
In 4 US state prisons, 3,300 inmates test positive, 96% without symptoms - throwaway888abc
https://www.reuters.com/article/us-health-coronavirus-prisons-testing-in/in-four-u-s-state-prisons-nearly-3300-inmates-test-positive-for-coronavirus-96-without-symptoms-idUSKCN2270RX
======
jwlake
One of the super-interesting things here, is that apparently everyone was in
the specific window where they test positive for the virus. This implies the
population was recently infected, had not been previously infected, and it
spread almost completely within a tight window.

This implies a shocking high R(effective) for that population. In 2 weeks
we'll have super interesting data one way of the other on the CFR.

~~~
danieltillett
A prison is very much like a cruise ship from a viral perspective. We know
from the cruise ship data like the Diamond Princess that most people had no
symptoms initially, but overtime most people became symptomatic [1].

Of course if we are really lucky and the prison was infected with a naturally
attenuated strain we should make use of it [2].

1\.
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078829/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078829/)

2\. [https://www.tillett.info/2020/04/12/how-would-a-search-
for-a...](https://www.tillett.info/2020/04/12/how-would-a-search-for-a-
natural-attenuated-sars-cov-2-strain-work-in-practice/)

~~~
Fjolsvith
> A prison is very much like a cruise ship from a viral perspective.

Prisons are much worse. Chow line with men almost heel to toe. Commissary
line. Med line. Recycled air. Big crowds in small spaces.

~~~
dotancohen

        > Prisons are much worse. Chow line with men almost
        > heel to toe. Commissary line. Med line. Recycled
        > air. Big crowds in small spaces.
    

How could the prison be much worse than the cruise ship you just described?

~~~
Zhenya
OP is describing a prison.

~~~
davidbanham
That's the joke.

------
finolex1
To add another data point, Singapore has been testing foreign workers living
in dormitories extensively, uncovering about 10,000 cases (about 80% of the
country's total cases). These are relatively fit individuals between the ages
of 20 and 40. However, the number of people in the ICU has remained remarkably
consistent at about ~20 people in the past 10 days (Fingers crossed it remains
that way).

[https://www.moh.gov.sg/news-highlights/details/46-more-
cases...](https://www.moh.gov.sg/news-highlights/details/46-more-cases-
discharged-618-new-cases-of-covid-19-infection-confirmed)

~~~
reddothomme
Many migrant workers in Singapore are the only breadwinners for their families
back home in Bangladesh/India/Myanmar. One of the reasons the Singapore
government has done extensive testing way beyond global standards is that many
of these foreign workers are financially disincentivized to seek medical help
the moment the first symptoms appear. The fact that Singapore's leader has
publicly promised stable incomes for this affected group speaks volumes of the
government.

As a fellow south east asian, I am deathly afraid of the under-reporting and
testing in other ASEAN countries. Singapore. A 2017 statista study of migrant
worker populations in South East Asia
([https://www.statista.com/statistics/711513/asean-number-
of-m...](https://www.statista.com/statistics/711513/asean-number-of-migrant-
workers-by-country/)) shows that Malaysia and Thailand have much larger
migrant worker populations than Singapore. Their living conditions are either
on par or worse than the ones living in Singapore, yet there are apparently no
Covid-19 clusters among migrant populations in other ASEAN countries. This is
extremely alarming.

~~~
_-___________-_
It would be _extremely alarming_ if there were large numbers of deaths or
hospital admissions occurring among the Singapore workers who are testing
positive. Given that there are virtually none, the lack of testing in other
ASEAN countries is hardly _extremely alarming_. A lack of data is less
concerning if you wouldn't do anything differently if you had the data.

~~~
bob33212
If it turns out that the infection rate is higher and the death rate is lower
for healthy individuals than originally estimated it would be extremely
alarming that were are not taking a totally different approach to handling
this pandemic

~~~
_-___________-_
agreed.

------
ivanhoe
I've read that asymptomatic carriers are though to be less infectious than
those with symptoms because of the lower concentration of virus in the saliva.
Also, many virologists mentioned in recent texts that the initial
concentration of the virus you receive can affect how sick you'll get - the
more viruses you're exposed to, the faster they can invade the body and the
more severe it will get.

Can those two facts be combined into a theory that asymptomatic carriers are
more likely to produce more mild and asymptomatic cases?

Don't know if it makes any sense (probably not), but it would certainly
explain how in some closed environments there's a prevalence for mild cases,
while in others there's a plenty of very sick people, regardless of the age.

~~~
jbritton
I have been wondering about the effect of the degree of initial infection. I
kind of assume the virus grows exponentially inside the body and would dwarf
the initial constant. If a low initial dose affects the severity of the
disease, I think that would be incredibly useful to know. I also wish there
was info on percentage of infection via fomites vs inhalation.

~~~
fermienrico
I think it’s the opposite. The initial conditions have a profound effect on
the exponential nature of the growth. Half the dose could mean that your
immune system can suppress it. There is probably critical rate at which both
growth rates match.

~~~
fermienrico
I don't think my response is 100% correct. The rate of change (derivative) of
an exponetial function is another exponential function. d/dx(2^x) =
(2^x)*ln(2). And if the base is e, then d/dx(e^x) = e^x.

~~~
fermienrico
Yo people, I don't understand why my statements are correct - please someone
with a math background or an epidemiologist comment here, I suck at math and I
don't understand how these growth rates compare. My comment is being upvoted
but it may not be true.

