-states-of-america

It seems that economists are a bit behind. I haven't been able to find any good modelling of short- and long-term economic effects COVID-19 under different mitigation scenarios. Any economists here?

Skip

There is indeed an uncomfortable silence in the economics world it seems? Biologists, epidemiologists, and physicians have lots of first principles, emerging data, and knowledge of prior epidemics to wrap their heads around. Even I feel comfortable rendering some basic opinions in this space though infectious disease, epidemiology, and virology have never been my focus.    I wonder if lack of precedent is keeping the best economists from hanging themselves out there.  The key issue seems to be how long can we shut down nonessential business and expect  a V-type recovery or, at the other extreme, the second great depression.  I worry the chance of a V recovery is already long gone. 

[PT20J]

1 hour ago, DXB said:

There is indeed an uncomfortable silence in the economics world it seems? Biologists, epidemiologists, and physicians have lots of first principles, emerging data, and knowledge of prior epidemics to wrap their heads around. Even I feel comfortable rendering some basic opinions in this space though infectious disease, epidemiology, and virology have never been my focus.    I wonder if lack of precedent is keeping the best economists from hanging themselves out there.  The key issue seems to be how long can we shut down nonessential business and expect  a V-type recovery or, at the other extreme, the second great depression.  I worry the chance of a V recovery is already long gone. 

A few papers are being written, but they are highly technical and not very specific from what I’ve read. The biggest problem seems to be lack of good modeling. The economic effects are pretty complex with lots of variables. But the one bit I’ve gleaned is that both supply side and demand side are expected to be disrupted for quite some time. There is a lot of talk in the media about  people wanting to get back to work, but several recent polls show that 60+% of Americans support continued stay at home orders. Here’s the latest https://apnews.com/9ed271ca13012d3b77a2b631c1979ce1.
Fox News got similar results in polls in Michigan and Pennsylvania https://www.foxnews.com/politics/fox-news-poll-april-18-21-2020-michigan. https://www.foxnews.com/politics/fox-news-poll-april-18-21-2020-pennsylvania. I’ve seen other polls with similar results. 

I suspect this means that workers will not return  en masse  even as restrictions are eased until they feel safe, and any subsequent uptick in death rate may scare them back to their homes. But, time will tell. I have no idea how an economist would account for this behavioral aspect in an economic impact model.

Skip

[JBear]

I am a immigrant from Taiwan and live in the States for almost 30 years.  Therefore, I have access to Mandarin speaking news from friends and families.  Taiwan has a democratic government and becomes the model of fighting CV19.  This 24 million people nation (live in 19K sq miles island) was originally estimated to be the second highest risky place from CV19 pandemic in the early this year because it's not far from the mainland China and it had daily flight to Wuhan city until Feb 6, 2020.    If you follow the news you know so far Taiwan have merely less than 400 people infected and only 1 death.

Taiwan is excluded from WHO because of China's influence (and ICAO,....etc.).  When the government sent 2 doctors to Wuhan in December 19 when they heard a rumor, they immediately know something's going on.  They sent warning letter to WHO but being ignored.  Taiwan activated the pandemic prevention act  (passed the legislation after SARS) on Jan 5 by detecting people's temperature on every airport and enforce self quarantine at home for the suspicious cases.

Enough of the detail.  You might ask, what's the condition today in Taiwan?   There is no lock down and most of the businesses are still open.  But there is wearing face mask enforcement in the public transportation system and going to the hospitals.  There's social distancing rule.   Despite all the restaurants and businesses are still open and everyone goes to work, it still impact the service industries very bad.   From the interviews I watched, there's about 40 to 50% decrease in restaurant businesses.

Here is a case happen 3 days ago in Taiwan.  Please think about it if you like to take this kind of "privacy lost during abnormal time"?
There was a warship returned from a 30 days mission several days ago.  Taiwan DOD did not check the soldiers' well being and allow them to go home.  And it turned out there're 30 confirmed cases and 70 suspected cases among the sailors.    About 2 days ago, there're 200,000 people in Taiwan receiving a text message saying that they might be in the closed proximity of these sailors in the past several days. Just take extra caution if they felt unwillingness, they can call the CV19 hotline 1922 for the help (Taiwan has the world best healthcare system and the full healthcare insurance).     The data was derived by the big data collected by the wireless providers and was promptly used to derive the resulting cellphone numbers for sending the text message.  TV news immediately questioned the president about the encroachment of the privacy.  President's response was "Because of the emergency situation, the information was used due to the abnormal time.  Taiwan has the pandemic legislation currently in effect which authorizes the head of CDC make such decision to use this data.".   And later survey shows the citizen approves this as people rather receive this text message than implement a lock down, which impact the freedom and economy greatly.

