Total cases can be misleading sometimes. Spain has a higher infection per population compared to the US for example. However, as JJ pointed out, the US outbreak is literally just starting in some highly populated areas compared to other countries.
As someone who lives in Seattle - yes, the local epidemic has slowed down. According to the official state data, the number of hospitalized patients in WA has gone from 638 to 642 over the four days from 4/6 to 4/10, and the number of ICU patients has gone from 191 to 191 in the same span.* There are still new cases being discovered and people dying, but it's pretty clear we've reached the peak in terms of a burden on the healthcare system.
Of course, this doesn't mean we can afford to open up and return to "normal" yet. There are still enough sick people out there, and infected people who don't know it, that the epidemic would come roaring back. Washington has been better than most parts of the USA with testing, but we still can't afford to contact-trace everyone that's infected and really squash it.
*The number of hospitals reporting varies day to day, but the two days I quoted had the same number. They should be comparable enough.
As someone who lives in Seattle - yes, the local epidemic has slowed down. According to the official state data, the number of hospitalized patients in WA has gone from 638 to 642 over the four days from 4/6 to 4/10, and the number of ICU patients has gone from 191 to 191 in the same span.* There are still new cases being discovered and people dying, but it's pretty clear we've reached the peak in terms of a burden on the healthcare system.
Of course, this doesn't mean we can afford to open up and return to "normal" yet. There are still enough sick people out there, and infected people who don't know it, that the epidemic would come roaring back. Washington has been better than most parts of the USA with testing, but we still can't afford to contact-trace everyone that's infected and really squash it.
*The number of hospitals reporting varies day to day, but the two days I quoted had the same number. They should be comparable enough.
But that's Seattle.
In Hidalgo County in Texas, we had 113 positive cases on 4/6 and 181 on 4/10. +35 JUST on the 10th, more than twice the second highest daily increase (+17) since I've been recording the daily updates starting March 30th. Fortunately, 4/11 was just +7. 8 of the last 11 days since it first hit double digit new cases have been double digit days. The first case in the county was May 21st. First death April 7th (128 cases). The numbers here are trending up and it's accelerating.
We have no statewide shelter-in-place order. We have a county-by-county. Some counties, like my birth county in central Texas, have nothing except closing non-essential businesses.
This is not going to be done by the end of April because of the staggered time it takes to get from the cities to the suburbs to the towns to the villages.
I've started a journal (a text document actually), where I take my temperature more or less daily, record when and where I leave my house, along with the daily county test results.
As someone who lives in Seattle - yes, the local epidemic has slowed down. According to the official state data, the number of hospitalized patients in WA has gone from 638 to 642 over the four days from 4/6 to 4/10, and the number of ICU patients has gone from 191 to 191 in the same span.* There are still new cases being discovered and people dying, but it's pretty clear we've reached the peak in terms of a burden on the healthcare system.
Of course, this doesn't mean we can afford to open up and return to "normal" yet. There are still enough sick people out there, and infected people who don't know it, that the epidemic would come roaring back. Washington has been better than most parts of the USA with testing, but we still can't afford to contact-trace everyone that's infected and really squash it.
*The number of hospitals reporting varies day to day, but the two days I quoted had the same number. They should be comparable enough.
Just for transparency's sake, at no point did I suggest that we should "return to normal."
In Hidalgo County in Texas, we had 113 positive cases on 4/6 and 181 on 4/10. +35 JUST on the 10th, more than twice the second highest daily increase (+17) since I've been recording the daily updates starting March 30th. Fortunately, 4/11 was just +7. 8 of the last 11 days since it first hit double digit new cases have been double digit days. The first case in the county was May 21st. First death April 7th (128 cases). The numbers here are trending up and it's accelerating.
We have no statewide shelter-in-place order. We have a county-by-county. Some counties, like my birth county in central Texas, have nothing except closing non-essential businesses.
This is not going to be done by the end of April because of the staggered time it takes to get from the cities to the suburbs to the towns to the villages.
I've started a journal (a text document actually), where I take my temperature more or less daily, record when and where I leave my house, along with the daily county test results.
Yeah, that's kind of the point. Washington state in general and King County in particular were slow to institute shelter in place or stay at home orders but now that they're in place and largely being maintained, it seems things are slowing down. That is, that taking countermeasures does work.
