Miami-Dade Antibody Tests Suggest Local COVID-19 Infections Exceed Confirmed Cases by a Factor of 16

The preliminary results imply an infection fatality rate of 0.2 percent, similar to estimates from two California studies.


Antibody tests in Miami-Dade County, Florida, suggest that something like 6 percent of local residents have been infected by the virus that causes COVID-19. That finding implies about 165,000 infections, or more than 16 times the official tally of confirmed cases when the results were announced on Friday. Based on the current Miami-Dade death toll, those results suggest a fatality rate of about 0.2 percent among people infected by the virus, similar to results from Santa Clara County and Los Angeles County in California but about one-third the rate implied by antibody tests in New York.

Miami-Dade Mayor Carlos Gimenez said "more than half" of the people who tested positive for antibodies reported no symptoms consistent with COVID-19 during the previous seven to 14 days. That finding is similar to the results of virus testing in Iceland, where about half of the volunteers from the general population who tested positive for the virus reported no symptoms.

"There are a lot of asymptomatic cases out there," Gimenez said, which is "something that we've known all along." Confirming that point highlights the importance of social distancing, he added, since carriers may not realize they are infected.

One concern raised by the antibody studies is the representativeness of the samples. The Santa Clara County study, which was conducted by researchers at Stanford University, was criticized for soliciting subjects through Facebook ads, which may have biased the sample toward people worried that they had been infected. The University of Southern California (USC) researchers who conducted the Los Angeles County study drew a random sample from a database maintained by a market research firm, capping participants from particular demographic categories so the sample would reflect the county's general population.

The Miami-Dade study, which was conducted by researchers at the University of Miami, was based on a random sample of about 1,400 people contacted through automated phone calls. Gimenez emphasized that the sample was designed to be representative of the county's population.

In New York, the state health department randomly selected about 3,000 subjects from shoppers across the state, which could have biased the sample in two different directions. Assuming that people who are feeling unwell or who think they may have been exposed to the COVID-19 virus are less likely to be out and about, the prevalence estimates—about 14 percent statewide and 21 percent in New York City—might be lower than the true rates. But if shoppers overrepresent people who have recovered from COVID-19 or who are more likely to have encountered carriers because they are more inclined to venture outside their homes, the true prevalence could be lower than the results suggest.

Another concern about these studies is the accuracy of the antibody tests. The Santa Clara County and the Los Angeles County studies both used tests manufactured by the Chinese company Hangzhou Biotest Biotech and distributed in the United States by Premier Biotech, which is based in Minneapolis. In validation tests, those kits generated false-positive results in two out of 371 samples, meaning the tests erroneously indicated the presence of antibodies 0.5 percent of the time. Subsequent tests of 30 samples drawn from non-COVID patients at Stanford Hospital did not generate any false positives.

In the Santa Clara County study, just 1.5 percent of about 3,300 samples tested positive. But after adjusting the results for ZIP code, race, and sex, the researchers estimated that roughly 3 percent of the county's residents had been infected as of early April. Critics of the study argued that plausible false-positive rates could make those results highly misleading. The authors of the study are working on a revised version that they say will address that point as well as the issue of sampling bias.

In Los Angeles County, the lead researcher, USC public policy professor Neeraj Sood, expressed confidence in the accuracy of the antibody tests. In that study, about 4 percent of the 863 subjects, who were selected to be representative of the county's adult population, tested positive for antibodies. "We think that the false-positive rate of the tests is really low," Sood said.

State researchers in New York developed and validated their own antibody tests "with federal approval," The New York Times reports. It's not clear what the false-positive rate might be.

The Miami-Dade study used tests produced by the North Carolina company BioMedomics. The company reports that its test generated 12 false positives out of 128 samples from uninfected people, meaning the results were erroneous more than 9 percent of the time—much higher than the false-positive rate for the Premier Biotech kits. Gimenez did not specifically address false positives, although he noted that antibody tests have "known limitations."

