A Covid-infected attendee emerges from CES in January(apmreports.org)
apmreports.org
A Covid-infected attendee emerges from CES in January
https://www.apmreports.org/story/2020/04/23/covid-infected-attendee-ces-tech-conference
36 comments
Same disclaimer applies for my comment, and adding that I'll be throwing out some of my own crackpot theories...
I'm in NYC, and am convinced my family had it in February. This leads me to also wonder if it wasn't rampaging its way through NYC for months before we had a confirmed case. My wife went to urgent care in tears because of breathing problems, a fever, etc. All we know was it was not the flu or strep and she eventually recovered. The rest of our family had at least mild symptoms, and given how infectious it is - how would we not have gotten it given we did no distancing whatsoever.
The thing I am trying to wrap my mind around, is that if it was so prevalent before we knew about it - how did we not notices so many people dropping dead, etc? I have two thoughts that I would love to explore more.
1. We know about the placebo effect. Why would there not be a reverse placebo effect for this virus? If my wife had been seeing non stop covid news in February about how scary this disease is, why would she not start panicking, having more breathing problems, worse symptoms, and maybe even take a turn for the worse? If giving a sugar pill to someone and calling it medicine can improve outcomes - surely watching dire cable news about how people with your symptoms are dying left and right could do the opposite.
2. Maybe those of us who got it early were lucky, because they just weren't exposed over and over like people who finally got it in March/April.
If either or both of these things were true, then it could explain why/how the fatality rate rose dramatically in March/April, which would explain better how this could fly under the radar for so long, but be so prevalent.
And who knows - maybe someday I'll get a chance to take an antibody test and will find that I'm wrong and my family just got hit with a bad cold.
I'm in NYC, and am convinced my family had it in February. This leads me to also wonder if it wasn't rampaging its way through NYC for months before we had a confirmed case. My wife went to urgent care in tears because of breathing problems, a fever, etc. All we know was it was not the flu or strep and she eventually recovered. The rest of our family had at least mild symptoms, and given how infectious it is - how would we not have gotten it given we did no distancing whatsoever.
The thing I am trying to wrap my mind around, is that if it was so prevalent before we knew about it - how did we not notices so many people dropping dead, etc? I have two thoughts that I would love to explore more.
1. We know about the placebo effect. Why would there not be a reverse placebo effect for this virus? If my wife had been seeing non stop covid news in February about how scary this disease is, why would she not start panicking, having more breathing problems, worse symptoms, and maybe even take a turn for the worse? If giving a sugar pill to someone and calling it medicine can improve outcomes - surely watching dire cable news about how people with your symptoms are dying left and right could do the opposite.
2. Maybe those of us who got it early were lucky, because they just weren't exposed over and over like people who finally got it in March/April.
If either or both of these things were true, then it could explain why/how the fatality rate rose dramatically in March/April, which would explain better how this could fly under the radar for so long, but be so prevalent.
And who knows - maybe someday I'll get a chance to take an antibody test and will find that I'm wrong and my family just got hit with a bad cold.
Three reasons to why it may not have been "noticed":
1. Early on it had only spread in a small percentage of the populace so the absolute number of deaths was too low to be noticed.
2. The deaths from the regular flu this year were very low, see: https://www.euromomo.eu/graphs-and-maps/
3. The antibodies test out of Europe and NYC are pointing to an IFC around 0.35-0.6 which could "only" be 3-6x the bad 2017 flu season, note Covid19 is still the worse pandemic in decades.
1. Early on it had only spread in a small percentage of the populace so the absolute number of deaths was too low to be noticed.
2. The deaths from the regular flu this year were very low, see: https://www.euromomo.eu/graphs-and-maps/
3. The antibodies test out of Europe and NYC are pointing to an IFC around 0.35-0.6 which could "only" be 3-6x the bad 2017 flu season, note Covid19 is still the worse pandemic in decades.
It's called the Nocebo effect [1]. It's discussed on Mind Field S2 E6 The Power of Suggestion.
[1] https://en.m.wikipedia.org/wiki/Nocebo
[1] https://en.m.wikipedia.org/wiki/Nocebo
Going off a tangent here but just wanted to comment how powerful the nocebo effect can be.
I'm familiar with it in the context of strength sports, where "tweaking" your back, knees, etc. is relatively common.
If you tweak something and immediately go "oh no no no I'm gonna be out for weeks now", it does happen. The pain only seems to get worse for days, you can't move, if it's your lower back sometimes you can barely get out of bed.