~~~
klmadfejno
The math is a simplification of a biological process that is highly variable
and poorly documented. Your original idea is a fine hypothesis, though the
suitability of the params behind exponential growth is mostly irrelevant.

~~~
jl2718
We’re learning a lot about virology during this time. Infection and immunity
are not binary, and now we have enough data to recognize that. We will also
learn a lot about mutation, things like carrier recombination. I think this
will change everything about how we attempt to control things through
vaccination.

------
marcell
I've been tracking the antibody study results in a spreadsheet, and they are
suggesting a 10-20x undercount of cases in the official "confirmed" numbers.
You can see the data I've collected here:
[https://docs.google.com/spreadsheets/d/16onEUBWIV5IqN1RCvTla...](https://docs.google.com/spreadsheets/d/16onEUBWIV5IqN1RCvTlad1jnQZ9W7p_P_yS-0D6j1-8)

~~~
cies
I did similar calculations, and found the institutions in charge give us very
unreliable data. The term "corona case" is very, very, ambiguous and cannot
the understood as such without a detailed explanation on how the counting was
done.

Thanks for sharing.

I found the peek in all-case mortality also very interesting, because that way
counting is much more unambiguous: dead is dead.

They showed a clear diversion from the "average" in recent weeks, but... they
did not show the stdev for the averages. Finally I found a chart that shows
that "outliers" are not uncommon.

[https://imgur.com/IPNiXRe](https://imgur.com/IPNiXRe)

~~~
bobongo
> because that way counting is much more unambiguous: dead is dead

Unrealistically low death stats coming from Turkey compared to cases easily
refute that argument.

Dead is dead, unless the state finds a way to claim that it was not a COVID19
dead.

~~~
krisoft
No. Not unless. You misunderstand what all cause mortality means. The state
can count COVID19 deaths as all bungee-jumping related the number still shows
up in the total death rate. If you know what is the usual statistic you can
show if there is an effect.

This is what “dead is dead” mean. One can argue what should count as a COVID19
case, and how exactly we are counting. There is a lot less argument over who
is dead and who is not.

~~~
bobongo
> You misunderstand what all cause mortality means.

It seems I actually missed the mention of "all-cause" while reading the
comment.

------
ineedasername
News articles from around April 10 indicate that mass testing hadn't begun, or
was just beginning (1 example here [0])

Reporting on 96% without symptoms is misleading without mentioning this: It
gives the impression that the # of coronavirus infections could be up to 24x
higher than the known positives cases. But symptoms can take 2-14 days to
develop, meaning it is entirely too soon to tell if these are all asymptomatic
cases, or merely pre-symptomatic.

[0] [https://www.dispatch.com/news/20200410/coronavirus-in-
marion...](https://www.dispatch.com/news/20200410/coronavirus-in-marion-
prison-rsquoweve-never-experienced-anything-like-this-beforersquo)

------
ilamont
96% are without symptoms _yet_.

There was a nursing home in Massachusetts which had 51 out of 98 residents
testing positive but asymptomatic in early April. While this sounded
encouraging in the sense no one was critically ill because of coronavirus, a
few weeks later 19 had died and about 30 more had tested positive.

Let’s wait a month until there is a clearer picture about the impact of the
virus on a particular population of people.

[https://www.boston.com/news/local-
news/2020/04/04/coronaviru...](https://www.boston.com/news/local-
news/2020/04/04/coronavirus-cases-wilmington-nursing-home/)

[https://www.wcvb.com/article/85-of-patients-at-wilmington-
ma...](https://www.wcvb.com/article/85-of-patients-at-wilmington-
massachusetts-nursing-home-test-positive-for-coronavirus/32087000)

~~~
JPKab
Did you see the NYC antibody sample that showed that approximately 21 percent
of citizens had antibodies? It seems like a nursing home is a pretty bad
representation of a population.

~~~
prussian
Am I the only one who is still confused by what they're finding in these
antibody tests? Are they looking for antibodies that attach to specific
features unique to SARS-CoV-2? Because I'm pretty sure even HCoV-NL63 enter
lung cells through ACE2 as well. How can they tell antibodies for these
viruses apart? Also aren't antibodies effectively developed in a sort of
random process?

~~~
SN76477
I am confused as can be about all of it now. First it was stay locked in, then
heard immunity, now they say heard immunity may not happen.

~~~
13415
If you're confused by this, you may need to check your news sources. Experts
have been explaining all of this for months. First, people need to stay locked
in and keep distance in order to slow down the spreading so health care
systems don't get overwhelmed. Second, the disease itself can only be stopped
once herd immunity is reached. Ideally, herd immunity is achieved by
vaccination, once there is one. Until then, social distancing is needed to
limit the number of deaths and keep the health system working. Third, it is
not yet clear whether long-lasting immunity can be achieved at all. It's very
likely, but there is not yet enough data. Immunity may last from 2 months to 2
years or longer. We don't know yet for sure.

~~~
arcticbull
Not sure why you're being downvoted, this is well established. Even with
everyone indoors, the US new infection rate remains around 40,000 new cases
per day recorded -- and holding steady. Now with states re-opening that can
only go one direction, until herd immunity is established.

~~~
IAmGraydon
Those are positive tests. They are remaining high because the number of tests
has been increasing. The important metric to track is percent positive tests,
which has been consistently dropping for weeks.

[https://coronavirus.1point3acres.com/en/test](https://coronavirus.1point3acres.com/en/test)

~~~
arcticbull
I'm curious if that's true -- based on that excellent data, it appears that
the number of people who test positive has been pretty much steady. Chances
are those were always, and remain, positive tests at the point of
care/admission to a hospital. The new tests are likely randos. So long as we
continue to see the same raw absolute number of positive tests, I'd say it's
not a win -- yet. There's been in fact a steady increase since 4/21 in
positive tests in real number terms.