Keeping in mind the potential problems with sampling and test accuracy, as well as the preliminary nature of the results, the four studies in California, New York, and Florida are broadly consistent in finding that the total number of infections far exceeds the number of confirmed cases. That result is not surprising, since virus testing in the United States so far has been skewed toward people with severe symptoms, who are not representative of everyone who has been infected. But the size of the gap between total infections and confirmed cases, which is crucial in estimating the infection fatality rate (IFR), remains controversial.

The estimated ratio of infections to confirmed cases covers a wide range in these studies: around 10 in New York, 16 in Miami-Dade, 40 in Los Angeles County, and nearly 70 in Santa Clara County (based on the middle estimates). Testing rates might explain some of this variation. New York has conducted more than three times as many COVID-19 tests per capita as California. Florida also has conducted more tests per capita than California has, although the difference (about a third) is much smaller.

If more aggressive testing detects a larger share of relatively mild cases, it might help explain why undocumented infections seem to be more common in California than in New York. Then again, New York may have tested more of its population simply because it has been hit harder by the epidemic.

Applying the IFR estimates from California and Florida to New York City leads to implausible, if not outright impossible, prevalence estimates that are inconsistent with the results of New York's antibody study. The explanation might be that the numbers from California and Florida, suggesting an IFR in the neighborhood of 0.2 percent, are wildly off. Perhaps the IFR implied by the New York results, around 0.6 percent, is closer to the truth.

It is also possible that the IFR is actually higher in New York, and especially in New York City, than in other parts of the country. In New York City, somewhere between 7 and 11 percent of confirmed cases have resulted in death (depending on whether you include "probable" COVID-19 deaths). That is much higher than the current crude case fatality rate (CFR) for the United States (5.6 percent), for California (nearly 4 percent), and for Florida (3.4 percent).

The crude CFR tends to rise as the epidemic progresses in a particular place, partly because there can be a lag of several weeks between infection and death (assuming a median incubation period of five days and an average time of 18 days between symptom onset and death). But in light of the recently documented COVID-19 death on February 6 in Santa Clara County, it seems the virus was already spreading in the San Francisco Bay Area by mid-January. New York and Florida both reported their first confirmed COVID-19 cases on March 1; they reported their first deaths on March 14 and March 6, respectively.

In other words, it does not look like New York City's remarkably high crude CFR can be explained by the advanced stage of its epidemic. An alternative explanation is  overburdened hospitals, which might have led to worse outcomes for COVID-19 patients. New York City's very high population density, in addition to helping the virus spread more there than in other areas of the country, may also have made it harder to protect especially vulnerable people from COVID-19.

Another possible explanation, much more speculative, is that New Yorkers happened to be hit by a deadlier strain of the virus. While Chinese researchers have identified two major strains, one of which seems to be more transmissible, it is not at all clear that one is more lethal than the other. But we do know, based on genetic analyses of the coronavirus, that New York City's epidemic was seeded by dozens of international travelers, primarily from Europe. By contrast, Jeanna Bryner notes on Live Science, California "had about eight initial introductions, mainly from Asia."

An antibody screening project that the U.S. Centers for Disease Control and Prevention (CDC) launched earlier this month should shed more light on the prevalence and lethality of the COVID-19 virus. The CDC is analyzing blood samples from people who were never diagnosed with COVID-19 in various locations affected by the epidemic. It also plans to begin conducting a nationally representative survey this summer. While the information gleaned from that research will come too late to shape the COVID-19 responses that have already imposed a tremendous economic cost on Americans, it may provide valuable guidance to policy makers as they decide when and how to relax sweeping restrictions aimed at curtailing the epidemic.

NEXT: WHO Deletes Misleading Tweet That Spread Paranoia About COVID-19 Reinfection

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  1. Likely less than 0.3 by the time we’re done counting over multiple years. 100-150K deaths are most probable in the US. Which matches the Hong Kong flu of 1968-70 timeframe. And no shelter in place was required then, and none is required now.

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    2. Well, I can’t blame governments for enacting shelter in places with the info they had at the time.

      It’ll be easy to say whether they were needed after this is all said and done. Hindsight is 20/20

      1. Well, I can. But I’m one of these crazy people who thinks that basic rights cannot be suspended.

      2. I disagree but can at least see the logic. However, that was like a month ago at this point, and all the data since the initial lockdowns are pointing one direction.