When you learn to distinguish between "I'm hurt" (something felt a little funny and it hurt a bit, but you're still functional) vs "I'm injured" (something actually went really wrong, like a major muscle strain, or blunt trauma), and learn to keep a positive attitude in the face of pain, you're back in a couple days.
There's a group called Barbell Medicine that completely changed my mindset when it comes to nocebo. They teach people to accept pain is part of life, and to assess it instead of immediately worrying or panicking about it and going into what they call "movement avoidance".
I'm familiar with it in the context of strength sports, where "tweaking" your back, knees, etc. is relatively common.
If you tweak something and immediately go "oh no no no I'm gonna be out for weeks now", it does happen. The pain only seems to get worse for days, you can't move, if it's your lower back sometimes you can barely get out of bed.
When you learn to distinguish between "I'm hurt" (something felt a little funny and it hurt a bit, but you're still functional) vs "I'm injured" (something actually went really wrong, like a major muscle strain, or blunt trauma), and learn to keep a positive attitude in the face of pain, you're back in a couple days.
There's a group called Barbell Medicine that completely changed my mindset when it comes to nocebo. They teach people to accept pain is part of life, and to assess it instead of immediately worrying or panicking about it and going into what they call "movement avoidance".
1. There's a Dr. House episode* about this phenomenon.
* https://www.youtube.com/watch?v=ox6HWOjbDSI
* https://www.youtube.com/watch?v=ox6HWOjbDSI
> I think we'll eventually find out COVID-19 has been around way earlier in 2019 than we thought.
Perhaps, but if it was, it was certainly happening at a significantly low rate, although that's probably how they all get started given that's it's expotential.
Since this has a higher fatality rate than traditional, common viruses I'd be most interested in the death rate of the population versus the normal average. Much like the NYTimes did for NYC[0], although much of data for 2019 seems to be absent unfortunately.
[0] https://www.nytimes.com/interactive/2020/04/10/upshot/corona...
Perhaps, but if it was, it was certainly happening at a significantly low rate, although that's probably how they all get started given that's it's expotential.
Since this has a higher fatality rate than traditional, common viruses I'd be most interested in the death rate of the population versus the normal average. Much like the NYTimes did for NYC[0], although much of data for 2019 seems to be absent unfortunately.
[0] https://www.nytimes.com/interactive/2020/04/10/upshot/corona...
You can buy 'em now on Alibaba. Not FDA approved, Your Accuracy May Vary.
Why didn't all of you spread the disease to everyone else in the neighborhood?
Not trying to spread misinformation, since we know that one function of this coronavirus weakens your immune system as well as protective lining to the lungs for opportunistic additional viruses and bacteria to get you, then if those other viruses and bacteria never show up then more people would be fine.
No different than the "clinical latency" stage of HIV where nothing happens for a decade until your immune system weakens and then a benign opportunistic infection causes you problems. Here it just happens a lot faster - while this coronavirus is also executing other functions in multiple different organs.
This leads to the possibility that there are other seasonal but otherwise benign viruses and bacteria that are prevalent, while this coronavirus is also spreading.
Is that really as much of a farfetched idea if everyone has been looking a different direction? Just harder to resolve and an area to put some energy and research.
No different than the "clinical latency" stage of HIV where nothing happens for a decade until your immune system weakens and then a benign opportunistic infection causes you problems. Here it just happens a lot faster - while this coronavirus is also executing other functions in multiple different organs.
This leads to the possibility that there are other seasonal but otherwise benign viruses and bacteria that are prevalent, while this coronavirus is also spreading.
Is that really as much of a farfetched idea if everyone has been looking a different direction? Just harder to resolve and an area to put some energy and research.
I stayed home the whole time. Was totally shot. And if they're right about COVID-19 spreading asymptomatically around 2 days before symptoms start, if my memory serves me right that would have coincided with the weekend for me.
To explain the cavalier attitude expressed by people with symptoms: the “CES Flu” is a real thing. I’ve gone 11 years in a row now, and either me or my brother usually catches it every year. Something about thousands of international visitors in the same space, touching all the same things I guess.
Interestingly, I took a really proactive approach this year with liberal hand sanitizer usage and neither of us got sick!
Interestingly, I took a really proactive approach this year with liberal hand sanitizer usage and neither of us got sick!
Drupal Flu too. DrupalCon, an event with just a few thousand attendees practically always spread illness. Read https://groups.drupal.org/node/294978 this post from 2013, it'll be eerily familiar:
> Learn to wash your hands properly. We all think we know how to wash our hands, but most of us don't. Really.
> Wash your hands regularly, especially after lots of handshaking (Some people even wish we could avoid shaking hands), or handling money — and always before eating.