------
freeflight
One of the more interesting differences between US prison populations and
others is that smoking tobacco is way more prevalent:

 _> Estimated smoking prevalence among inmates was approximately 50% in
2003–2004, compared to 21% among noninstitutionalized adults._ [0]

Which might play a major role in the spread and the actual severity of
COVID-19 as French researchers are speculating that nicotine could be
responsible for blocking the ACE2 receptors that COVID-19 uses to get into
cells, which could explain why there's such a low incidence of tobacco smokers
among patients, far below what should be expected [1].

There's nothing really concrete yet, for now they want to experiment with
nicotine patches as treatment.

But in that context, prison populations could make for an interesting control
group: Maybe the prevalence of smoking is what keeps the virus less severe,
due to reduced viral load reaching cells, and thus fewer carriers are
symptomatic?

[0]
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5100810/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5100810/)

[1]
[https://www.qeios.com/read/article/574](https://www.qeios.com/read/article/574)

~~~
acconrad
I could see this making sense for tobacco users that don't smoke (e.g. chewing
tobacco) but for people that smoke...I mean this is a respiratory illness. If
you have compromised lungs this seems like it would be a nightmare for
smokers. Are you concerned at all with the veracity of these claims?

~~~
freeflight
Not at all, I'm merely sharing information that might be interesting to this
situation.

Nowhere did I declare anything as fact, I even called something "speculation"
by researchers when they don't consider it much one themselves:

 _> There are however, sufficient scientific data to suggest that smoking
protection is likely to be mediated by nicotine. SARS-CoV2 is known to use the
angiotensin converting enzyme 2 (ACE2) receptor for cell entry[14-16], and
there is evidence that nicotine modulates ACE2 expression[17]which could in
turn modulate the nicotinic acetyl choline receptor (manuscript submitted). We
hypothesize that SARS-CoV2 might alter the control of the nicotine receptor by
acetylcholine. This hypothesis may also explain why previous studies have
found an association between smoking and Covid-19 severity[1, 9, 10]. As
hospitals generally impose smoking cessation and nicotine withdrawal at the
time of hospitalization, tobacco (nicotine) cessation could lead to the
release of nicotine receptors, that are increased in smokers, and to a
“rebound effect” responsible for the worsening of disease observed in
hospitalized smokers._

In that context, it really doesn't matter if this is a "respiratory illness",
as nicotine can be applied in a number of ways, like patches.

So even tho it might seem counter-intuitive, this could be part of a plausible
explanation why smokers are so underrepresented among COVID-19 patients not
just in France, but also in the US and China.

------
elihu
Some possibilities: there is widespread infection from a common source around
the same time, and many of those "asymptomatic" inmates aren't going to stay
that way; the test has false positives; the population of this prison is
comprised mostly of people who tend to be asymptomatic carriers (for example,
if most prisoners are in their early 20's); COVID-19 has a lot more
asymptomatic carriers than we thought.

~~~
greedo
It's 4 prisons. The odds of there being one Typhoid Mary is unlikely.

------
IAmEveryone
Plugging the 96% into New York numbers results in 155,000 / 4 * 100 =
3,875,000 infected people in NYC, or about half the population.

This is assuming that tests in NYC currently include every infected and
symptomatic person. Considering the official advice for people with mild
symptoms is to stay home (and not seek a test), that assumption is ...
optimistic.

It also wouldn't fit with the anti-body tests that have been done in NYC that
showed figures closer to 15-20%.

So I'd expect about 1/2 to 2/3 of these 96% to develop symptoms within the
next week.

The other possibility is the prison population not being representative of the
general population. That's probably true in terms of fatality rates, because
they are younger. I'm not entirely sure if that age imbalance is just as
strong for _any_ symptoms as it is for risk of hospitalisation and death.

------
azakai
It doesn't appear to mention what type of test was done. Were they checking
for current active infection, or for antibodies which would indicate if the
person has ever been infected? (if the latter, they may have had symptoms back
then)

~~~
ImaCake
I am not willing to even consider these results until more details about
testing are revealed. There has already been so much misinformation about
testing and results that I am incredibly skeptical of any results now.

~~~
djsumdog
Same here. Is there any chance the viral load test is also testing positive
for other coronaviruses that are not SARS-CoV-2? Because I can't find any
information addressing that.

------
alexbanks
Before the deluge of "But wait two weeks" comments, I just want to ask at what
point we accept that the potentially of totally asymptomatic cases is insanely
high, far higher than anyone thought?

~~~
tyingq
There's also the nuance of US state prison care quality. _" Without symptoms"_
could just mean _" not obviously gasping for air"_.

~~~
lostlogin
Amnesty International campaign against this and are currently calling for the
release of ICE detainees. Judging by a skim of their releases even those
obviously gasping for air don’t necessarily get the care they need. It’s a
truely massive system which in itself is part of the problem, though the
exceptionally low bar for the care of prisoners is Amnesty’s primary angle.

[https://www.amnesty.org/en/latest/news/2020/04/usa-
covid19-p...](https://www.amnesty.org/en/latest/news/2020/04/usa-
covid19-pandemic-authorities-must-release-immigration-detainees/)

~~~
SlowRobotAhead
> Amnesty International campaign against this and are currently calling for
> the release of ICE detainees.