Total cases can be misleading sometimes. Spain has a higher infection per population compared to the US for example. However, as JJ pointed out, the US outbreak is literally just starting in some highly populated areas compared to other countries.
That's because the US is spread out. There's a lot of empty land with outsized electoral power but few people in the US. We'll catch up to per population yet.
As someone who lives in Seattle - yes, the local epidemic has slowed down. According to the official state data, the number of hospitalized patients in WA has gone from 638 to 642 over the four days from 4/6 to 4/10, and the number of ICU patients has gone from 191 to 191 in the same span.* There are still new cases being discovered and people dying, but it's pretty clear we've reached the peak in terms of a burden on the healthcare system.
Of course, this doesn't mean we can afford to open up and return to "normal" yet. There are still enough sick people out there, and infected people who don't know it, that the epidemic would come roaring back. Washington has been better than most parts of the USA with testing, but we still can't afford to contact-trace everyone that's infected and really squash it.
*The number of hospitals reporting varies day to day, but the two days I quoted had the same number. They should be comparable enough.
Just for transparency's sake, at no point did I suggest that we should "return to normal."
In Hidalgo County in Texas, we had 113 positive cases on 4/6 and 181 on 4/10. +35 JUST on the 10th, more than twice the second highest daily increase (+17) since I've been recording the daily updates starting March 30th. Fortunately, 4/11 was just +7. 8 of the last 11 days since it first hit double digit new cases have been double digit days. The first case in the county was May 21st. First death April 7th (128 cases). The numbers here are trending up and it's accelerating.
We have no statewide shelter-in-place order. We have a county-by-county. Some counties, like my birth county in central Texas, have nothing except closing non-essential businesses.
This is not going to be done by the end of April because of the staggered time it takes to get from the cities to the suburbs to the towns to the villages.
I've started a journal (a text document actually), where I take my temperature more or less daily, record when and where I leave my house, along with the daily county test results.
Yeah, that's kind of the point. Washington state in general and King County in particular were slow to institute shelter in place or stay at home orders but now that they're in place and largely being maintained, it seems things are slowing down. That is, that taking countermeasures does work.
Supposedly on Friday, Trump was wrestling with some big decision that he was going to announce soon.
It's probably going to be him declaring the crisis over and that everyone get out of the hospital and go back to work which would be the opposite of taking countermeasures.
I guess we'll see.
I mean, I don't want to dream but the announcement could be him resigning and walk away which is the thing he did 6 times to his businesses when he declared bankruptcy.
A little update to something I said a while ago in this thread vis-a-vie the amount of time the virus is active on various surfaces. Having just seen an expert in her field, it turns out that rather than lasting up to 24 hours on paper the virus actually starts to break down in only half an hour. Can still be viable on plastic for up to 72 hours though. So definitely thanks for that "toy town" plastic money Mark Carney.
So according to a new (small) study there's been three different strains identified. This might explain some of the reinfections. There's a type A, B, C
While I don't know about other countries, a professor of virology made an interesting observation on the TV news this morning. According to them, the coronavirus test for if a person currently has the disease only has an accuracy of around 70%. They also said that some of the discrepancy can attributed to the way the test is administered and even the time of day it was performed. Surprisingly (to me at least) they also said that the anti-body test, used to see if someone has had the disease and recovered, is actually more accurate but I don't think that they gave an actual percentage figure for that.
So there is a very good chance that, as @Balrog99 said above, that those who are seemingly now testing positive is down to that 30% of inaccuracy (assuming that the tests are at least near identical in different countries).
@smeagolheart While interesting that chart doesn't show the whole picture. I do know that here in the UK we have cases amongst people who have returned from both Spain and Italy. So the picture is a whole lot messier than that infographic shows.
While I don't know about other countries, a professor of virology made an interesting observation on the TV news this morning. According to them, the coronavirus test for if a person currently has the disease only has an accuracy of around 70%. They also said that some of the discrepancy can attributed to the way the test is administered and even the time of day it was performed. Surprisingly (to me at least) they also said that the anti-body test, used to see if someone has had the disease and recovered, is actually more accurate but I don't think that they gave an actual percentage figure for that.
So there is a very good chance that, as @Balrog99 said above, that those who are seemingly now testing positive is down to that 30% of inaccuracy (assuming that the tests are at least near identical in different countries).
@smeagolheart While interesting that chart doesn't show the whole picture. I do know that here in the UK we have cases amongst people who have returned from both Spain and Italy. So the picture is a whole lot messier than that infographic shows.
