[docbrown]

> I still think there's a possibility this virus was already in the US before 2020.

Yeah, I don’t understand why people are so against the idea of it being in the U.S. before 2020. There’s no possible way we can trace every American who may have traveled within the China region or interacted with another person who was in that region around the start of COVID spreading. Just because there were no official cases of COVID does not mean it was not here.

I had a roommate visit Japan in November. He came back and was extremely ill for about a week. No hospitalizations but he was out of commission and isolated by himself.

[kbenson]

I think the main evidence against it being here siginifgantly earlier is that we see how it spread when it was definitely here, so why wouldn't we have seen hot spots like Atlanta and New York earlier then?

[bb2018]

Yeah - if someone could point me to a nursing home where 5% of the population died in a week in December/January I'd believe it - anecdotes about people being having the flu in the winter isn't the most convincing.

[docbrown]

> if someone could point me to a nursing home where 5% of the population died in a week

Sure, if we were talking about mortality rates but we’re not. we’re simply talking about prevalence of COVID prior to the major breakout of February and beyond. These are two completely different things to be looking at.

I’ve worked in nursing homes during that time of December where people were dying. Did we think to send bloodwork off to test for some novel coronavirus? Of course not. Secondly, using the example of a nursing home as the sample population is silly as they are not the ones who were traveling. It’d be their family members and caregivers who traveled and then brought the disease into the facility.

[bb2018]

I think you are missing the statistical point I and others are making. If the disease was introduced in a meaningful way in December/January it would be a statistical certainty we would see signs of it (such as nursing homes having huge waves of deaths or total mortality in subregions surging).

I'm not sure what your counterclaim is? There are no samples in America tested from that time period that would show that there was Covid nor is there any statistical evidence that would suggest there was Covid.

[apatters]

What specific evidence would you be expecting to see in December or January? The infection fatality rate for this disease is probably below 1%, and we don't know what percentage of the population is infected. We don't truly know how quickly it spreads. Nursing home populations are at greater risk, but even if the IFR is 3-5% for that cohort, the population mortality would be some fraction of that, and most of the deaths would be people with pre-existing conditions, and the deaths would be attributed to those conditions.

If there was a year-on-year increase of 1-2% in nursing home deaths for a month or two, would that register with anybody? Maybe they would have noticed if a lot of people were being put on respirators? But if no one knew about COVID they would probably just chalk that up to it being a bad flu season.

[IanCal]

> Nursing home populations are at greater risk, but even if the IFR is 3-5% for that cohort, the population mortality would be some fraction of that,

Looking much higher than that. 80+ is 15-20% and 70-79 is 8% (https://www.worldometers.info/coronavirus/coronavirus-age-se...). It'll be concentrated more in people with pre-existing conditions so I expect nursing homes would see greater figures than that.

> Statistics from Kirkland now appear to tell the national story. Of 129 staff members, visitors and residents who got sick, all but one of the 22 who died were older residents,

https://www.theguardian.com/us-news/2020/may/11/nursing-home...

So we're not talking about one or two deaths but a large proportion of your residents suddenly getting ill in the same way and of those a large proportion dying over a short period.

[docbrown]

Why does it have to be introduced in a “meaningful way” to be relevant? If there was at most a single case of it within the U.S. that would show that the disease spread earlier than what is assumed. Again, your argument rests solely on the idea of there must be thousands of death in order for this disease to exist within the states. That is an odd way to think about this.

It’d also be kind of hard to go back and rerun tests for people during those months, which shows why it’s very difficult to pinpoint when this disease started to really spread. I mean, if France and China both had cases during the month of November and December, you’d be hard pressed to say it’s not possible there were similar cases in the U.S albeit undiscovered.

[bparsons]

It is not particularly unusual for a nursing home to see very high death rates around flu season. In the UK, where they have an excellent healthcare system, the average lifespan of a nursing home resident is 2.2 years.

Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6143238/

[docbrown]

somewhat of a dated article (2010) but the average lifespan of those admitted to nursing homes for EoLC is actually only about six months.[1]

however, some may stay longer, but then they have to worry about their condition worsening and eventually not allowing them to do ADLs (bathing, eating, dressing) on their own. the average length of stay before disablement is close to two years [2]

1: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1532-5415....

2: https://academic.oup.com/biomedgerontology/article/74/6/917/...

[docbrown]

I understand that line of thinking but that would imply the prevalence rate of COVID was in complete parallel with the incidence rate. The former is what we do not know and that's clear when we've had patients labs reran from 2019 and found it was positive for COVID. Government data from China says the first case can be traced back to 17 November 2019 and even then they're unsure if that was patient zero[0]

How many American's were in Asia, China, or surrounding areas between October and December of 2019? How many of them were possibly infected? Nobody knows because there was no plan put in place with regard to travel to mainland China until the end of January 2020; even then since 1 January 2020, there were 430,000 people who traveled from China to the U.S.[1]

0: https://www.scmp.com/news/china/society/article/3074991/coro...

1: https://www.nytimes.com/2020/04/04/us/coronavirus-china-trav...

[Filligree]

Perhaps it mutated at some point to become more infectious, and that mutation happened in Asia.