I agree we should do it here if that's an option.  Anyway the wireless providers already have the same data of our where-about if you carry a cellphone. (That's how they can send the calls to you while you moving around).  But there's an on-going development in the US better than using the cellphone data and sending the text messages; I heard Apple and Google are building a Bluetooth warning app in their cellphone O/S.  When one near a known CV19 patient,  the cellphone will provide a warn without reveal your personal identity or the patient's identity.  I hope this invention can deploy soon and help to restore our normal life.  But again, do you really think your where-about is not collected when you carry a cellphone?  I am not saying we should give up our rights but instead, we should use it smartly in situation like today.  Google and Apple actually already have your data all the time and they sell to their affiliates.  Instead of selling to affiliates without my consent, I rather use it to protect my freedom to go out, my freedom to work and protect the economy.

My $0.02

 

[Shadrach]

7 hours ago, DXB said:

Active infection and history of infection require two separate types of tests - these are generally done with detecting viral RNA in the first case and serum antibody in the second.  

Both types of tests have imprecision, making interpretation particulary difficult in populations where the condition being tested is not very common. Then there are multiple flavors of both types of tests - for antibody tests the two varieties were described well by @bradp above.

A negative test for an active infection - does that indictate immunity?  That is a subtle question - as RNA goes down the antibody generally comes up.  The ability of RNA tests to detect infected people starts to decline right after symptom onset, except in the people who will get scary sick in the second week.  The antibody tests (particularly the IgM component) will identify some of those diagnoses in sick people missed by RNA, as will CT scans of the chest. 

Then there is the question of how reflective serum antibody is of immunity, and how much of that immunity is a direct result of the antibody - that answer is coming, but it may some time. The implications for vaccine development are profound.

Earlier in this thread you mentioned false positives, but made no mention of false negatives. Are false positives a more prevalent error in antibody testing?

These are the statistical comparisons for PCR vs IgM/IgR that I’ve seen.

Edited April 23, 2020 by Shadrach

[afward]

7 hours ago, DXB said:

There is indeed an uncomfortable silence in the economics world it seems? Biologists, epidemiologists, and physicians have lots of first principles, emerging data, and knowledge of prior epidemics to wrap their heads around. Even I feel comfortable rendering some basic opinions in this space though infectious disease, epidemiology, and virology have never been my focus.    I wonder if lack of precedent is keeping the best economists from hanging themselves out there.  The key issue seems to be how long can we shut down nonessential business and expect  a V-type recovery or, at the other extreme, the second great depression.  I worry the chance of a V recovery is already long gone. 

A good economist is also a good psychologist...  One cannot forecast human behavior without understanding the human decision-making process.  And not just everyone has been trained to have or consistently use a good process.  In any case, I think the economists are in a bit of a bind because the human factors really aren't well-understood enough to be up to the task.

But to the point of recovery, I think it really depends on the actions of those who were financially secure during the duration of the lock-down: If we continue to hold back, recovery will be slow or non-existent.  If we return to normal or even elevated spending levels (especially if we choose local businesses and US-made products), recovery will be assured (though it may not be rapid).

No, I didn't stay at a Holiday Inn last night...  Take it all with an appropriate grain (boulder?) of salt.

[AH-1 Cobra Pilot]

1 hour ago, afward said:

A good economist is also a good psychologist...  One cannot forecast human behavior without understanding the human decision-making process.  And not just everyone has been trained to have or consistently use a good process.  In any case, I think the economists are in a bit of a bind because the human factors really aren't well-understood enough to be up to the task.

But to the point of recovery, I think it really depends on the actions of those who were financially secure during the duration of the lock-down: If we continue to hold back, recovery will be slow or non-existent.  If we return to normal or even elevated spending levels (especially if we choose local businesses and US-made products), recovery will be assured (though it may not be rapid).

No, I didn't stay at a Holiday Inn last night...  Take it all with an appropriate grain (boulder?) of salt.

I think you could economize on your use of words.  i.e.  "One cannot forecast human behavior without understanding the human decision-making process."

[afward]

Just now, Ah-1 Cobra Pilot said:

I think you could economize on your use of words.  i.e.  "One cannot forecast human behavior without understanding the human decision-making process."

Fair point.

Personally, I subscribe to the incentives model of economic theory, which is one of the simpler approaches (though it also suffers from lots of hidden variables, too).  It does, however, let us make some generalized statements about what people will do and be more right than wrong.  And really that's what I was getting at with the "understanding the human decision making process."