> Don't touch your face, especially your eyes, nose or mouth.
Really, covid instructions are nothing new.
> Learn to wash your hands properly. We all think we know how to wash our hands, but most of us don't. Really.
> Wash your hands regularly, especially after lots of handshaking (Some people even wish we could avoid shaking hands), or handling money — and always before eating.
> Don't touch your face, especially your eyes, nose or mouth.
Really, covid instructions are nothing new.
I've personally gotten the 'Drupal Flu' twice, there are just so many surfaces and items that multiple people (often hundreds) touch including elevator buttons, door handles, coffee carafes, stuff on vendor tables, etc. — even if you are diligent in washing hands and trying to avoid rubbing eyes, etc., it doesn't take much.
It's telling that usually one or two vendors have a freebie that consists of some sample-size medication and vitamin packs.
It's telling that usually one or two vendors have a freebie that consists of some sample-size medication and vitamin packs.
This is a known phenomenon at science fiction conventions as well, typically known as "con crud". It's not uncommon for a large percentage of attendees to all get sick immediately after an event.
It turns out conventions of any type are excellent vectors for spreading contagion.
It turns out conventions of any type are excellent vectors for spreading contagion.
And it should be almost tautologically obvious, but this is extremely common for music festivals, which adds in the additional challenges of low sleep and immunocompromise caused by drug usage (drugs like mdma are thought to be immunosuppressive in recreational doses)
My first time at CES (and AVN in the same week), a number of years ago, I left with something that resembled the flu and a sinus infection. Everyone told me that's typical.
Color me deeply skeptical. All the data we see out of "real" hotspots like New York seem to show a fairly clear progression on infection rate, days-to-show-symptoms, days-to-go-south, and days-to-die. If ConFlu was Covid, we would have seen a much more clear connection and growth. I would expect for Nevada to have been in a New York scenario.
I'm not saying this isn't COVID, it sounds like it might very well have been, but isn't "picking up the con crud" a stereotype of all conventions?
I'm amazed (not surprised however) that this neologism is at least a decade old:
https://www.urbandictionary.com/define.php?term=con%20crud
edit: of course there's a 1995 citation from Usenet:
https://en.wiktionary.org/wiki/Citations:con_crud
https://www.urbandictionary.com/define.php?term=con%20crud
edit: of course there's a 1995 citation from Usenet:
https://en.wiktionary.org/wiki/Citations:con_crud
Isn't it considerably more likely that the flu they all had from CES was... well... the flu? Given January is the tail-end of flu season?
Incidentally I’ve noticed tons of people talking about having come down sick at the beginning of January in the US and assuming they must have had covid. It’s like people forgot how many different respiratory infections are out there.
We’ve gone from “covid19 is just a flu” to “the flu was really covid19 !!11!!”.
It will take years of research to untangle truth from “feelings”.
It will take years of research to untangle truth from “feelings”.
Retrospective antibody testing should be viewed carefully, given the relatively low specificity (i.e., high rate of false positives).
If there’s a high clinical suspicion (could be relevant in this case, though it may also represent the normal flu), the utility of the testing improves.
If there’s a high clinical suspicion (could be relevant in this case, though it may also represent the normal flu), the utility of the testing improves.
Where are you getting low specificity for antibody tests? Most I’ve seen are 98+% with lower sensitivities.
Ah, I'd be quite interested seeing your 98+% specificity antibody!
Looking at the three out of four FDA EUA-approved serology tests (see https://www.fda.gov/medical-devices/emergency-situations-med...) most do not report sensitivities up to 98%, with the notable exception of Ortho Vitro, though the diversity of the samples they test isn't described.
1. Cellex - https://www.fda.gov/media/136625/download
2. Ortho Vitros - https://www.fda.gov/media/136967/download
3. Chembio - https://www.fda.gov/media/136963/download
Looking at the three out of four FDA EUA-approved serology tests (see https://www.fda.gov/medical-devices/emergency-situations-med...) most do not report sensitivities up to 98%, with the notable exception of Ortho Vitro, though the diversity of the samples they test isn't described.
1. Cellex - https://www.fda.gov/media/136625/download
2. Ortho Vitros - https://www.fda.gov/media/136967/download
3. Chembio - https://www.fda.gov/media/136963/download
I went to CES this year, and a week and a half after (a typical incubation time for Covid-19) I started coming down with a strange lower respiratory illness that involved joint aches (my sacroiliac joint in particular, which I think I had stressed horribly the past year, suddenly became excruciatingly painful as I got sick to the point where I couldn't sleep), and intense on/off fevers/chills that lasted way longer than I am used to... and yet my cough was unproductive, I had no sinus or other involvement (which I always get), and I simply didn't have any other symptoms I am used to with a flu; it essentially seemed like "pneumonia maybe but with the wrong progression".
