
“It'll all be over by Christmas” (Part 2) - jacquesm
http://www.antipope.org/charlie/blog-static/2020/07/itll-all-be-over-by-christmas-.html
======
atemerev
Here are my observations as an actual epidemiologist:

1) Quarantine / non-pharmaceutical interventions effects start to be visible
after about 2 weeks from their introduction, and are fully effective after 1.5
months.

2) Daily new deaths growth lags from daily new cases growth about a month
(which is somewhat obvious, but needs to be reiterated).

So, unless some new mitigation measures are going to be introduced _right
now_, this record-breaking growth will continue for quite more than a few
weeks, followed by the corresponding growth of deaths a month later. We are
far away from the saturation point and any resemblance of "population
immunity".

~~~
ghiculescu
#2 isn’t obvious to me. Can you explain why?

~~~
mononcqc
The time for symptoms to show up is of roughly 2 weeks but the median time is
at about 6-8 days. After symptoms show up, it takes a while before people get
hospitalized, and then mortality seem to take roughly 21-24 days after
hospitalization.

This means that from the time someone is infected until they die, a month and
a half can have gone through.

By the time you take new isolation measures, you have to wait roughly two
weeks to see if daily infection rates start to vary. But the lethality at this
point, assuming no change in healthcare system overload, can be more or less
statically predicted for weeks after the fact.

Those are called "lagging indicators"; the main thing you try to prevent are
deaths, which you can lower by reducing the overload on the healthcare
systems, which you can lower by controlling infection rates and keeping them
low.

Due to the duration of the disease's evolution, you get to see if your
policies really worked more than a month and a half after enacting them, which
is extremely slow for a disease that propagates at exponential rates. So
people look for proxies like infection rates that are still lagging, but far
less so.

Do note that the one good metric you want in the end is going to be "excess
deaths", which counts the impact of not just the diseases, but of all other
side issues that the disease may have caused. This can usually take months up
to years to properly account and analyze.

~~~
ghiculescu
Yep. That was obvious.

Thanks!

~~~
jacquesm
I don't understand. If it wasn't obvious before then it can't be obvious now.
You've had it explained to you. If it was obvious then that would not have
been necessary.

~~~
s1artibartfast
Sometimes I will look all over for my keys, only to find them in my pocket.
This is the obvious place to check first, but I am not perfect, so sometimes I
overlook it.

------
dcolkitt
For reference, the well-worn anecdote about everyone saying "it'll all be over
by Christmas" at the beginning of World War I didn't actually really happen.

That was a later anachronism, and the phrase "over by Christmas" doesn't
appear until late 1917. It was used as an intentional exaggeration to describe
how those in Britain at the end of the war felt about the decision to enter
the war in 1914.

The reality is that very observers anticipated an "easy" war. Virtually
everybody predicted that the conflict would be the most destructive since the
Napoleonic wars, and collapse the world economy. Overwhelming majority of the
British public and politicians expressed a preference for neutrality. It
wasn't until the Germans marched straight through the heart of neutral
Belgium, and their sheer degree of wanton looting and destruction, that public
opinion turned.

It's very clear that even in 1914 nobody thought it would be an "easy" war.
Germany's Rape of Belgium led Britain, and later America, to reluctantly
intervene. However it's a testament to the sheer scale of carnage in World War
I that even these very dour predictions turned out to be underestimates.

~~~
Stratoscope
> _The reality is that very observers anticipated an "easy" war._

Just for clarity, I think you meant:

> _The reality is that very few observers anticipated an "easy" war._

------
zaroth
I saw something very bizarre yesterday, which seems like it could totally
explain the surging case counts while death rate continues to fall, but I
can’t quite believe it’s really happening.

Apparently since about mid-April the CDC decided that the COVID Case Count
would include not just positive tests, but also “probable” cases.

Probable cases are not like the _Presumptive Positive_ cases we had early on
where a state lab had a positive test but they wanted to confirm it at the CDC
lab.