Virus aside, when are they not?

------
crazygringo
Every article I see about people testing asymptomatic is followed by comments
insisting they were asymptomatic _when tested_ , with no idea of whether they
_stayed_ asymptomatic or whether virtually all of them had symptoms a few days
later, thus basically invalid.

But this _doesn 't seem like a hard problem to solve, folks_. Is nobody
bothering to _follow up_ with the asymptomatic people a week later? Just take
their mobile phone number, and text them en masse with a quick Y/N question as
to whether or not they got sick?

This stuff _baffles_ me. This is literally a matter of life-and-death, and yet
the most basic questions seem to be unanswered. (Or are these follow-up
surveys being done but the media just refuses to report them because it now
feels like week-old news? I'd love to know.)

~~~
vosper
> Just take their mobile phone number, and text them en masse with a quick Y/N
> question as to whether or not they got sick?

I've been wondering why this isn't just being done for everyone in the
country, every few days?

"The main symptoms of COVID-19 are X, Y, Z. If you think you may have COVID-19
please respond "Yes" to this text message. This is free. Your response is
private and used to understand the spread of COVID-19 in our country. Please
visit [http://some.link](http://some.link) for more information"

If someone responds "yes" you could follow up with some more questions, if
that was useful. And then text them a few days later to see if they're feeling
better or worse, or maybe ask them to describe how they feel.

There are lots of problems with this idea: people lying or not taking it
seriously; people not responding; not everyone has a cellphone; some people
will be worried about privacy, etc etc...

But surely there'd be something useful to learn from it? And it seems like it
should be easy to do, really, if you got the mobile providers on board (or
just order them to help).

~~~
alexis_fr
Do you even need to be an official to do that? Perhaps a newspaper could do
it, to accurate news.

~~~
notatoad
I saw it suggested on Twitter yesterday that the political polling firms
should be doing some coronavirus polling, tracking trends in self-reported
cases the same way they track public opinion.

I'm not sure if that would be scientifically useful in any way, but it sure
would be interesting.

~~~
jackcosgrove
See my reply to GP.

------
lettergram
People can test positive and are most contagious before they show symptoms. As
opposed to influenza where people with symptoms are most contagious. The delay
in the onset of symptoms is why this is a very difficult virus to contain.

Further, the accuracy of our tests is questionable and hopefully improving.

Finally, viral shedding has been seen up to 35+ days since symptom onset.
Meaning if they showed symptoms a month ago, they may still test positive.

[https://www.aarp.org/health/conditions-
treatments/info-2020/...](https://www.aarp.org/health/conditions-
treatments/info-2020/onset-of-covid-19-symptoms.html)

------
colmvp
As a Canadian, I'm shaking my head at our officials who said "we do know that
asymptomatic people are not the key driver of epidemics" as a response to
concerns back in January of the potential for the virus to grow in our country
via incoming travelers who came from hot spots and were not screened or forced
to isolate if they expressed no symptoms.

Now our long term care facilities are being overrun with cases potentially
because we waited until deaths piled up before testing asymptomatic caretakers
for the virus.

~~~
tempestn
Agreed 100%. Here in BC, public health wasn't even saying, "It's not known
whether asymptomatic carriers can spread the virus," but actually, "Evidence
suggests asymptomatic carriers _can not_ spread the virus." Something that as
far as I can tell was never actually true. This was reported in public
briefings, was repeated by public health nurses on the call-in lines, and was
distributed as the government's official position to daycare workers,
presumably among others. Really mind-boggling to me. I can only assume
somewhere along the line lack of evidence got confused for evidence of lack,
and just kept getting parroted from there.

~~~
antonvs
> "Evidence suggests asymptomatic carriers can not spread the virus."

I don't understand this. How would that even work? If you're infected, what
would stop you from shedding virus like anyone else? Is there a precedent for
this, for respiratory viruses?

~~~
hilbertseries
Both SARS and MERS were not particularly contagious during the incubation
phase.

------
sandworm101
Fine non-Covid point:

>>> The United States has more people behind bars than any other nation, a
total incarcerated population of nearly 2.3 million as of 2017 — nearly half
of which is in state prisons. Smaller numbers are locked in federal prisons
and local jails, which typically hold people for relatively short periods as
they await trial.

That isn't correct. "Local Jails" hold two general populations: people serving
less than a year (generally non-felony convictions) and people awaiting legal
process. The infamous Rikers Island in NY is technically a "local jail".
People regularly stay in these facilities for YEARS. The AVERAGE stay at
Rikers is 6+ months. (Total stay, not time between appearances.)

The distinction between "jail" and "prison" in the US is academic. For
purposes of disease, and certainly from the perspective of inmates, both are
prisons where large populations are locked up in confined quarters for years
at a time.

------
giardini
The Reuters article is not useful. It doesn't tell us the type of tests being
done, and certainly says nothing about false positives. Like most other
articles, this article is what I call "bullshit" but John Ionnidis calls:

"Lies, Damned Lies, and Medical Science":

[https://www.theatlantic.com/magazine/archive/2010/11/lies-
da...](https://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-
and-medical-science/308269/)

Dr. Ioannidis on Why We Don't Have Reliable Data Surrounding COVID-19:

[https://www.youtube.com/watch?v=QUvWaxuurzQ&feature=emb_logo](https://www.youtube.com/watch?v=QUvWaxuurzQ&feature=emb_logo)