        This is no longer about the virus. It’s political.

        1. I’m with Zeb on this. Basic Rights should not be suspended. I also don’t think it really ever was about the virus, it was 100% political. Even those that tried to hold out had to end up doing something because the other side was attacking for not doing anything. All theater. No hard data was given, just pedaling fear, uncertainty, and doubt.

    3. If the death to infection rate is .3, then given NYC 12,067 deaths and a population of 8.3 million, then roughly 1/2 of NYC has it (or had it). The math: 12067/.003/8300000. And if the death to infection rate is .1 (as some have suggested), everyone in NYC already has it…. problem solved. Deaths should be dropping off very quickly now…

      Your data/assumptions are wrong.

      Also your logic is flawed. The current death rate is with 1) much better medical system and 2) with social distance/isolation whatever you want to call it. This will still make COVID-19 much worse.

      I just went to an autoparts store. Got everything I needed and all I had to do was stand a few feet apart from everyone there. No big deal. Social distancing doesn’t equate to lock down.

      1. I see you subscribe to the idea that population density, ages, comorbidities, environment, etc. font play a roll in why New York could have an IFR of 0.6 and other places could have an IFR of 0.2.

        I also see you like to completely ignore that thousands of businesses are closed and different states/cities enacted different policies vis-a-vis lockdowns and shelter in place.

        But please, continue to condescend to us simple folk.

        1. After re-reading I see that you said “Don’t play a role” (not font). That is what I want to ask Jacob Sullum and other Reason writers. I may have seen it at one point, but in the last ten or so articles I have read here, they don’t discuss the role that age and co-morbidities and possibly CA’s climate Jan to April compared to NY could possibly have on the differences in IFR.

          1. Why would they? It doesn’t fit with mandated script the media has been given.

      2. Distancing works great at stores when you’re driving your own car to get there and back. What happens to the benefit of staying a few feet apart once you’re riding mass transit and breathing captive/recirculated air with the rest of the people in there (and the people who have disembarked recently) for 5-15 minutes at a time?

        There are probably a lot of parts of the U.S. that never needed to self-quarantine or stay “safer at home”, mostly small towns and rural areas with low population density and a relatively small percentage of the populace living in multi-unit housing (at least with more than 4 units per building). People in a rural county with under 50k population can probably maintain better social distance without making many changes to their lives than people living in older buildings in Brooklyn and Manhattan could achieve without putting plastic sheeting over the vents in their apartments and only opening the door once every 96 hours.

  2. How much longer can politicians ignore data while shrieking about how we have to believe the science?

    Oh wait, we just gotta wait two more weeks for the bodies in the street.

    1. “How much longer can politicians ignore data while shrieking about how we have to believe the science?”


      1. Until we make them un-politicians

        1. Yup. Hopefully that comes via the ballot box instead of another box.

          1. Disagree. ‘Boxes’ in preferred order (in this case):
            1. Jury
            2. Ballot
            3. Ammo
            4. Soap

            1. For Politicians?

              Should be number one on your list.

              1. This is one where John and I, I think, agree. I think you can practice the principles of social darwinism even if it isn’t a thing. Getting bad leaders out of positions of power diligently ensures that only the supernaturally gifted ever hold positions of power for any amount of time. Executing everyone in a position of power every time just ensures you get the violent and sociopathic idiots with nothing to lose in positions of power.

                1. Even if you get them out of office (for awhile) they are still politicians and will spend as much time and effort as needed to get back into office.

        2. The only way to do that is to make them non-existent.

    2. Which politicians are still shrieking at this point? I can’t think of one need story I’ve read in this past week that wasn’t about this or that politician supporting or making plans to “open things back up”. That seems to be the new consensus.

      1. OK, there is AOC, but her logic for why people shouldn’t go back to work is, err, peculiar.

      2. One governor yesterday said “phase one” was a roughly TWO YEAR plan. All the others are making “scientific plans” without looking at the actual scientific data. There is no worry about overwhelming the system in 99% of the country. This is already too widespread to stop. It has been for months. All of this lockdown bullshit has been just that — bullshit.