The criteria for a “probable case” does not require a positive lab test at
all, but simply a combination of symptoms (like a cough or fever) and contact
with another person who themselves was positive or probably positive.

Collin County (6th largest county in Texas) had a council meeting which
included a presentation on this where they walk through the new criteria,
which includes a slide showing how 1 positive lab test can result in the case
count increasing by 17.

Here’s an excerpt from that part of the council meeting;

[https://twitter.com/sav_says_/status/1278090647140995073?s=2...](https://twitter.com/sav_says_/status/1278090647140995073?s=21)

And in case you’re dubious, here’s the whole meeting, and you can scroll to
about 15:25 to see this part;

[https://collincountytx.new.swagit.com/videos/62477](https://collincountytx.new.swagit.com/videos/62477)

~~~
heavyset_go
This is standard. You can fairly well deduce that someone died from CoVID from
their presentation of symptoms, and a CT scan. A test is not necessary to make
that determination, and similarly, it is a waste to test the dead when there
are plenty of people who are alive and presenting symptoms today.

~~~
guscost
This was _not_ standard in [most of] the US two months ago.

~~~
heavyset_go
They certainly were doing this in the NYC area when tests were scarce and the
dead were piling up. People were complaining about it without understanding
the implications then, too.

~~~
guscost
Are you arguing that they have started doing this in other places because
tests are scarce? Because the dead are piling up? Really?

~~~
heavyset_go
Please refer to a few months ago when the dead were piling up in NY faster
than the infected could be tested for CoVID.

------
eagsalazar2
We should all agree to come back and read this thread in 3 weeks and, many of
us, apologize for being completely wrong in our angry, condescending and
ultimately irrational responses, then think deeply about where we were coming
from in this moment.

~~~
jacquesm
It's mostly hope. But hope is not a strategy and never was. The time to
_really_ fix this was early February at the latest. Acting too late in order
to protect 'the market' did more damage to the market than would have ever
been the case if the initial response had been on point. The difference
between the countries that acted immediately, a bit later and much too late is
stark.

------
wayneftw
HTTPS link - [https://www.antipope.org/charlie/blog-static/2020/07/itll-
al...](https://www.antipope.org/charlie/blog-static/2020/07/itll-all-be-over-
by-christmas-.html)

Surprised it didn’t redirect by itself.

------
numpad0
cache:

[http://webcache.googleusercontent.com/search?q=cache:http://...](http://webcache.googleusercontent.com/search?q=cache:http://www.antipope.org/charlie/blog-
static/2020/07/itll-all-be-over-by-christmas-.html&)

[http://web.archive.org/web/20200703132003/http://www.antipop...](http://web.archive.org/web/20200703132003/http://www.antipope.org/charlie/blog-
static/2020/07/itll-all-be-over-by-christmas-.html)

[https://megalodon.jp/2020-0703-2248-09/www.antipope.org/char...](https://megalodon.jp/2020-0703-2248-09/www.antipope.org/charlie/blog-
static/2020/07/itll-all-be-over-by-christmas-.html)

------
seren
This is not a very productive comment, but I really love blogs over twitter
threads, or instagram story, or any other shallow system, even more so when it
is written by a professional writer, with some British humor sprinkled on top
of it.

------
ribs
While the text is pleasantly written and free of noticeable counterfactuals,
it’s just a recounting of what’s happened. It doesn’t provide new insight.