Note that there are economists that disagree with the incentives model, largely on the basis that it's too simple to accurately model anything.  I can't discount that, though I've found in my career (not in economics!) that the KISS theory usually provides the cleanest and most useful result.

[DXB]

2 hours ago, Shadrach said:

Earlier in this thread you mentioned false positives, but made no mention of false negatives. Are false positives a more prevalent error in antibody testing?

These are the statistical comparisons for PCR vs IgM/IgR that I’ve seen.

False positives and false negatives are inherent flaws of the tests to similar degrees I think, based on both the sensitivity and specifity numbers I've seen being in the 90-95% range  - these are the ways to measure the quality of a test in absolute terms.

We have been talking about is positive predictive value (PPV) - chances a positive test is true.

You are now asking about negative predictive value (NPV) - chances a negative test is true.

NPV and PPV numbers are linked to sensitivity and specificity but also are  also exquisitely sensitive to the frequency of the condition being tested in the specific population being considered - the more common the condition, the better the test performs.  

In an unselected random population in the US, NPV will be much better than PPV because there are many more true negatives out there right now (whether it's active infection or antibody you are testing) than there are true positives. But remember, if your population is the ICU at Bellevue Hospital in Manhattan, the opposite will be true, and you will be much more vulnerable to false negatives. i.e. NPV will plummet. And you can imagine every population between these two extremes generating a wide range of test performance. 

BTW never has there been a time when these considerations are more relevant to the general public. Pretty soon all of us will have access to a lateral flow immunoassay that looks like a pregnancy test. We will prick our finger, put a drop of blood on it, and get an answer.  Even if that test is of top quality, most people will put too much confidence in that answer because they don't grasp the predictions of Bayes' theorem.  This guy explains it better than I ever could.  If you're going to get into the test business, it may be worth a deep dive.

I'm also tempted to tell you about how test predictive value likely changes dramatically for a single individual during the multi-week course of an infection, but we'll save it for another day 

 

[AH-1 Cobra Pilot]

7 hours ago, JBear said:

Please think about it if you like to take this kind of "privacy lost during abnormal time"?

 

Once you set the precedent, you will never be able to stop it.  There is a big difference between a private company having some of my data, (What will they do with it?  Send me more ads?  BFD.) and a government agency having my data.  We have seen our share of tin-pot dictators arise lately.  (Anyone here in Michigan?  Not only can Home Depot not sell you paint, but you cannot even walk down the paint aisle.)  I do not worry about the stated reasons about tracking my movements, (such as disease prevention), it is always the unstated future "reasons" I worry about.

[Shadrach]

Just now, DXB said:

False positives and false negatives are inherent flaws of the tests to similar degrees I think, based on both the sensitivity and specifity numbers I've seen being in the 90-95% range  - these are the ways to measure the quality of a test in absolute terms.

We have been talking about is positive predictive value (PPV) - chances a positive test is true.

You are now asking about negative predictive value (NPV) - chances a negative test is true.

NPV and PPV numbers are linked to sensitivity and specificity but also are  also exquisitely sensitive to the frequency of the condition being tested in the specific population being considered - the more common the condition, the better the test performs.  

In an unselected random population in the US, NPV will be much better than PPV because there are many more true negatives out there right now (whether it's active infection or antibody you are testing) than there are true positives. But remember, if your population is the ICU at Bellevue Hospital in Manhattan, the opposite will be true, and you will be much more vulnerable to false negatives. i.e. NPV will plummet. And you can imagine every population between these two extremes generating a wide range of test performance. 

BTW never has there been a time when these considerations are more relevant to the general public. Pretty soon all of us will have access to a lateral flow immunoassay that looks like a pregnancy test. We will prick our finger, put a drop of blood on it, and get an answer.  Even if that test is of top quality, most people will put too much confidence in that answer because they don't grasp the predictions of Bayes' theorem.  This guy explains it better than I ever could.  If you're going to get into the test business, it may be worth a deep dive.

I'm also tempted to tell you about how test predictive value likely changes dramatically for a single individual during the multi-week course of an infection, but we'll save it for another day 

 

Thank you Dev.  I will take Bayes' Theorem plunge.  I suppose this boils down to no data verses flawed data. I'm sure someone smarter than me could calculate the accuracy level at which somewhat data become more useful than none in a particular population. 

Anecdotally speaking,  just in my sphere of influence I know a significant number of people that were hit with sever cold and flu symptoms early in the year.  Extreme fevers (by adult standards) and dry cough are consistent across the group.  Some had sore throats, some developed pneumonia (I did for the firs time in my life).  There are a number of people that believe they've had the disease.  I understand the concerns about people putting too much confidence in a test but over time there is no doubt in my mind that we're going to see some people doing the same with self diagnosis.  Some of them may even be correct.  The bottom line is that people under duress will convince themselves of whatever is needed in order to avoid financial ruin.  The economy is still a ways off from that but it's only going to get more dire if we remain in lock down.  