TR
@TarotRedhand
Yes it will be messier than it shows. I believe the intent is to show a big picture overview.
For example, America is listed as Type A however this is mainly on the West Coast. The East Coast which has more New York and way more fatalities has more cases of Type B.
A claim of "70%" accuracy on the test? The rate of false negatives might be up to 30%, but there's no way the rate of false positives is that high. After all, the places that really test a lot have tended to have less than 10% of tests come back positive. If the false positive rate were anywhere near that high, the test would be useless for the purposes it's being used for.
No, I'm pretty sure the rate of false positives on this one is very low. Nearly all positive tests are people that have the virus in them.
A claim of "70%" accuracy on the test? The rate of false negatives might be up to 30%, but there's no way the rate of false positives is that high. After all, the places that really test a lot have tended to have less than 10% of tests come back positive. If the false positive rate were anywhere near that high, the test would be useless for the purposes it's being used for.
No, I'm pretty sure the rate of false positives on this one is very low. Nearly all positive tests are people that have the virus in them.
No matter how low the false positive rate is, when you do millions of tests there are going to be a significant number of them. False positives are also going to show up more in countries that are screening the entire population, instead of of only the symptomatic. Probably why this is happening more in South Korea.
A claim of "70%" accuracy on the test? The rate of false negatives might be up to 30%, but there's no way the rate of false positives is that high. After all, the places that really test a lot have tended to have less than 10% of tests come back positive. If the false positive rate were anywhere near that high, the test would be useless for the purposes it's being used for.
No, I'm pretty sure the rate of false positives on this one is very low. Nearly all positive tests are people that have the virus in them.
A high false negative rate is actually a bad thing, worse than false positive. Means that LOTS people might be walking around thinking and claiming they're disease free, when they're infected. Furthermore, if they're sick enough to be treated professionally, doctors might misdiagnose it as some other disease, hence why the assumption that in the absence of a positive test, COVID-like symptoms that aren't explained by other diseases are PRESUMED COVID.
A claim of "70%" accuracy on the test? The rate of false negatives might be up to 30%, but there's no way the rate of false positives is that high. After all, the places that really test a lot have tended to have less than 10% of tests come back positive. If the false positive rate were anywhere near that high, the test would be useless for the purposes it's being used for.
No, I'm pretty sure the rate of false positives on this one is very low. Nearly all positive tests are people that have the virus in them.
No matter how low the false positive rate is, when you do millions of tests there are going to be a significant number of them. False positives are also going to show up more in countries that are screening the entire population, instead of of only the symptomatic. Probably why this is happening more in South Korea.
To me, it's unclear if false positives are really a big thing or false positives are people with the virus but with minor or no outward symptoms who can still infect others.
By definition: a false positive does not have the virus and cannot affect others, while a false negative has the virus but is via screening not identified as such.
Intermediate versions of this do not exist
The Office for National Statistics has collated deaths on a weekly basis in the UK since 2005. In the week ending 3rd April there were over 6,000 more deaths than expected (140% of the average for this week). That makes it easily the worst week for deaths since this data started being collected.
3,500 of those deaths are attributable to Covid-19. That includes deaths in the community where the death certificate refers to the likelihood that Covid-19 was present (whether or not a test was carried out). However, that still leaves a significant unexplained increase over the average and it's important that an explanation is found.
It seems likely that part of the difference is due to under-reporting of Covid-19 in the absence of test data, but it's not clear whether that accounts for the bulk of the difference. It's possible there are also significant numbers of additional deaths as a result of the current lockdown. There are various factors that could explain that, e.g.
- people not calling the emergency services as quickly as they should do, either due to not wanting to bother them or fear of infection (separate data confirms that A&E services have been much less busy than expected recently).
- there is a government list of particularly vulnerable people and arrangements to support those, but it's likely there are at least a few who have fallen through cracks in this new system and may not be getting required support such as medicines delivery.
- the requirements for social distancing may have an impact on both mental and physical health.
I don't think there was an option to introducing severe restrictions due to the sheer scale of the potential deaths from Covid-19, but it's important that we get a better understanding of the wider impacts of those restrictions as soon as possible to help plan for the best possible outcome. At present there's no guarantee there will ever be an effective treatment for the disease, but even if there is that's likely to be quite a few months away, leaving social distancing as the only real way to protect against the disease for some time. Balancing the benefits and harms from that in the longer term means we need to be studying the impacts of social distancing as well as the impacts from Covid-19.