Also, who was being quoted in the title?

~~~
SloopJon
> Also, who was being quoted in the title?

It's from World War I. See this comment on the (flagged) submission of the
last post:

[https://news.ycombinator.com/item?id=22897805](https://news.ycombinator.com/item?id=22897805)

------
SmokeyHamster
>Hydroxychloroquine is a bust (snake oil is about what you can expect from a
snake oil salesman).

Several studies have now confirmed it's beneficial:

[https://www.sciencetimes.com/articles/25658/20200512/hydroxy...](https://www.sciencetimes.com/articles/25658/20200512/hydroxychloroquine-
azithromycin-zinc-triple-combo-proved-effective-coronavirus-patients-
study.htm)

[https://amp.cnn.com/cnn/2020/07/02/health/hydroxychloroquine...](https://amp.cnn.com/cnn/2020/07/02/health/hydroxychloroquine-
coronavirus-detroit-study/index.html)

and the studies "debunking" it's benefits or claiming it's evenbad have been
retracted by their publishers as bad science.

[https://bgr.com/2020/06/05/coronavirus-drug-update-
massive-h...](https://bgr.com/2020/06/05/coronavirus-drug-update-massive-
hydroxychloroquine-study-retracted/)

[https://www.npr.org/sections/coronavirus-live-
updates/2020/0...](https://www.npr.org/sections/coronavirus-live-
updates/2020/06/04/870022834/authors-retract-hydroxychloroquine-study-citing-
concern-over-data)

Why is this so controversial? Hydroxychloroquine's been used for years as a
treatment for Malaria and high altitude sickness, since both of those cause a
decrease in blood oxygen and it helps increase the body's hemoglobin
production.

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7175905/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7175905/)

He's so desperate to Tuck Frump that he's now throwing out good science that
disagrees with his politics? No one, not even Trump said hydroxychloroquine
was a panacea or vaccine, just something that could potentially help that we
were "looking into", and everyone on the left lost their minds.

Edit: To everyone downvoting me, link to proof (e.g. peer reviewed study that
hasn't been retracted) that Hydroxychloroquine has absolutely zero benefits,
and I'll promise to vote Biden. I'll hold my breath...

------
gfodor
A sure sign someone's brain has been addled by partisanship is if they embrace
the idea that certain drugs being researched have a red or blue hue to them.

One output of all this is that those who, for example, reveal their
expectation of HCQ to have been one of 'snake oil' simply due to a Trump tweet
have taken themselves off the field when it comes to rational discourse.

edit: For those down-voting me, my guess is you were not reading papers back
in early February from China and South Korea as I was about early drugs worth
trialing. If your expectations of a given drug's efficacy was informed by
political tweets you weren't paying attention to the trial pipeline.

~~~
saalweachter
> For those down-voting me, my guess is you were not reading papers back in
> early February from China and South Korea as I was about early drugs worth
> trialing. If your expectations of a given drug's efficacy was informed by
> political tweets you weren't paying attention to the trial pipeline.

This is, kind of exactly how snake oil works? It's not even the typical South
Park / "2\. ????" plan.

It's "1\. Take a treatment that people are already credulous towards." "2\.
Sell it for lots of money while pretending it's a sure thing." "3\. Run away
with lots of money before anyone catches on that it's not actually
worthwhile."

The thing with snake oil and real science based medicine is that they both
start with that first step, of grabbing a bunch of things that seem plausible.
The difference is that science based medicine first tests to see if it works
_before_ selling it for lots of money to lots of people as a cure, instead of
after (or never). The initial ideas and plausibility are only occasionally
different; science is a tool for finding a lot of things that don't work, and
a very few that do.

~~~
gfodor
I have no idea what you're talking about. There were medical papers published
out of SK in February indicating preliminary signs that some drugs were worth
investigating. The investigations happened. The results were published.

If you were sitting through that process feeling like you knew which way it
was going to go one way or the other based upon political tweets then you'd
describe it as "snake oil" as the author did, when in fact it was just the
normal, albeit accelerated, clinical research process with a lot of noise from
the bleachers. My own assessment is any scenarios where preliminary data was
less than ideal (eg due to non-randomization) was published in the interest of
sharing information due to the urgency of the crisis to help guide further
controlled trial development. And look, it worked, most of the drugs who had
early papers published with clinical patient data pointing in a positive
direction did in fact get into trials. Unfortunately so far there have been no
home runs but some solid base hits.

The reality is that most of these kinds of things like using the term "snake
oil" to describe HCQ are an obvious "tell" on the part of people who consider
themselves immune to cognitive dissonance and confirmation bias to be anything
but.

------
beervirus
New evidence has been coming out that HCQ + azithromycin is not a bust. Not a
magic bullet, but a very decent mitigation.

[https://www.ijidonline.com/article/S1201-9712(20)30534-8/ful...](https://www.ijidonline.com/article/S1201-9712\(20\)30534-8/fulltext)

~~~
belltaco
That's an observational study, which don't turn to be true all the time. The
randomized controlled trials have shown it's a bust.

~~~
jonhohle
From the author:

> “Our dosing also differed from other studies not showing a benefit of the
> drug. And other studies are either not peer reviewed, have limited numbers
> of patients, different patient populations or other differences from our
> patients.”