~~~
djsumdog
I was doing stuff with the Johns Hopkins data and it has all kinds problems
with it (not to mention the format is terrible; time series as columns?!).
They also tacked on the retroactive New York cases to the end to the time
series data. I did a post on it:

[https://battlepenguin.com/tech/fighting-with-the-
data/](https://battlepenguin.com/tech/fighting-with-the-data/)

------
H8crilA
This is actually not such a bad thing. It means that the true case rate is
much much higher, and thus the true fatality rate is much much lower.

~~~
spikels
On the other hand this means it is much more infectious and there are many
more infective asymptotic carriers. This will almost certainly make it
impossible to contain using traditional public health means such as contact
tracing and quarantining.

------
Jemm
Reuter’s website is a shit show of moving popping, sliding gizmos. Makes it
unreadable. I can’t imagine using a screen reader with that.

It is like constantly rearranging the furniture while a blind person is in the
store.

------
aazaa
No mention of what kind of test was performed. And this article is not alone -
most don't bother.

The kind of test matters. A qPCR tests the presence of an active infection.
Antibody test determines past exposure.

Each has different expectations for symptoms, communicability, and prognosis.

It's not a lot to ask - just report the kind of test that was done, and do so
with in the first two paragraphs. Then let me draw my own conclusions about
what the study means.

That's a minimum. Ideally, an article would mention the exact brand of test
that was performed. If heterogeneous testing methods were used, report that as
well.

~~~
shawnz
If it were an antibody test then I don't think it would be correct to say that
they "tested positive for coronavirus", and also it wouldn't make sense to
talk about their symptomaticity

------
ineedasername
I see a lot of people dismissing the shared air space & HVAC systems as
possible vectors of infection besides close contact, but you have to remember
a very important factor:

Droplets exist in a continuum, not a binary of big == fall to ground, small ==
stay in the air. There's a range, and as they get smaller they stay in the air
longer.

 _Large droplets ( >50 μm in diameter) settle on the ground almost
immediately, and intermediate-sized droplets (10–50 μm) settle within several
minutes. Small particles (<10 μm), including droplet nuclei from evaporated
larger particles, can remain airborne for hours and are easily inhaled deep
into the respiratory tract._ [0]

As such, while particles that stay aloft longer may not exists in sufficient
quantities when it is just one infected, or a few infected inmates, that
changes with the # of infected. With each infected inmate the concentrations
of those small particles will increase.

Let's say that normally the small particles exist at 3% the necessary quantity
to infect another person. Then 33 inmates and staff get sick through close
contact, and all of a sudden the concentrations of small droplets is
sufficient to infect people. You hit a critical mass, and each additional
infection only makes it worse, creating a rapid downward spiral.

[0]
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4147198/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4147198/)

------
Brendinooo
I don't know a lot about the antibody tests. Is the novel coronavirus novel
enough that they know exactly the kind they're testing? Is it a specific test
for SARS-CoV-2?

~~~
FabHK
There are many antibody tests. The one I’ve read about (from the Charité in
Berlin) was designed (or found) to also test positive for the “original” SARS,
and for very closely related bat viruses (neither of which should present an
issue when testing humans today), but not for other corona viruses (such as
the common cold etc.).

That test has also very carefully been validated, with excellent sensitivity
(=few false negatives) and specificity (=few false positives). Not sure all
available tests have gone through quite so thorough validation.

------
codecamper
I've read there are over 10,000 strains of the virus, some more deadly than
others!
[https://www.scmp.com/news/china/science/article/3080771/coro...](https://www.scmp.com/news/china/science/article/3080771/coronavirus-
mutations-affect-deadliness-strains-chinese-study)

------
gridlockd
With _those_ kinds or positive rates, I have to start wondering about the
specificity of those tests.

The UK government recently hat to gave up on millions of antibody tests
because they just didn't work.

Coronaviruses in general are endemic and almost always go without symptoms and
would also eventually spread to the majority of the prison population.

------
Munky-Necan
The cruise ships were a great Petri dish and so far it is believed that
asymptomatic patients comprise 15-20%, but more research is needed.

[https://www.niid.go.jp/niid/en/2019-ncov-e/9417-covid-dp-
fe-...](https://www.niid.go.jp/niid/en/2019-ncov-e/9417-covid-dp-fe-02.html)

------
creddit
I'd guess smoking rates are very high in prisons. It seems smokers (even
former) are much better off than non-smokers.

~~~
hkeide
That's the opposite of everything I've read

~~~
frereubu
I think they're referring to this:
[https://www.theguardian.com/world/2020/apr/22/french-
study-s...](https://www.theguardian.com/world/2020/apr/22/french-study-
suggests-smokers-at-lower-risk-of-getting-coronavirus)

The idea is that nicotine may lower your chances of infection, but once
established I imagine that smoking will definitely reduce your chances of
survival.

~~~
samatman
Well, it lowers your chance of being listed as an infected person.

Presuming this is true (lots of evidence but still much too early to be sure),
there's two possibilities: nicotine makes a person less likely to be infected,
or nicotine makes it less likely that the infected will develop any symptoms.
No symptoms, no test, that's been the rule until quite recently.