I also watched an interview with Paul Lem CEO of Spartan Bioscience and the interviewer kept hammering about 'until we can get a vaccine' I guess the nxt convo people will be having is 'should the vac be mandatory for travel, work etc'.
The Office for National Statistics has collated deaths on a weekly basis in the UK since 2005. In the week ending 3rd April there were over 6,000 more deaths than expected (140% of the average for this week). That makes it easily the worst week for deaths since this data started being collected.
3,500 of those deaths are attributable to Covid-19. That includes deaths in the community where the death certificate refers to the likelihood that Covid-19 was present (whether or not a test was carried out). However, that still leaves a significant unexplained increase over the average and it's important that an explanation is found.
It seems likely that part of the difference is due to under-reporting of Covid-19 in the absence of test data, but it's not clear whether that accounts for the bulk of the difference. It's possible there are also significant numbers of additional deaths as a result of the current lockdown. There are various factors that could explain that, e.g.
- people not calling the emergency services as quickly as they should do, either due to not wanting to bother them or fear of infection (separate data confirms that A&E services have been much less busy than expected recently).
- there is a government list of particularly vulnerable people and arrangements to support those, but it's likely there are at least a few who have fallen through cracks in this new system and may not be getting required support such as medicines delivery.
- the requirements for social distancing may have an impact on both mental and physical health.
I don't think there was an option to introducing severe restrictions due to the sheer scale of the potential deaths from Covid-19, but it's important that we get a better understanding of the wider impacts of those restrictions as soon as possible to help plan for the best possible outcome. At present there's no guarantee there will ever be an effective treatment for the disease, but even if there is that's likely to be quite a few months away, leaving social distancing as the only real way to protect against the disease for some time. Balancing the benefits and harms from that in the longer term means we need to be studying the impacts of social distancing as well as the impacts from Covid-19.
A common refrain here in the US is that the economic hardship will cause as many deaths as the virus. There is no evidence of this. In fact, it's the opposite. There was no spike in mortality rates in 2008-2009. It actually went DOWN in the Great Depression. It's a cute phrase and nothing more.
The Office for National Statistics has collated deaths on a weekly basis in the UK since 2005. In the week ending 3rd April there were over 6,000 more deaths than expected (140% of the average for this week). That makes it easily the worst week for deaths since this data started being collected.
3,500 of those deaths are attributable to Covid-19. That includes deaths in the community where the death certificate refers to the likelihood that Covid-19 was present (whether or not a test was carried out). However, that still leaves a significant unexplained increase over the average and it's important that an explanation is found.
It seems likely that part of the difference is due to under-reporting of Covid-19 in the absence of test data, but it's not clear whether that accounts for the bulk of the difference. It's possible there are also significant numbers of additional deaths as a result of the current lockdown. There are various factors that could explain that, e.g.
- people not calling the emergency services as quickly as they should do, either due to not wanting to bother them or fear of infection (separate data confirms that A&E services have been much less busy than expected recently).
- there is a government list of particularly vulnerable people and arrangements to support those, but it's likely there are at least a few who have fallen through cracks in this new system and may not be getting required support such as medicines delivery.
- the requirements for social distancing may have an impact on both mental and physical health.
I don't think there was an option to introducing severe restrictions due to the sheer scale of the potential deaths from Covid-19, but it's important that we get a better understanding of the wider impacts of those restrictions as soon as possible to help plan for the best possible outcome. At present there's no guarantee there will ever be an effective treatment for the disease, but even if there is that's likely to be quite a few months away, leaving social distancing as the only real way to protect against the disease for some time. Balancing the benefits and harms from that in the longer term means we need to be studying the impacts of social distancing as well as the impacts from Covid-19.
A common refrain here in the US is that the economic hardship will cause as many deaths as the virus. There is no evidence of this. In fact, it's the opposite. There was no spike in mortality rates in 2008-2009. It actually went DOWN in the Great Depression. It's a cure phrase and nothing more.
It's not just economic hardship though, it's the wider impacts of social distancing. For instance, although I haven't seen specific figures, there have been references to suicide helplines being much busier in the US - and there are lots of less direct potential methods to increase the chance of death (like lack of people to help with accidents, poor nutrition, lack of exercise, more unwillingness than usual to call an ambulance etc).