Regardless, I was knocked out for a while due to the fevers and lack of sleep. When I was just sort of getting better, I was visited by a coworker who, two weeks after he saw me for a day--and he notably spent most of that day with me, including multiple meals: we are two people at the top of a small company and I had been sick a while, so we had a lot to catch up on)--got sick with what we later determined was Covid-19 by positive test (but like, weeks later, at which point I hadn't been sick for a long long time, so there seemed no point in trying to use a viral test on me).
FWIW, we have good alternative explanations for where he got Covid-19, where I got sick with a shorter incubation time (involving me getting very little sleep while traveling to a handful of back-to-back events), and why I had joint pains (a particular series of flights and car trips that were similar to what I think first caused me issues a year ago... I didn't understand this until a month later, btw: I am changing my style and quantity of travel); but I really wish it were easy for me to quickly get an antibody test to see whether I have already had this (though that still won't ever tell me for sure as I could have had an asymptomatic case more recently... le sigh).
Regardless, I was knocked out for a while due to the fevers and lack of sleep. When I was just sort of getting better, I was visited by a coworker who, two weeks after he saw me for a day--and he notably spent most of that day with me, including multiple meals: we are two people at the top of a small company and I had been sick a while, so we had a lot to catch up on)--got sick with what we later determined was Covid-19 by positive test (but like, weeks later, at which point I hadn't been sick for a long long time, so there seemed no point in trying to use a viral test on me).
FWIW, we have good alternative explanations for where he got Covid-19, where I got sick with a shorter incubation time (involving me getting very little sleep while traveling to a handful of back-to-back events), and why I had joint pains (a particular series of flights and car trips that were similar to what I think first caused me issues a year ago... I didn't understand this until a month later, btw: I am changing my style and quantity of travel); but I really wish it were easy for me to quickly get an antibody test to see whether I have already had this (though that still won't ever tell me for sure as I could have had an asymptomatic case more recently... le sigh).
I was in Seattle (where it supposedly entered the US) in mid-December and got pretty much the same symptoms as you, a week and a half after!
Everyone else on the trip was sick, too.
I've never had the flu.
Everyone else on the trip was sick, too.
I've never had the flu.
I know that "con flu" is mostly anecdotal, but a preponderance of evidence is still a preponderance of evidence, and quite litterally every person person I've known that regularly goes to conferences and conventions has not only heard of con flu, but has had it on more than one occasion. It's absolutely a thing.
[deleted]
I came back from CES to home in Eugene, OR, and fell ill. I missed 10 days of work. I am an anesthesiologist, and I knew that I have a viral illness (high fever, myalgias, SOB, etc). At the time I tested negative for influenza. Interestingly, I've been in a quarantine for a month. And I wore N95 for two weeks prior to the quarantine, because of my super paranoid wife. So if I can get tested for antibodies, it will be almost certainly CES, if I am positive.
This is a fascinating article. To retrospectively test attendees might shed a lot of light on the early spread.
I think we'll eventually find out COVID-19 has been around way earlier in 2019 than we thought. I've seen both here on HN and elsewhere anecdotal reports of people having a "flu like nothing before" in late 2019 and early 2020 in the US. There's at least one report of Italian doctors seeing a "strange pneumonia" in November (https://www.scmp.com/news/china/society/article/3076334/coro...).
My own story is this. My wife went with her team to a Chinese karaoke bar here in Seattle, in International District, in mid-November. Everyone fell very, very sick (one person has a lingering dry cough to this day). Fever for days on end, cough, etc. It seemed like the flu, except my wife and others claim it just felt different from other times they had the flu.
I caught it from my wife, and it did feel different. I'd never had a fever run for so long, and the way it progressed was just different. And the most unusual thing was that it seemed to affect my heart. I take a beta blocker to control frequent PVCs. But on the days immediately following "recovery" (by which I mean no more fever), I just couldn't move around too much or my heart would start throwing PVCs like crazy, as if I hadn't taken my meds. I was also feeling very weak and faint, which never happened to me before (I'm usually able to exercise just fine right after recovering from illness).
To add to the anecdote, our daughter caught it too but she just seemed to have a mild cold, which also matches the majority of infant COVID-19 cases.
I hope serological tests become widely available, since I'm really curious to know if I actually had it back then. Obviously in the mean time I'm not assuming I did, and I'm staying home and avoiding all human contact I can.