[BorealOne]

Great discussion on this thread, and as Anthony notes, an informed and thoughtful one - which is rare in these troubled times. 

While the virus doesn't do politics or economics, it does create new conditions for both.

<speech on> As a lawyer working at the intersections of resource development, constitutional and public law in Canada, I'm seeing daily evidence that our existing legal orders are being challenged in the current crisis in unprecedented ways. If anything is clear - we'll need both an informed and enlightened leadership (not just politicians, but at all levels of society) and an informed and altruistic citizenry to navigate this crisis. I don't think that we can say with any confidence that those conditions exist, but at least in a democracy, we have to the option create them. We can be moved by the angels of our better natures, and work to protect each other while maintaining the foundations of our many rights and freedoms. I think we all recognize that in any functioning society, no right is absolute, and that in many cases, our individual liberties must necessarily give way to protecting our fellow citizens from harm. In an emergency, those imperatives are greater. At the same time, we must hold those who are in power accountable for their decisions by insisting on transparency and best evidence to inform policy, and equally, be vigilant against misinformation and on guard against those who would use the present crisis to further their own ends. <speech off>

For more and much more eloquent thoughts in a similar vein, I'd recommend this piece by historian Yuval Noah Harari in the Financial Times of London as he weighs the impacts and benefits of using surveillance technology to fight the virus. He argues that we can have freedom, privacy and health - but it will require much more of all of us and our institutions.

https://www.ft.com/content/19d90308-6858-11ea-a3c9-1fe6fedcca75

[bonal]

For many years we loved to listen to and watch Carl Sagans account of the vastness of the universe with billions and billions of galaxies. This was a number most people could not get their heads around. Well now with the Covid stimulus and relief bills we finally have a workable comparison 

Edited April 23, 2020 by bonal

[PT20J]

32 minutes ago, bonal said:

For many years we loved to listen to and watch Carl Sagens account of the vastness of the universe with billions and billions of galaxies. This was a number most people could not get their heads around. Well now with the Covid stimulus and relief bills we finally have a workable comparison 

Deficits when I was a kid.

[bonal]

Spelling corrected 

[MooneyMitch]

Wow!!! Congress just passed another stimulus bill....... I’m curious, just how much money does the Federal Government really have anyway??? 

[David_H]

44 minutes ago, MooneyMitch said:

Wow!!! Congress just passed another stimulus bill....... I’m curious, just how much money does the Federal Government really have anyway??? 

I was under the impression that these were interest bearing loans... to be paid for by the future labor of citizens of the United States.

[Eight8Victor]

Have any of you business owners gotten any of the PPP money? None of my customers (small business owners) have received anything. I applied three weeks ago and nothing. Just curious.

[chrisk]

On 4/22/2020 at 5:56 PM, M016576 said:

Because it’s a different circumstance.  During involuntary servitude, one is compensated for their work, despite the “involuntary” part.  The same cannot be said for slavery.

thinking of being impressed into service aboard British warships in the 17-1800’s.... or if you’ve ever “Sea Wolf” by Jack London... great examples there.

And being drafted is some how different than " being impressed into service aboard British warships in the 17-1800’" ?  My point was: the "involuntary service" wording was included as a consequence of the first American draft that occurred during the civil war.   Something that courts in the 1900's seemed to ignore

 

[Shadrach]

https://www.cnbc.com/2020/04/22/no-lockdown-in-sweden-but-stockholm-could-see-herd-immunity-in-weeks.html
interesting read.

[Ross Taylor]

1 hour ago, Eight8Victor said:

Have any of you business owners gotten any of the PPP money? None of my customers (small business owners) have received anything. I applied three weeks ago and nothing. Just curious.

Not us. And to my knowledge, no business in Flagstaff has (I've asked our local Small Business Development Council, too). But at this point, I'm not sure we'd want it. Since we are a restaurant and unable to offer dine-in service, it doesn't make much sense to hire back servers and bartenders and staff.

Did you read the article about the lady who owns two spas and she got over $200,000 through this program, but her staff was upset because they were enjoying the paid time off...

[PT20J]

2 hours ago, Eight8Victor said:

Have any of you business owners gotten any of the PPP money? None of my customers (small business owners) have received anything. I applied three weeks ago and nothing. Just curious.