New York has now changed their method of accounting for deaths to include a separate category for people whose death was probably the result of Covid-19. That will add another 3,778 people to the Covid-19 count since March 11 (though those have not yet been added into national statistics). However, there are another 3,000+ people who have died in the past month in New York over and above the expected average. As with the UK, it's important to understand what is driving these deaths. Unless you have some evidence of the cause of these, I think it's dangerous to assume these are the result of the disease, as opposed to the measures being taken to contain it.
I think it's almost certain there will be a balancing point where the cure does become more harmful than the disease, even if you take only the very narrow definition of deaths as your parameter. My earlier point was that, in order to better understand where that balancing point might be, it's necessary to understand what's driving the high current death rates.
By definition: a false positive does not have the virus and cannot affect others, while a false negative has the virus but is via screening not identified as such.
Intermediate versions of this do not exist
My question was not the textbook definition but more how much of an issue each situation was in the real world.
Are there a lot of false positives? (does not have the virus) or are they positive test results that show an infection but the person shows no symptoms. That person feels fine, says they are fine. But they are still infectious. Will cases like this be dismissed as a false positive in the wild? Surely they might be dismissed as false positives.
(see my previous post for fuller info) FWIW Captain Tom Moore finished his 100 laps at 8:30 BST. At that point the Just Giving website was still experiencing exceptional traffic. He says he will continue doing laps of his garden until people stop donating. From his initial target to raise £1000 for NHS charities, the total raised up to a few minutes ago was £12.1 million. Donations have come in from 53 countries around the world and, at the rate this is still going, I wouldn't be surprised if the final total, when people stop donating, exceeds £15 million. Not bad for a 99 year old who will be 100 on the 30th April.
By definition: a false positive does not have the virus and cannot affect others, while a false negative has the virus but is via screening not identified as such.
Intermediate versions of this do not exist
My question was not the textbook definition but more how much of an issue each situation was in the real world.
Are there a lot of false positives? (does not have the virus) or are they positive test results that show an infection but the person shows no symptoms. That person feels fine, says they are fine. But they are still infectious. Will cases like this be dismissed as a false positive in the wild? Surely they might be dismissed as false positives.
if they are infected and show no symptoms they are still true positives. If the test suggests it (while it may not be true) then you don't know but they still enforce the isolation rules etc as if you are infected.
In essence the false positive and false negative rates are tested in the lab. You do a certain number of cell growths, infect a set number, then test your actual test and determine the rates. You can probably validate in vivo but that is rarely done because you need to do swab and growth per patient and then check for secondary responses (other cells that the test does not check).
The Office for National Statistics has collated deaths on a weekly basis in the UK since 2005. In the week ending 3rd April there were over 6,000 more deaths than expected (140% of the average for this week). That makes it easily the worst week for deaths since this data started being collected.
3,500 of those deaths are attributable to Covid-19. That includes deaths in the community where the death certificate refers to the likelihood that Covid-19 was present (whether or not a test was carried out). However, that still leaves a significant unexplained increase over the average and it's important that an explanation is found.
It seems likely that part of the difference is due to under-reporting of Covid-19 in the absence of test data, but it's not clear whether that accounts for the bulk of the difference. It's possible there are also significant numbers of additional deaths as a result of the current lockdown. There are various factors that could explain that, e.g.
- people not calling the emergency services as quickly as they should do, either due to not wanting to bother them or fear of infection (separate data confirms that A&E services have been much less busy than expected recently).
- there is a government list of particularly vulnerable people and arrangements to support those, but it's likely there are at least a few who have fallen through cracks in this new system and may not be getting required support such as medicines delivery.
- the requirements for social distancing may have an impact on both mental and physical health.
I don't think there was an option to introducing severe restrictions due to the sheer scale of the potential deaths from Covid-19, but it's important that we get a better understanding of the wider impacts of those restrictions as soon as possible to help plan for the best possible outcome. At present there's no guarantee there will ever be an effective treatment for the disease, but even if there is that's likely to be quite a few months away, leaving social distancing as the only real way to protect against the disease for some time. Balancing the benefits and harms from that in the longer term means we need to be studying the impacts of social distancing as well as the impacts from Covid-19.
A common refrain here in the US is that the economic hardship will cause as many deaths as the virus. There is no evidence of this. In fact, it's the opposite. There was no spike in mortality rates in 2008-2009. It actually went DOWN in the Great Depression. It's a cure phrase and nothing more.
