Antibody studies spur debate, skepticism | April 24, 2020 | Palo Alto Weekly | Palo Alto Online |

Palo Alto Weekly

News - April 24, 2020

Antibody studies spur debate, skepticism

Researchers at Stanford and USC suggest that the virus has lower fatality rate

by Gennady Sheyner

A pair of studies conducted by researchers in Santa Clara and Los Angeles counties drew national attention this week with a finding that COVID-19 is much more widespread — and far less deadly — than public health officials had assumed.

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Staff Writer Gennady Sheyner can be emailed at [email protected]

Comments

16 people like this
Posted by Moot
a resident of Another Palo Alto neighborhood
on Apr 24, 2020 at 9:34 am

This article must have been written before the New York study came out with similar information.

Web Link

One fifth of New York was already infected. This is a bizarre virus that just doesn't affect everyone the same way, and symptoms may not even be apparent.


8 people like this
Posted by Anon
a resident of Another Palo Alto neighborhood
on Apr 24, 2020 at 9:46 am

IF the results of the now-three studies turn out to be statistically sound (that is controversial), Santa Clara County is still far from a herd immunity level, as noted in the article:

"We are far, far, far from herd immunity and not likely to get there until we have a vaccine."

It may be that New York City is at or near that level, where there will be a decline just because so many people already have antibodies. The thing is, I really don't want to go through what those folks in New York City have been through.


32 people like this
Posted by Dan
a resident of Professorville
on Apr 24, 2020 at 10:27 am

The most important thing from all these studies is clearning up misinformation about the true fatality rate of Covid. Most news sources have been terribly misleading by reporting the number of "cases", which is defined as people who have tested positively, not people who were actually infected. This is terribly misleading as it drastically overstates the fatality rate of the disease.

Recall the media has been talking about a 3% fatality rate, and implying that 3% of people who get infected die. The reality that they should have been reporting on is 3% of people who were so sick that they went to the hospital and were actually able to get tested went on to die.

The new antibody studies all show that the actual fatality rate is more like 0.1% to 0.2% of people who become infected. Said another way, 1 or 2 people out of every 1,000 people infected who will die.

This number needs to be further drilled down on, because it's not evenly distributed across the population. If you are younger than 50, and you don't have underlying conditions, the actual chance of you dying from Covid is extremly low - like less than one in ten thousand, or even less than one in one hundred thousand if you are younger than 30 and healthy. If you are in one of the highest risk groups, then your risk may be more like 1 percent.

As we get more and more data like this, it should help us all be more informed about the risks to both us and to our fellow citizens. It should also inform our policy as we begin restart our economy - it's pretty clear that in the short term the high risk groups still need to be protected and to take serious precautions. But for the lower risk groups, we probably need to be more focused on making sure they do not transmit the disease to higher risk groups than on protecting themselves.

The prevalence data is a different discussion, with different policy implications - about 5% in Santa Clara have already contracted and recovered from Covid, and about 20% in Manhattan - which shows we have a long way before we get to herd immunity.


11 people like this
Posted by Other Tom
a resident of Downtown North
on Apr 24, 2020 at 10:51 am

Really? The conclusions of the study may or may not be valid, but you can't tell from the incredibly flawed study. 3600 self selected people from facebook who knew they would be tested for having had COVID. Don't you think those who have been sick would sign up more than the average joe? And there were only 50 positives. Pretty small and very skewed sample. They really should apologize.


27 people like this
Posted by Dan
a resident of Professorville
on Apr 24, 2020 at 11:11 am

Hi "other Tom"

I think that is a very reasonable question to ask about just the single Stanford study, but multiple studies around the world are starting to come back with similar data. In the United States the studies done in New York and in Los Angeles by USC all point to very similar conclusions.

All we can do at any point in time is act on the best data we have. The good news is that our visibility into this disease and pandemic is getting clearer almost every day, and we can all use it to inform our actions.


3 people like this
Posted by Gale Johnson
a resident of Adobe-Meadow
on Apr 24, 2020 at 11:50 am

I will probably never feel comfortable/relaxed dining out with my lady friend, Dona, again and that has always been a special time for us. We have been dining out together for several years and and we select restaurants each time with different ethnic foods and from different countries. We have 19 of those under our belts. At one time the fabulous food was really under our belts and in our tummies. When the relaxation starts to include local restaurants I might get my enthusiasm built back up a little bit, but it will never be the same...masked servers wearing gloves will be a new experience...and not one I'm looking forward to.

I have had the thrilling experience of having a Caesar Salad prepared/tossed at our table, and the Steak Dianne flamed at our table. At the table now means at least 6 feet away. That's not really 'at your table'. Close and within viewing distance of the show, but not right at our table.