        1. “I, personally, think Phase One will be a two year affair,” Oliver said. “There are a lot of people working on this, and I hope they prove me wrong, but I don’t see it happening in less than two years.”

          So not the Virginia governor himself, but his chief medical guy. That’s my bad.

          1. Close enough. He no doubt has the Virginia governor’s ear.

          2. Ralphie #GovBlackFaceBabyKillerGunGrabber Northam is a total POS. We are willing to pay anyone willing to take him his Lt.Gov and his AG off our hands. NY, CA, IL ….. they’re your type of guys and here’s your chance to make money off of them.

      3. Rahman Emmanuel is pretty high profile for Democrats.

        The Atlanta mayor.

        Governor Hogan just 3 days ago said too early to open.

        Governor Baker said less than a week ago it was too early.

        So do you even pay attention? Many democrats are holding the course.

        1. I can’t follow it all. That’s why I asked.

          1. It really isn’t.

      4. Which politicians are still shrieking at this point?

        Governor Pritzker ordered masks in public starting May 1. I expect, as long as people get to choose whether they identify with pink or gold or black or whatever triangles, the civil libertarians here at Reason will be pleased.

        1. Governor Pritzker ordered masks in public starting May 1.

          And it should be noted that they aren’t N95 masks, just face coverings. The same masks that we’ve been hearing for weeks are ineffective at preventing COVID transmission.

          1. Like I saidm the world is now an airport. Safety theater for everyone!

        2. Harris County, Texas (where Houston is) had the county judge issue a mask order with a $1000 fine that started yesterday. The police basically said “No we aren’t enforcing it” and then the Gov yesterday announced that starting Friday no local masks orders could include fines. So yes some are still yelling, but the sensible people are no longer listening.

    3. “How much longer can politicians ignore data while shrieking about how we have to believe the science?”

      Just until they can justify bailing out the states and their outrageous pension funds.

      . . . then we can all go back to normal.

      1. Well, THEY will go back to normal. (not that this has been hard on government employees) The people out of work will still be fucked. And since the cratered tax base won’t fund those pensions, we’re gonna need another bailout after the first bailout.

    4. How much longer before people ignore the orders? We didn’t lock down and .005% of us have died. Way less than opiods.

    5. “How much longer can politicians ignore data while shrieking about how we have to believe the science?”

      When is the election again? How much have Trump’s numbers, and those of the rest of the Republican Party, fallen so far?

      That long.

    6. Who’s the Science Pope? Al Gore is already emperor of the Moon, so it can’t be him.

      1. Tony Continuum is very smarter than this reality’s Tony

  3. A mysterious disease that preferentially kills feeble people, brown people, and New Yorkers?

    Has anyone called this the the Literally Hitler Virus yet?

  4. “How much longer can politicians ignore data while shrieking about how we have to believe the science?”

    The virus is a book about Hitler?

  5. Copy -> Paste error. Still no edit button.

    1. The writers seem to have no editors, why should we?

    2. Can’t you read your comment and edit it before hitting “submit?”

      1. No time!

      2. Anyone who has taken a writing course knows that you are your own worse editor. Especially if you edit just after you wrote something. If you are going to do your own editing it is best to leave it awhile and then come back and edit. This is because it is easier to see errors with a fresh eye. Your brain knows what you meant to say and thus supplies the correction automatically. It is also how most adults read. We rarely read the whole word but rather focus on the first and last letter and our brain, which is equipped to see patterns supplies the rest from memory and experience. Your thought process is also much quicker than you can type or write, therefore it is not uncommon, even for talented experiences writers to skip ahead while writing, i.e. leave out words, or misuse a word. This is more of a problem with higher IQs and high functioning Autistics, whose brains are already geared up (for lack of a better phrase) and who have above average pattern recognition.

        1. Throw in Reason’s glitchy website and stupid pop-ups…

        2. Professional editor: All this is true. Self-editing is a recipe for disaster.

          1. Wut r u taking abut? I never mak mystakes.

        3. I bet you’re a blast at parties 😉

  6. “The preliminary results imply an infection fatality rate of 0.2 percent, similar to estimates from two California studies.”

    I guess they’ll just have to keep testing until they get the frightening results they’re looking for. If at first you don’t succeed, try, try again.