~~~
belltaco
Also from the author:

>However, our results should be interpreted with some caution and should not
be applied to patients treated outside of hospital settings. Our results also
require further confirmation in prospective, randomized controlled trials that
rigorously evaluate the safety, and efficacy of hydroxychloroquine therapy for
COVID-19 in hospitalized patients.

The main issue is that retrospective studies like this show promise _all the
time_ and then frequently fizzle out in RCTs. If you're not used to reading
studies they will sound very promising, someone who's been reading studies for
10 years will understand why this and the French studies that started the hype
early on can be very misleading.

------
thedrbrian
Hydroxychloroquine might not be as bust as people thought

[https://www.preprints.org/manuscript/202007.0025/v1/download](https://www.preprints.org/manuscript/202007.0025/v1/download)

~~~
wizzwizz4
I very much doubt that. Certain compounds of zinc are known to help; I bet
that's the effect they're seeing.

~~~
sipior
In fact the paper explicitly discusses (p. 14-16) potential synergistic
effects between zinc and hydroxychloroquine, and provides references to
another study suggesting the same. Care to comment, Doctor?

~~~
imustbeevil
Based on their "risk stratification requirements" it's unclear whether the
majority of "non-HCQ" patients were (d) over 60 with pre-existing conditions
or (e) under 60 with no symptoms, as those seem to be the two groups excluded
from the study. My initial hypothesis, that the paper doesn't mention once
anywhere, would be that they were unable to treat significantly more older
people with pre-existing conditions, leading to the obvious result of those
people being more likely to die.

~~~
sipior
That could very well be true. Do you have any data to back up your initial
hypothesis?

~~~
imustbeevil
I looked through their scientific paper and couldn't find any data about the
demographics of the declined patients. The only information I can find is the
classification of their groups, which seems to exclude the two classes I
mentioned above.

If we assume that the majority of "non HCQ" patients were of group (e), young
people, then their rate of mortality in this paper would be at least an order
of magnitude higher than that of any previous paper, therefor I would expect
group (d), old people with complications, to be more likely to have higher
representation in their "non HCQ" group.

I didn't conduct this study so I don't have access to the raw data not
provided in the paper.

------
jancsika
> To be fair, George Floyd was brutally murdered by the Minneapolis police
> department on May 25th, and the predictive blog entry I'm referring back to
> was posted more than a month earlier.

That's not the only such murder, and it's not the only one caught on video.

If a "predictive blog" isn't based largely on the body of publicly available
past evidence (i.e., history), what's the point of the endeavor?

~~~
brianmcc
It's a predictive blog _entry_ , not a predictive blog overall. He's not some
genius super forecaster like Dom Cummings :-)

He is though successful Sci-Fi author Charles Stross in case you didn't pick
that up from the page, and he's penned some pretty insightful posts in his
time blogging too.

------
SmokeyHamster
>Because the US lockdown didn't really begin to lift until June, the USA is
hitting this secondary surge right now, and some states are trying to lock
down again. Red states with Republican governors who are in complete denial
are getting hit badly, though—notably Texas and Florida.

They really had to get partisan, didn't they? Unfortunately, the data doesn't
support this claim. The fatality rate in both Texas and Florida has been flat
since peaking in April, and their overall number of cases has been just a
fraction of what they are in California and New York. But hey, they're run by
Republicans, therefore we have to call them evil, meanwhile ignore the
thousands of people literally massing in the streets spreading Covid in
Democrat-run states...