If it's the latter, it could explain what's going on here. I doubt that's the
explanation, but it's possible.

~~~
creddit
There seems to be a reasonable path to effect regarding regulation of ACE2
which is the primary receptor molecule for COVID.

[https://www.qeios.com/read/article/571](https://www.qeios.com/read/article/571)

------
laufj
I'm curious how they determined if inmates were asymptomatic. If it was just
asking, the symptoms may be under reported. In prison, you try and appear
invincible, your survival depends on it, so I could imagine many people saying
they are asymptomatic when they are not.

~~~
Meckin
So many assumptions, I highly doubt from my time being in prisons others would
think... Oh man that guy has the cold.. He must be weak.

------
eblah
Does anyone know if there's been any studies on those who have taken no
medications at all in past X days vs those that take any (either OTC or
otherwise) and those with and without symptoms?

I ask because I'd assume drug use would be lower in prisons, and among those
in poorer countries. I'm just wondering if a particular set of drugs could
accelerate/make this worse?

That said, I'm not sure this is even possible to obtain metrics on, it'd just
be interesting to see if there's any type of correlation to rule out. I
realize there's been conflicting studies on whether certain heart meds may
accelerate, but I've not been able to find anything about any drugs use
whatsoever.

------
unexaminedlife
I'm curious to know exactly what the science is behind the tests being
performed currently. And how does a body typically fight a virus in the first
place?

This might sound amateurish (it is), but I have been picturing this virus and
how our bodies are fighting it similar to how our bodies fight cancer. Tons of
people who never end up with cancer diagnosis are constantly fighting off
cancer cells, it's just that the capacity of their (relatively) healthy bodies
exceeds the total # of cancer cells they need to fight off.

Is it possible these tests have become too sensitive to where they're easily
detecting the virus in seemingly healthy people?

------
bouncycastle
Maybe the virus has evolved (through natural selection) to not to kill its
hosts?

~~~
travbrack
People who die from the virus usually infect many others before death. There
isn't really any selection pressure for keeping the host alive.

~~~
bouncycastle
Sure, but people who don't show symptoms can infect more! So in that case, the
less potent one becomes more dominant, no?

Meanwhile those who show symptoms are more likely to stop infecting as soon as
they're isolated.

That said, I'm not sure if there has been any different stands identified yet?

------
kortex
Maybe we can institute a work-recovery program where inmates can do high-
exposure work (once they are truly recovered). give them experience and a
feeling of duty and purpose.

Nah, they'll probably just keep using em for slave labor.

------
empath75
The nature of exponential growth is such that no matter when you test, 50%
will have gotten it within the last doubling period. If it’s doubling every
three days, half have caught it in the last 3 days, 75% in the last 6 days,
86% in the last 9 and so on. Given the long incubation period it makes sense
that the vast majority are currently asymptomatic. I think that will be the
case at every point during exponential growth, even if the ultimates fatality
rate is quite high.

------
randyrand
Do states have an legal obligation to prevent the spread of disease in
prisons? It seems like prison does not provide enough space to stop people
from dying from diseases.

I wonder if you can sue.

------
rsuelzer
Are these antibody or antigen tests? I am extremely suspect that the antibody
tests being used are not delivering false positives. There was a study that
showed 800,000 people in Los Angeles likely have antibodies. This does not
make sense given that the ICU admissions did not even remotely track that of
Northern Italy, which shared a similar population size. I suspect that these
antibody tests are picking up a positive on another another Coronavirus.

------
BurningFrog
Two questions:

1\. How good is this test? Maybe people have no symptoms because the test is
wrong?

2\. Is there some reason prisoners would deny having symptoms even if they
did?

------
CryptoPunk
So it strikes me as possible that SARS-CoV-2 has a very high r value and
lethality on par with flu viruses, but is killing a lot more people than flu
viruses due to the lack of pre-existing immunity, combined with the rapid
spread through the population claiming those most vulnerable to it all at
once.

------
ageofwant
An asymptomatic presentation would not include a chest x-ray. People with
visible lung lesions and 60% oxygenation levels doe not exhibit any symptoms.
The body's warning system is wired to C02 concentrations, and C02 gets
evacuated so people report feeling fine while they have significant lung
damage.

------
luckydata
96% asymptomatic FOR NOW. We’ll see later.

~~~
SlowRobotAhead
Will we though? Or more likely we’ll never hear about stats from these four
state prisons again?

------
robocat
If the virus moves fast through a population (like we might expect in a
crowded prison) then all the population in one provision will have a single
strain.

However, this is 4 prisons: do staff or inmates move between prisons more
often than say every week?

It is possible (although unlikely) the virus strain is less spdangerous.

------
kgin
Alone, this doesn't show anything. But following this population for 3 weeks
should tell us a alot.

------
ping_pong
Is there the possibility that these test results are wrong? The spread is far
wider than what would be expected and that means that quarantining and contact
tracing would be eseentially useless. But we've seen that both are very
useful.

~~~
Ascetik
Look up Dr. Andrew Kaufman on Youtube. Medicamentum Authenticam.

------
JoeAltmaier
Lets not get too excited about this. Whatever the numbers, that's interesting
and worth recording for planning. But whatever they are, they result in "way
too many deaths". This is still a very dangerous and rapidly-spreading virus.

~~~
k2enemy
Where is the cutoff between "way too many deaths" and not too many deaths? I
don't mean to be glib, but it is an important question that needs to be
weighed against destroying all of our economic institutions.