    1. We have three studies with a fairly high degree of agreement, using two different methods and one study with a much higher rate, in an area with extremely high mortality, such that it could be considered an outlier. Isn’t it possible that New York is an outlier with a unique set of circumstances, and that the three studies that agree is closer to the norm?

      1. Yeah, but if they keep getting the wrong answer, they’ll have to keep studying it until they get the right one!

        It works the same way with global warming and gun control, too. If the statistics suggest that we shouldn’t be pro-gun control, radical environmentalists, then you know the studies must be wrong!

        1. If the statistics suggest that we shouldn’t be pro-gun control, radical environmentalists, then you know the studies must be wrong!

          And once agains (more for the viewing audience at home) even if the stats say you should push the fat man in front of the trolley car, it’s still a crime, morally wrong, and something you shouldn’t do.

      2. I should have written that first post in sarcasm font.

        1. I can’t believe it hasn’t been invented yet.

          1. It’s called Comic Papyrus

            1. Comic Papyrus walks into a bar.

              Bartender says “we don’t serve your type in here.”

      3. soldier….provisionally, yes = Isn’t it possible that New York is an outlier with a unique set of circumstances, and that the three studies that agree is closer to the norm?

      4. What it might imply is that the infection fatality rate VARIES with the infection rate.

        So if in NYC you on average are subjected to, let’s say, five people per day in close contact, out of 25, and, in Florida, around one in 20, then the viral load you’re getting in FL would be less, and thus, you would have a better chance to survive.

        In other word, all of these studies could be approximately correct.

        1. “What it might imply is that the infection fatality rate VARIES with the infection rate.”

          This. The term for it is amplification. Which makes sense, given that this is a new version of an old virus – meaning that it still shares much in common with the older versions.

          So your immune system probably already has some degree of recognition – circulating antibodies that are at least partially responsive to the exterior of the virus (core proteins probably not so much.)

          Meaning limited exposure tending towards a limited infection, while greater exposure tending towards overwhelming your ability to mount an adequate defense and a much more severe illness.

        2. People seem to be largely ignoring the viral load question. Seems important.

          1. Given the sorts that are doing the most yammering I think it less “ignoring” and more “don’t even know it’s existence.”

  7. They say 64 percent of all the world’s statistics are made up right there on the spot
    82.4 percent of people believe ’em whether they’re accurate statistics or not
    I don’t know what you believe but I do know there’s no doubt
    I need another double shot of something 90 proof
    I got too much to think about

    The Statistician’s Blues

    1. A few years ago I picked up a couple bottles of single cask barrel proof rums from St. Lucia Distillery that clocked in at just over 140 proof.

    2. The Statistician’s Blues

      In case Remy’s reading this, I was expecting this melody.

  8. Great. Another ‘study’ from a suspect pool of subjects, adjusted all to hell, with false positives and false negatives and a bunch of other reasons to ignore this one too.
    All we know for sure is that some people will get sick, and some will not. Of those who get sick, some will die and some will not.
    And we also know the fascists closing down the economy was a big mistake.

    1. I would say that three studies, using two different methods, with similar results is the beginning of a trend. If it is such, then we can consider New York an outlier and not the norm.

      1. This. That they all unequivocally point in the same direction speaks volumes.

  9. How the hell can the estimated cases exceed the confirmed cases? I thought we had decided “confirmed” now means “not confirmed but we’re going to guess it might have been” in coronavirus fatality counts so why can’t we call guesstimated infection cases confirmed cases as well?

  10. We don’t need antibody tests and fatality rates to tell us that there is no need to shut down society for a disease that almost exclusively kills 80 year olds with preexisting conditions.

    1. All around the world, the median age of death is basically the country’s life expectancy. If we stop this people from dying of COVID do we shut the world down in September to stop them from dying of regular flu?

      1. There will be no more 80 year olds. They will all be dead if you keep going outside.
        Why do you want to kill grandpa??

  11. Right from the beginning this smelled like politicians raising a fuss for their own glory — supposedly took three weeks in Wuhan alone. Then there was the cruise ship (Princess Diamond I believe) which had a remarkably low infection rate for so many people so cooped up. The navy ships carried the same tune.