[Texas fatality
rate]([https://www.google.com/search?source=hp&ei=gUn_XoLnLJmxytMPu...](https://www.google.com/search?source=hp&ei=gUn_XoLnLJmxytMPupSHsA8&q=texas+covid+fatality+rate&oq=texas+covid+fatality+rate&gs_lcp=CgZwc3ktYWIQAzICCAAyAggAMgYIABAWEB4yBggAEBYQHjIGCAAQFhAeMgYIABAWEB4yBggAEBYQHjIGCAAQFhAeMggIABAWEAoQHjIGCAAQFhAeOgUIABCxAzoFCAAQgwE6AgguOgUILhCxAzoFCC4QgwFQTFjeIWD-
ImgAcAB4AYAB6wGIAeYRkgEGMjAuNC4xmAEAoAEBqgEHZ3dzLXdpeg&sclient=psy-
ab&ved=0ahUKEwjCq__6rbHqAhWZmHIEHTrKAfYQ4dUDCAk&uact=5)).

[Florida fatality
rate]([https://www.google.com/search?source=hp&ei=tEn_XoKrOpesytMPj...](https://www.google.com/search?source=hp&ei=tEn_XoKrOpesytMPjo6HWA&q=florida+covid+fatality+rate&oq=florida+covid+fatality+rate&gs_lcp=CgZwc3ktYWIQAzICCAAyBggAEBYQHjIGCAAQFhAeMgYIABAWEB4yBggAEBYQHjIGCAAQFhAeMgYIABAWEB4yBggAEBYQHjIGCAAQFhAeMgYIABAWEB46BwgAEIMBEEM6BAgAEEM6BQgAEJECOgcILhCxAxBDOgUIABCxAzoCCC46BQgAEIMBOgQIABAKOgcIABCxAxBDUP4BWOsqYOcraAFwAHgBgAGVAogBiRqSAQcxNC4xMS4zmAEAoAEBqgEHZ3dzLXdpeg&sclient=psy-
ab&ved=0ahUKEwiC1bWTrrHqAhUXlnIEHQ7HAQsQ4dUDCAk&uact=5)).

Overall cases are either flat or slightly increasing, as was predicted. The
lockdown was never expected to make Covid go away. Only to ["flatten the
curve"]([https://healthblog.uofmhealth.org/wellness-
prevention/flatte...](https://healthblog.uofmhealth.org/wellness-
prevention/flattening-curve-for-covid-19-what-does-it-mean-and-how-can-you-
help)), e.g. slow down the spread so that hospitals wouldn't get overwhelmed.

~~~
Hello71
this is a joke, right?

[https://www.google.com/search?q=texas+covid+cases](https://www.google.com/search?q=texas+covid+cases)

[https://www.google.com/search?q=florida+covid+cases](https://www.google.com/search?q=florida+covid+cases)

~~~
SmokeyHamster
this is a joke, right?

Cases != fatalities.

A lot of places are doing a lot more testing. That causes case count to rise.
That doesn't mean the disease is spreading beyond control. If it were, the
fatality rate would also be increasing, which it's not.

Sorry, but you're going to have to find some other reason to justify your
partisan hate boner.

~~~
ggggtez
Your data doesn't show testing rate. Maybe it could be true, but your data
doesn't come anywhere close to showing it... And in fact, when we actually
find the data that would prove it, the data shows the opposite. [1]

If you check Florida, you'll see that they actually _decreased_ testing by
22%, and _still_ had an increase in positive cases (over 300%!). Testing less,
and getting more sick people is basically the definition of it being out of
control.

[1] [https://www.propublica.org/article/state-coronavirus-data-
do...](https://www.propublica.org/article/state-coronavirus-data-doesnt-
support-trumps-misleading-testing-claims)

The Governor of Florida is even quoted _in this article_ as disagreeing with
you, and admitting that testing doesn't account for the increase. While he
might not be an expert, it should make you take another look, as this is
politically damaging for him to say his party leader is wrong.