~~~
pgsbathhouse2
> that needs to be weighed against destroying all of our economic
> institutions.

No it doesn't. Like the statement alone doesn't even have any credence, let
alone following through with it.

Incredibly daft.

~~~
CryptoPunk
Economic institutions sustain people's lives. Declining productivity
translates to loss in life expectancy.

~~~
JoeAltmaier
If everything else remains unchanged. Which it isn't. Changes are happening
every day.

And nobody plans to stay in this mode forever. Medicine is making tremendous
progress at an astonishing rate. They just need time.

Stay patient.

~~~
CryptoPunk
There are viral infections for which vaccines were never successfully
developed, despite over a decade of research and trials. There is no guarantee
a vaccine will be developed for SARS-CoV-2 in anything approaching a timely
manner. People need to weigh the costs and risks of a near total freeze on
economic activity against those of letting the virus run its course until herd
immunity develops.

~~~
JoeAltmaier
There are 115 trials underway. There are 100,000 very smart investigators
working day and night. There has already been tremendous progress.

My niece works at a lab developing a cheap test. Two of their researchers have
already died of this virus (they went to work despite the risks). Don't make
fools of them, by falling into despair and negativity.

~~~
CryptoPunk
A vaccine for HIV was never found.

I hope they succeed in creating a vaccine for COVID19, but resting the lifting
of a highly destructive mass-lockdown of healthy people on a hope, is
reckless.

Contingency plans need to be created; a definite end date for the lockdowns,
irrespective of whether a vaccine exists.

------
konschubert
One potential cause: We habe hints now (Charité Study) that previous
infections with other, less harmful corona viruses may provide some degree of
immunity (unconfirmed).

Maybe one or more these other coronaviruses made rounds in this prison earlier
this year?

------
atmosx
Same thing happened in a Greek “hot spot”, a prison for refugees. These places
were build to host X number of inmates but in reality they host close to 50X.
The population were infected at nearly 100% without symptoms.

------
8note
From what I can tell, this makes a strong suggestion that were much further
through infecting the whole population than we think.

Anyone with some bayesian ideas on by how much?

------
m3kw9
Yet elsewhere, hospitals are flooded and body bags piled.

~~~
thatsenough
Because people with the worst symptoms go to the hospital.

------
anticensor
They should be conscripted to the war front with symptom-suppressing
medication, to prevent further contamination of inmates.

------
FabHK
Would be nice if they had specified what test (PCR from throat swap, from
sputum, from stool; antibody test; …).

------
OrgNet
I wish I could get an anti-body test done because I had flu-like symptoms
before any tests were available

------
DeathArrow
Is there a an explanation for why US has the highest prison population in the
world?

------
puskavi
Mutation or less harmful strain?

------
MrPatan
Does anybody know the false positive rate of the test?

Could this be an artifact of that plus low actual incidence like:

\- False positive rate of 10%

\- 100 tests

\- 1 true positives. All with symptoms

\- 9 false positives. All without symptoms (duh!)

Headline: "90% asymptomatic!"

Truth: "Shitty test procedure!"

Yes, yes, I know you know this. Do you think people doing tests and writing
headlines know this?

What is the false positive rate?

~~~
cwillu
> They started with the Marion Correctional Institution, which houses 2,500
> prisoners in north central Ohio, many of them older with pre-existing health
> conditions. After testing 2,300 inmates for the coronavirus, they were
> shocked. Of the 2,028 who tested positive, close to 95% had no symptoms.

~~~
jfasi
This is the relevant response. What the commenter is trying to imply is that
the authors of this study are so staggeringly stupid that they overlooked the
possibility of false positives when designing this experiment.

In reality, this test would need a false positive rate of over eighty percent
to explain this kind of asymptomatic infection rate.

Also, prisons are useful because due to the close quarters it can be taken as
a given that a substantial proportion of the population is infected, further
minimizing the danger of these sorts of errors. The choice of population
suggests a sophisticated experiment design, and the commenter is implying that
the study authors made a statistics 101-level error.

~~~
MrPatan
As someone else has said on another comment, it just needs the experimenter to
be infected and a bit careless, and there is your high percentage of positive
results.

Plus yeah, to be honest, you dismiss staggering stupidity leading to juicy
headlines at your own risk.

------
pcdoodle
Hope they didn't give them the batch that arstechnica reported contaminated.

------
vrtx0
I posted the following comment on a very similar Reuters article about
asymptomatic rates on an aircraft carrier 8 days ago (on a Friday):

\- - IMHO, this article is intentionally misleading. The incubation period is
currently estimated to be 2-14 days (mean is 5.6 days per CDC, similar per
WHO). The article doesn’t mention any dates or time frames, but does mention:
”Roughly 60 percent of the over 600 sailors who tested positive so far have
not shown symptoms of COVID-19” — note how “so far” is ambiguous in that
sentence. It also states, “The Navy’s testing of the entire 4,800-member crew
of the aircraft carrier - which is about 94% complete...”, which seems to
indicate nowhere near enough time has elapsed to draw any sort of conclusion.
This paper [1] found that testing of all pregnancy patients in a hospital
yielded 34% asymptomatic cases. That number drops to 8% “shortly after
discharge”, and could be lower than 8% (Again, no timeframe is stated). [1]
[https://www.sciencedirect.com/science/article/pii/S258993332...](https://www.sciencedirect.com/science/article/pii/S2589933320300483)
\- -

If you just s/navy/prisons/ and s/[navy figures]/[prison figures] (and forgive
my oversimplification of RegEx captures), I think that comment works just as
well here.

At the risk of sounding paranoid, does this seem like a campaign of
misinformation by omission? Or perhaps I’m being overly critical?

The key issue I take with both articles is that they speculate _a lot_ , but
gloss over the fact that no timeframes are provided to determine what
percentage could actually be asymptomatic and never develop symptoms vs.
simply being pre-symptomatic at the time of testing.

If the article were focused on how quickly this virus can spread in closed
quarters, that would be one thing. But this rather lengthy article only has
one sentence in the middle that even mentions asymptomatic cases eventually
developing symptoms:

“Some people diagnosed as asymptomatic when tested for the coronavirus,
however, may go on to develop symptoms later, according to researchers.”

Also, this article mentions testing asymptomatic prisoners (universal
testing), but it doesn’t say why these specific prisons where chosen first.
Perhaps some had at least one positive test result? If so, wouldn’t the close
quarters explain most of the relatively high rates of asymptomatic positives
reported, given the (initially) exponential curve of spread over time?

------
nodesocket
Isn't this a bit of promising news, means herd immunity is probably much
deeper and larger than we are currently aware.