    What’s this now, 4 studies showing a similarly remarkably normal infection rate? And all the stats showing average age of death well over 70? And all the deaths attributed to coronavirus simply for being infected when dead?

    The signs have been obvious for months. This is no worse than SARS or MERS or Ebola, and all this hoopla is politicians making themselves look relevant in the age of Trump. For all his faults, Trump is in some ways the most honest transparent politician since Jimmy Carter or Andrew Jackson, and I attribute that to scaring all the ordinary old-fashioned politicians (including AOC and her squad) into going over the top and trying to make themselves appear fresh and relevant.

    1. The signs have been obvious for months. This is no worse than SARS or MERS or Ebola, and all this hoopla is politicians making themselves look relevant in the age of Trump.

      I’m sorry, but no….this is one of the more ludicrous statements I’ve read in the past few weeks. 50K people dead in 6 weeks is pretty fucking bad. Get your head out of your derriere.

      We won’t know just bad this is for some time.

      1. 50K people dead in 6 weeks

        We don’t know that this is true.

        The CDC and state health officers have been very open about the fact that dying WITH C19 is counted as dying FROM C19. That in amongst the fatality rate, beyond the first inflation is a second–presumed C19 deaths.

        And they speak openly about these things.

        So we have no way of knowing how many people actually died FROM C19.

        But I will say this–in previous pandemics, they didn’t ‘presume’ or ‘assign’ deaths to the pandemic. They knew.

        1. But I will say this–in previous pandemics, they didn’t ‘presume’ or ‘assign’ deaths to the pandemic. They knew!

          Yes, in 1919 they had perfect tests that accurately told them what killed each person.

        2. Azathoth makes a key point. My understanding is that states are defining dying with C19 is the same as dying because of C19. But additionally, having C19 seems to scale far beyond having a positive test, it also includes just having symptoms, and in some cases just being in an environment where others have symptoms.

          Having radically different definitions that determine when to record a death with C19 as the cause will certainly give different mortality rates.

          It is also my understanding that the CDC data specifically looks at what was written on the death certificates, as opposed to just using state tallies. Any intel on the validity of that would be helpful.

      2. 50K people dead in 6 weeks is pretty fucking bad.

        First, it isn’t 6 weeks. We’re at the end of Apr. and the first case was reported in Jan. It’s closer to 8 weeks.

        Second, heart disease killed 72-96K people in the same amount of time* (likely more due to doctors’ visits and elective surgeries being curtailed), Cancer killed 60-80K, other respiratory illness kills 22-45K. It’s a bad flu season. It’s the first one they ‘called accurately’, unfortunately, they did it in such a manner that instead of future warnings being heeded, they will be actively dispised, refuted, and ignored. A wolf was coming for the sheep and they shouted that the sky is/was falling.

        *Our perception of time being, apparently, a bit subjective.

        1. Mar 30: 4000 deaths
          Apr 26: 55,000 deaths

          That’s 50k in 4 weeks.

    2. I saw the handwriting on the wall early, too. That’s why my portfolio is now 2 times what it was when this started…

  12. The longer humans shelter in place, the less robust our immune systems become. When we finally emerge from our homes, more of us will catch colds and other viruses because of the sheltering logic. Our immune systems get stronger by being exposed to bacteria, viruses and germs.

    You don’t quarantine healthy people, unless you want them to get less healthy.


    2. That’s basically what happened during the Spanish flu. The first wave wasn’t all that bad and places practiced social distancing and isolation to varying degrees, but sick troops brought home a stronger, mutated strain and the second wave was the worst of the three main spikes. The ones who had been exposed in the first wave ended up having antibodies and weren’t hit as bad as the people who weren’t.

      1. I looked that up, holy hell

        “Reported cases of Spanish flu dropped off over the summer of 1918, and there was hope at the beginning of August that the virus had run its course. In retrospect, it was only the calm before the storm. Somewhere in Europe, a mutated strain of the Spanish flu virus had emerged that had the power to kill a perfectly healthy young man or woman within 24 hours of showing the first signs of infection.”