16 people like this
Posted by rita vrhel
a resident of Crescent Park
on Apr 24, 2020 at 12:11 pm

Interesting studies. Yes, self selection is not a randomized study. Will be fascinating to see what additional scientifically conducted studies reveal.
The final and correct answer is a long way off.I hope the results do not deter officials from restoring our shameful Public Health System and planning for the next pandemic; which we know will occur.

In the meantime; we are best to be safe and follow the State and Country guidelines.


7 people like this
Posted by Sophie
a resident of Another Palo Alto neighborhood
on Apr 24, 2020 at 12:37 pm

From the result of their blood survey, the German team estimated the death rate in the municipality at 0.37% overall, a figure significantly lower than what’s shown on a dashboard maintained by Johns Hopkins, where the death rate in Germany among reported cases is 2%.

Web Link


8 people like this
Posted by Sophie
a resident of Another Palo Alto neighborhood
on Apr 24, 2020 at 12:40 pm

[Post removed.]


7 people like this
Posted by Robert
a resident of Mountain View
on Apr 24, 2020 at 1:07 pm

I've already expressed my concerns about sample bias, particularly in the Stanford study that solicited donors on Facebook, word of mouth, and TV news to a lesser extent. I see these findings, if confirmed to be approximately true, are both good news and bad news.

The good news would be 1) the death rate MAY be a at least an order of magnitude lower than previously thought, and 2) we could be well on the way to "herd immunity". Note that authorities in Sweden, which took a more passive approach and let the infection spread, said this week that they are approaching the beginnings of herd immunity.

The bad news would be that people who are susceptible due to other serious pre-existing medical conditions (comorbidities), must continue to exercise extreme caution because there will be a significant of fraction of asymptomatic "silent carriers" who can infect them. Any easing of shelter in place regulations must be designed to protect these most vulnerable people.

And this is where the need for "unlimited" on-demand cheap and fast viral testing comes in --- and we're months away from that under any reasonable scenario.


7 people like this
Posted by KrozNest
a resident of Old Palo Alto
on Apr 24, 2020 at 1:19 pm

It sounds as if there may have been irregularities in the way the recruitment was done for this study.

See:
Web Link


10 people like this
Posted by What Will They Do Next
a resident of Old Palo Alto
on Apr 24, 2020 at 1:50 pm

Dr. Sara Cody, Santa Clara County's health official stated,"We are far, far, far from herd immunity and not likely to get there until we have a vaccine."

It's important for people to understand that vaccination in and of itself, does not equate to immunity. If it were true that it did, we would no longer have a myriad of diseases that specific vaccines were developed to prevent.

While it is also true that some vaccines have had great success (smallpox, polio and a few others), the majority have not eradicated the diseases they were intended to. Jonas Salk (polio vaccine) was said to have stated that the vaccine itself didn't eliminate polio, but it was developed at a time when greatly improved sanitary and hygienic measures were being practiced in the U.S., which he believed contributed to its' overall success.

Robert, who posted above makes a very valid point when he says that "people who are susceptible due to other serious pre-existing medical conditions (comorbidities), must continue to exercise extreme caution because there will be a significant fraction of asymptomatic "silent carriers" who can infect them. Any easing of shelter in place regulations must be designed to protect these most vulnerable people."

And for the rest of us, lifting the shelter in place restrictions should begin soon with judicious precautions being practiced by the most vulnerable, who most likely know they fit the category and can do much to self protect.


5 people like this
Posted by Johnny
a resident of Midtown
on Apr 24, 2020 at 2:04 pm

When the infection rate is low, the false positive will make the study results unreliable. if the false positv rate is 2%,then most the positive results in the Stanford and LA sdudies may be false. The anit body test will only be useful when the infection rate is at least 3,4 fold higher than the false positive rate. If you use New York City study, positive is about 20% and fatality is about 0.7%.


3 people like this
Posted by Resident
a resident of Downtown North
on Apr 24, 2020 at 2:10 pm

Sample selection was poorly done. Self selected people from Facebook advertisement. That's a very small potential group of folks. That already is statistically not representative of the population.


5 people like this
Posted by Dave Wiltsee
a resident of another community
on Apr 24, 2020 at 3:52 pm

The notorious Carnival cruise ship which spread the virus early has now reported the following: 2596 confirmed cases; 65 deaths. That would seem to be a reasonable "control group", although the close proximity of those affected over the period of several weeks might exaggerate both figures applied to the broader community. On the other hand, at this time we do not know the outcome for those confirmed positives who have not (yet) died.

Still, these statistics indicate a death rate of 2.5%, considerably higher than either study cited here.


3 people like this
Posted by ASR
a resident of College Terrace
on Apr 24, 2020 at 3:58 pm

We need solid recommendations on what to do to be safe.

If we need to social distance for years to come, we need to know.

If we shouldn’t eat animals we need to know.