This may explain it. https://www.cnn.com/2020/04/21/business/small-business-loans-ppp-lawsuit/index.html

[bradp]

12 hours ago, Ross Taylor said:

Not us. And to my knowledge, no business in Flagstaff has (I've asked our local Small Business Development Council, too). But at this point, I'm not sure we'd want it. Since we are a restaurant and unable to offer dine-in service, it doesn't make much sense to hire back servers and bartenders and staff.

Did you read the article about the lady who owns two spas and she got over $200,000 through this program, but her staff was upset because they were enjoying the paid time off...

I saw the article.  Between state and federal unemployment insurance the employees were making more on unemployment.  The threshold depends on how restrictive the states unemployment insurance program is, but somewhere between 30-70k annual salary, below which you’re making more not working. Unlikely she was paying a living wage for the area.  Many spas only employ a few front end workers with the majority independent contractors essentially providing a cut to the company for use of the space.  

[Yooper Rocketman]

On 4/23/2020 at 10:26 AM, Ah-1 Cobra Pilot said:

We have seen our share of tin-pot dictators arise lately.  (Anyone here in Michigan?  Not only can Home Depot not sell you paint, but you cannot even walk down the paint aisle.) 

Yep, and you can't go fishing in a boat with a motor on it.  Her reasoning, you will have to go to the gas station and buy gas and that's an infectious place.  (And all the snowbirds driving back from Arizona this year bought a $2 box of glad sandwich bags to use over their hands gassing up their vehicles and threw them away when done).  My fishing boat motor gets the tank filled once a year, and was filled last fall with Stabil.  We mostly troll with the electric trolling motor.   I might need gas by ....... October.  We need sanity to this.

My wife and I voluntarily self quaranteen'ed  for two weeks when we returned from our Florida home (3 weeks ago).  She had time to work on interior projects, one of which was painting.  Nope, can't buy paint.  Now we COULD drive to Green Bay and get some, but not really practical.

I established a complete protocol at my truck dealership WELL before any lock downs were happening in the country.  I had two employee meetings, broken down by departments and people size, where I could establish the 6 foot distancing.  Everybody looked at me like I was nuts as I pointed where each of them should stand in an open area we were having the meeting.  The concept was nothing they had heard of at that time (7-8 weeks ago).  I went over ALL the CDC recommended policies to keep our people and facility safe.  I was probably the first business in the area outside of the hospital and nursing homes to implement these policies.  A few weeks later I flew to Florida and the Michigan Stay at home order was implemented 3 days after I left.  I had numerous manager meetings, updating and changing policies as necessary from Florida by conference call.

So, two weeks out of my business drove me nuts.  I had no way to ensure safe practices I had implemented were being practiced (we are dealing with employees here, right).  My first day to return to work was last Friday.  After two hours in my office I decide to walk around my dealership (25,000 SF Facility) and within 2 minutes, spot two guys shoulder to shoulder talking, nothing that couldn't have been done 6 feet apart.  I immediately call them out on it.  I walk through the dealership and within 5 minutes, I see the same two, now out on the shop floor, guess what, standing shoulder to shoulder looking in a tool box.  Now I'm pissed.  I call out the one, my LONGEST TIME employee, and he throws his hands up and walks out of the dealership. 

We are an essential business to the transportation industry.  We fix governmental plow trucks, wreckers, log trucks (supplying pulp for toilet paper), ambulances, fire trucks, trucks hauling gasoline and food products.  I CAN'T have this virus go through my dealership.  I have no more issues with distancing or masking up when two need to complete a project close to each other.  The choice is that or masks on for their entire shift, and that's not likely to happen since they HATE THEM.

So now, Michigan's governor is looking at a continued lock down.  We'll see if the U.P. is included, but clearly one blanket doesn't fit all.  There are 16,377 square miles in the U.P., with 311,000 residents. That is 20 people per square mile.  Considering couples and families under one roof, that's probably 6-7 residences per square mile.  Just for those not familiar with "land", that's around one residence per 100 acres.  Now I know we have "cities", and those folks are closer, but social distancing is working fine here.  Our U.P. legislators have been literally begging for a more reasonable policy in the U.P.  Currently we have 65 confirmed cases.  At the "published normal flue infection rate" our 311,000 residences would normally see 311 cases (.1%) .  We would need 5 times the current COVID-19 infection rate to even meet normal flu rates.

Further lock down in Detroit and a few other hot spots in the lower peninsula clearly make sense.  In the U.P. ........  I will tell you; "THE NATIVES ARE GETTING RESTLESS".

Okay, off my soap box.

Tom

Correction.  There’s been 65 documented cases, BUT 11 Fatalities.  We would need the fatality count to increase by 30 times to match the normal flue fatality rate.