  13. The Miami-Dade study, which was conducted by researchers at the University of Miami, was based on a random sample of about 1,400 people contacted through automated phone calls. Gimenez emphasized that the sample was designed to be representative of the county’s population.

    Because the entire population is known to respond to random automated phone calls?

    1. In their defense, the sampling is more representative after the the shelter-in-place orders were put in place than before.

  14. My shocked face. No mask.

  15. If none of those that orchestrated this are killed for it, their power and will to exercise that power will only grow

    1. If none of those that orchestrated this are killed for it, their power and will to exercise that power will only grow.

      “Nicky, be very careful what you say next. Who?”

      1. Bill Gates would send a message…

        1. That they should have stopped making OSs with Win7?

          No, I think it would need to be politicians, media, or both. And no one would bother listening to the killers’ message: they’d just condemn the entire thing, and see no connection whatsoever to the victims’ past actions.

        2. What is Bill Gates supposed to have done?

  16. Exposed. Not infected. Is there any other goddamn disease with which we assume the the presence of antibodies necessarily implies infection? It’s infuriating

    1. You’re a physician right? I’ve got a question for ya (or anyone who might shed some light.)

      There’s been an awful lot of buzz about the reliability of the results of these studies due to false-positive probabilities. But what about false-negatives?

      If they occur at roughly the same rate, then wouldn’t it be a statistical wash? Are false-negative probabilities known and just not emphasized? Do these types of tests preclude the possibility of false-negative results?

      I’m too lazy (or apathetic) to research it, but maybe someone here knows something.

      1. It depends. In this case, because there are fewer positives, a false positive introduces more “skew” than a false negative. If true positives and negatives were equal, you’re correct that it would be a wash.

        1. Well shit, now that you said it, that’s both simple and obvious. Well ya know what they say: “there are no stupid questions… just stupid questioners.”

    2. Exposed vs infected is a false distinction. They are not medically different. If you were “exposed” enough that your body begins producing antibodies, then you were “infected”. So to your question, every other disease carries the assumption that the presence of antibodies implied infection.

      I think the distinction you are trying to make is between “exposed” and “infectious“. You can be exposed (and infected) at a low enough level that you are creating antibodies but your immune system shuts the infection down before you begin shedding virons yourself. Thus, you are infected but not infectious. (Note: While this biological response is known to be possible for some diseases, it is unknown whether humans can be non-infectious for COVID-19.)

      1. thanks rossami! this is my understanding as well. your body can’t make anti-bodies for something that it has not been infected with. flu-type vaccines give the body a weak infection to help it start producing antibodies. I’m not aware of anyway to produce anti-bodies with never being infected.

        I don’t think anyone is implying that the presence of anti-bodies implies active infection. that would be done with a standard c19 test.

  17. How about ‘New York’s death rate is higher because they facilitated the spread of Covid-19 in nursing homes, which dramatically increased infection rates among the most vulnerable population’? That seems like a pretty plausible reason why NY’s death rate is so much higher than everywhere else.

    1. Oh come on. Your suggesting that they sent positive cases back to nursing homes to recover. What kind of government would do that.

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  19. just an avalanche of data on this now

    test and trace was always spitting into a hurricane

  20. Let’s run some numbers about this false-positive “undercutting”. According to the article, the test showed 165,000 positives. To make that 6%, the local population must have been 2.75 million. Assuming a full 10% of the positives were false-positives, that means only 148,500 true-positives. That works out to 5.4% of the population. Which, granted, is not 16 times higher than the official tally of confirmed cases – it’s 15 times higher.

    This is the best quibble they’ve got?

    1. It’s Reason (drink) and this is a pandemic, the science reporter multiplied by New York and came up with 12.4M people infected.

  21. just an avalanche of data on this now

    test and trace was always spitting into a hurricane

    note implied IFRs vary wildly everywhere else, too… Hubei, Daegu, and NY all got hit much harder than their respective countries… given that we know there are 30+ strains, IFR may vary quite a bit across them (and gentler strains of anything are usually more easily spread)

  22. and as if we needed more bad news… even younger asymptos are having strokes at alarming rates

  23. At Mount Sinai, the largest medical system in New York City, physician-researcher J Mocco said the number of patients coming in with large blood blockages in their brains doubled during the three weeks of the covid-19 surge to more than 32, even as the number of other emergencies fell. More than half of were covid-19 positive.