1 person likes this
Posted by Resident
a resident of Midtown
on Apr 24, 2020 at 5:59 pm

One idea that hasn't been explored, so far as I know, is that small herds can develop herd immunity a lot more quickly than large herds. If a city like NYC has enough smaller living units, for example, that means an appreciable section of the population is already immune, thereby reducing the threshold for overall herd immunity. If NYC has a 20% infection rate it may have already reached its herd immunity level.


9 people like this
Posted by Sophie
a resident of Another Palo Alto neighborhood
on Apr 24, 2020 at 6:17 pm

Bret Stephens in the NYT:

As of Friday, there have been more Covid-19 fatalities on Long Island’s Nassau County (population 1.4 million) than in all of California (population 40 million).
Yet Americans are being told they must still play by New York rules — with all the hardships they entail — despite having neither New York’s living conditions nor New York’s health outcomes. This is bad medicine, misguided public policy, and horrible politics.


Web Link


11 people like this
Posted by Boho
a resident of Greenmeadow
on Apr 24, 2020 at 6:22 pm

You could be forgiven for thinking that the media is rooting for this to be worse than it actually is.


4 people like this
Posted by Barron Park dad
a resident of Barron Park
on Apr 24, 2020 at 10:20 pm

Is this true? Is so, the Stanford study could be very flawed.

BuzzFeed News: A Stanford Professor’s Wife Recruited People For His Coronavirus Study By Claiming It Would Reveal If They Could “Return To Work Without Fear”

Web Link


2 people like this
Posted by Barron Park dad
a resident of Barron Park
on Apr 24, 2020 at 10:25 pm

“Bhattacharya has also been making the rounds of conservative media. Here he is on Tucker Carlson a week ago saying that the COVID19 death rate is ‘likely orders of magnitude lower’ than previously thought.”

Web Link


1 person likes this
Posted by JA3+
a resident of Crescent Park
on Apr 25, 2020 at 12:13 pm

"About 6 percent of Miami-Dade’s population — about 165,000 residents — have antibodies indicating a past infection by the novel coronavirus, dwarfing the state health department’s tally of about 10,600 cases, according to preliminary study results announced by University of Miami researchers Friday."

Web Link


Like this comment
Posted by rld
a resident of another community
on Apr 26, 2020 at 7:44 pm

We do not seem to have age-stratified results for the SCC and LA serum antibody studies, and maybe not the Heinesburg Germany study either.

It is possible that various age groups have different infection prevalences.

Also, the infection fatality rate being reported is the aggregate, and we know that younger groups have lower case fatality rates, so they probably also have lower infection fatality rates. It is easy to imagine that subpopulations such as younger people without comorbidity will have extremely low IFR, even in the range of seasonal flu.

So, one can imagine that younger healthy people may choose to or be allowed to reach herd immunity. The age boundary might be relatively high, depending on the IFR based on age.


In an article in Vox.com, the SCC and LA tests did not stratify for age:

About the SCC study:
'The study also didn’t control for age. “The overall effects of such biases is hard to ascertain,” authors wrote.'

Web Link


4 people like this
Posted by Anon
a resident of Another Palo Alto neighborhood
on Apr 27, 2020 at 10:07 am

Posted by rld, a resident of another community

>> Also, the infection fatality rate being reported is the aggregate, and we know that younger groups have lower case fatality rates, so they probably also have lower infection fatality rates. It is easy to imagine that subpopulations such as younger people without comorbidity will have extremely low IFR, even in the range of seasonal flu.

It is somewhat surprising to me that the politically "conservative" opinion seems to be "get back to business as normal", even though we now know that policy would have a life-expectancy-shortening effect on older people. I can understand a starving tribe of hunters-gatherers asking the old people to sacrifice themselves for the sake of their grandchildren. It is kind of surprising to ask presumably respected elders to sacrifice themselves now, with vast amounts of food available for everyone, so that people can go back to eating out, going to bars, going to sports events, and other ways of spending discretionary income.

The presumably low "overall death rate" that the conservative media are touting conceals a very large impact on seniors, but, I guess that is OK with "conservatives".

Instead, how about we figure out how to continue running, or, re-start, the engines of actual productivity, and, learn to live without rubbing shoulders with each other as much. Zoom, Skype, Facetime, Webex, Microsoft Teams, etc., private offices for office workers with private filtered air, etc, etc. We don't need to cough on each other to get productive work done.


Like this comment
Posted by John Mamin
a resident of St. Claire Gardens
on May 23, 2020 at 12:07 pm

I don’t know if it is the reporter who wrote the article, or the researchers who did the study, but somebody seems unclear on the concept of significant figures. It makes no sense to give infection rates to three significant figures (“between 2.49% and 4.16%”) when the uncertainty is that large. Also, how could the true fatality rate be 0.05%? Maybe this was plausible in March, but with nearly 100,000 deaths in the US to date, even if half the country were already infected, the inferred rate would still be higher.


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