~~~
DanBC
WHO says we can't assume previous infection means future immunity.

[https://www.who.int/news-
room/commentaries/detail/immunity-p...](https://www.who.int/news-
room/commentaries/detail/immunity-passports-in-the-context-of-covid-19)

~~~
nodesocket
Not sure why I am getting downvoted, I guess covid-19 shaming is a thing. From
what I've read people who appear to get it again is actually just a relapse of
the original infection[1].

[1] [https://thehill.com/changing-america/well-
being/prevention-c...](https://thehill.com/changing-america/well-
being/prevention-cures/491988-fauci-recovered-coronavirus-patients-will-
likely)

~~~
cm2187
I must say that for a community of rather technical people when not scientists
and engineers, hackernews has a surprisingly high level of FUD-pushers and
doomers on that topic. I put that on account of anxiety.

------
greendesk
Are there differences in vaccination in the affected population? A noteable
difference is the age group of high risk group is ~65 in Italy and ~80 in
Sweden. (Citation needed, I only found secondary sources). These ages
correspond to changes in vaccine regimen in the affected countries. Might the
younger inmates have been vaccinated differently?

------
OrgNet
Georgia's actions don't seem so dumb now...

------
barli
how is this related to hacking?

------
kensai
Ioannidis was right all along.

------
adamnemecek
No, they will develop symptoms. Test again in two weeks.

~~~
DoreenMichele
I'm in a high risk category with an incurable respiratory condition. I'm
convinced I've already had it and I'm mostly recovered now.

I was mostly asymptomatic. The biggest thing going on was that I was very
tired, which was also something easily explained by other things going on, so
I was basically already on the mend before I concluded I must have had it.

I believe we are barking up the wrong tree. We are looking for respiratory
distress because it leads to low oxygen levels. I think we need to be looking
more at what it does to the blood. Fortunately, some doctors are looking in
that direction, but I think not enough, probably.

My symptoms were similar to anemia. It's easily missed because you mostly lack
energy.

Again, there can be lots of reasons a person has low energy. It can be quite
hard to say "Clearly, this symptom is indicative of Coronavirus."

So I suspect a lot of people will never be overtly symptomatic in the ways the
world is looking for with its huge focus on lung issues.

~~~
nradov
Doctors are already seeing blood clots in many COVID-19 patients. Strokes,
heart attacks, and pulmonary embolisms appear to be much more common than with
other forms of viral pneumonia. Some hospitals have incorporated blood
thinners into their treatment protocols.

~~~
DoreenMichele
Yeah, I'm aware. For example:
[https://news.ycombinator.com/item?id=22883260](https://news.ycombinator.com/item?id=22883260)

I also had an interesting discussion with someone who is apparently some kind
of medical researcher about zinc and blood stuff. This was very helpful to me
and my sons in trying to recover our energy levels, which also firms up my
suspicions that a. we had the infection and b. my mental models are less wrong
than some of what is out there.

------
w3mmpp
> by throwaway888abc

Pretty funny, good enough for reuters but not for HN it seems...

------
leon1717
Whether a conspiracy or a fuck-up, the more weaknesses of democracy exposed by
this virus, the more benefits the survivals will have in the long run. DT be
like:"Kill all those intouchables, so I'll have another 4 years sitting on the
bloody throne!"

------
covidSurvivor19
At this point only thing I can ask is, forget the shutdowns, when we'll we
recognize the most viral thing about COVID was the histeria? Having lived
closely through the swine flu, it was quite a bit worse, affected people under
60 which tend to be more socially active and no shutdowns were required. In
fact one of the learnings/facts of that crisis were that masks are mostly
useless to prevent contagion.

------
briandear
> The numbers are the latest evidence to suggest that people who are
> asymptomatic — contagious but not physically sick — may be driving the
> spread of the virus

That’s also suggesting that the fatality rate is nowhere near what we have
been led to believe.

~~~
icebraining
What have we been led to believe?

------
sergiotapia
>“It adds to the understanding that we have a severe undercount of cases in
the U.S.,” said Dr. Leana Wen,

There it is! Now can we get back to normal. Of those 4% with symptoms, what
tiny percentage need advanced hospitalization? Of that tiny percentage, what
tinier percentage still, die?