    Remember when Zika was going to give newborns around the globe microcephaly and we shut down the olympics?

    Turns out, when you shut down bars and restaurants, force people to stay home rather than going to the gym or consuming their favorite blood thinners, more of them die of strokes. Also, in a pandemic, more people test positive.

    1. Whoops. Meant as a reply to TallDave.

      P.S. – I’m astounded that, with all the COVID deaths piling up, doctors have all this time on their hands to publish journal articles, referee articles, etc. Not that communications should cease, but it seems like these neurosurgeons are looking for work.

  24. So it’s about twice as deadly as the flu.

    We’ve lived with the flu for over a hundred years, and we’ll live with this too. If the liberal scumbags will allow us too that is.

  25. “There are a lot of asymptomatic cases out there,” Gimenez said, which is “something that we’ve known all along.” Confirming that point highlights the importance of social distancing, he added, since carriers may not realize they are infected.

    Seems like another interpretation would be that it highlights the pointlessness of social distancing. It spread a lot without anyone noticing. It’s not going to be contained.


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  28. “Based on the current Miami-Dade death toll, those results suggest a fatality rate of about 0.2 percent among people infected by the virus, similar to results from Santa Clara County and Los Angeles County in California but about one-third the rate implied by antibody tests in New York.”

    If it’s 1/3 the rate of New York it’s because in New York they count you as being killed by coronavirus if you test positive after you die of blunt trauma. Their mortality numbers are bullshit. Increasingly, so are the mortality numbers from everywhere else, like the People’s State of Illinois, which just admitted that they attribute deaths to corona that had nothing to do with it.

  29. Why does Reason keep acting like there’s a contradiction if the infection rate in one area differs from the infection rate in another area? Or that it’s suspicious if the ratio of positive diagnoses to results implied by a random sampling differs from place to place?

    We have all sorts of reason to expect different infection rates in different areas, and obviously a ratio of already-diagnosed to percent actually infected depends on how much testing has been done in the area.

  30. Hindsight is indeed 20/20.

    Looking back six to eight weeks or so things looked like they could get pretty grim. Nobody believed they were getting the truth out of China, but what we were getting was bad enough to think things could get really ugly, and then Italy did nothing to help those perceptions.

    My big fear wasn’t that everyone was going to die . I sort of trusted that our outcomes were not going to be as grim as those places. Mostly because our health system truly is better, but also due to differences in things like population density, underlying health conditions/environmental disease, better nutrition, etc.

    No my fear was that enough critical people – people who actually do the important stuff like haul freight, maintain the power grid, stock store shelves, etc. were going to get sick and have to self isolate/take off work. That starts happening and, at some critical level it really becomes TEOTWAWKI, if only for a limited time. I work in long term care facilities and remember having conversations with facility leadership back in February about the possibility of needed to house staff on site – basically a Fort Apache type scenario.

    Thankfully, with more information, and our experience of the last six weeks of sort-of-social-distancing it looks like that is not, and probably never was, in the cards.

    Now it’s time to find our way out of the mess. I’m perfectly willing to forego the blame game so long as we do start unwinding restrictions ASAP. The longer people hem and haw the more blame becomes part of the game.

    1. (And by Fort Apache I’m not talking about any sort of Road Warrior world, more that the facilities would be cutting themselves, and their remaining healthy staff from the disease.)

    2. Yes it is at this point. Like a dog chasing its tail with the daily number projections.

      You might have seen this. Everything a clinician needs to know I think.

  31. need weekly wastewater studies everywhere #MeasureThePee

  32. I wish it seemed like this would be entirely sarcastic, but the lockdowns in CA would probably end tomorrow if the President publicly called them “critical to saving lives” three times in 24 hours, or tweeted that “flattening the curve” seems to be working.

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  34. “Undocumented infections” higher in California and New York. Jeez…

  35. This article seems to reach a bogus conclusion as only those with symptoms are tested. You can’t extrapolate from such an unrepresentative group.

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