It's not just economic hardship though, it's the wider impacts of social distancing. For instance, although I haven't seen specific figures, there have been references to suicide helplines being much busier in the US - and there are lots of less direct potential methods to increase the chance of death (like lack of people to help with accidents, poor nutrition, lack of exercise, more unwillingness than usual to call an ambulance etc).
New York has now changed their method of accounting for deaths to include a separate category for people whose death was probably the result of Covid-19. That will add another 3,778 people to the Covid-19 count since March 11 (though those have not yet been added into national statistics). However, there are another 3,000+ people who have died in the past month in New York over and above the expected average. As with the UK, it's important to understand what is driving these deaths. Unless you have some evidence of the cause of these, I think it's dangerous to assume these are the result of the disease, as opposed to the measures being taken to contain it.
I think it's almost certain there will be a balancing point where the cure does become more harmful than the disease, even if you take only the very narrow definition of deaths as your parameter. My earlier point was that, in order to better understand where that balancing point might be, it's necessary to understand what's driving the high current death rates.
I don't think it's safe to assume ALL of the unexplained excess deaths are caused by the virus, but I think it's certainly safe to assume that MOST of them are. For instance, I'm willing to bet alot of deaths that are officially being labeled as "pneumonia" or "heart attack" are, in fact, the result of COVID-19 CAUSING one of those two things to take place. So I and no one else has hard numbers, but I'd wager rather heavily that upwards of 75% of these discrepancies to past years are directly related to complications from the virus. Two weeks of eating Hungry Man dinners and not taking a walk isn't causing a massive death spike. And a suicide is going to be fairly easy to ascertain as just that. And all this does is focus on the criminal lack of testing in the US. We have no idea how many people actually have the virus. People who have the virus don't even necessarily know they have the virus. You could be fine on Tuesday and dead in your recliner on Friday afternoon.
@jjstraka34 Mostly agree, but (according to my local hospitals), it takes about 2 weeks from the onset of symptoms to kill you, if its gonna kill you. This is on average, so of course it varies, and the time to death is probably significantly shorter depending on your risk factors.
The Office for National Statistics has collated deaths on a weekly basis in the UK since 2005. In the week ending 3rd April there were over 6,000 more deaths than expected (140% of the average for this week). That makes it easily the worst week for deaths since this data started being collected.
3,500 of those deaths are attributable to Covid-19. That includes deaths in the community where the death certificate refers to the likelihood that Covid-19 was present (whether or not a test was carried out). However, that still leaves a significant unexplained increase over the average and it's important that an explanation is found.
It seems likely that part of the difference is due to under-reporting of Covid-19 in the absence of test data, but it's not clear whether that accounts for the bulk of the difference. It's possible there are also significant numbers of additional deaths as a result of the current lockdown. There are various factors that could explain that, e.g.
- people not calling the emergency services as quickly as they should do, either due to not wanting to bother them or fear of infection (separate data confirms that A&E services have been much less busy than expected recently).
- there is a government list of particularly vulnerable people and arrangements to support those, but it's likely there are at least a few who have fallen through cracks in this new system and may not be getting required support such as medicines delivery.
- the requirements for social distancing may have an impact on both mental and physical health.
I don't think there was an option to introducing severe restrictions due to the sheer scale of the potential deaths from Covid-19, but it's important that we get a better understanding of the wider impacts of those restrictions as soon as possible to help plan for the best possible outcome. At present there's no guarantee there will ever be an effective treatment for the disease, but even if there is that's likely to be quite a few months away, leaving social distancing as the only real way to protect against the disease for some time. Balancing the benefits and harms from that in the longer term means we need to be studying the impacts of social distancing as well as the impacts from Covid-19.
A common refrain here in the US is that the economic hardship will cause as many deaths as the virus. There is no evidence of this. In fact, it's the opposite. There was no spike in mortality rates in 2008-2009. It actually went DOWN in the Great Depression. It's a cure phrase and nothing more.
It's not just economic hardship though, it's the wider impacts of social distancing. For instance, although I haven't seen specific figures, there have been references to suicide helplines being much busier in the US - and there are lots of less direct potential methods to increase the chance of death (like lack of people to help with accidents, poor nutrition, lack of exercise, more unwillingness than usual to call an ambulance etc).
New York has now changed their method of accounting for deaths to include a separate category for people whose death was probably the result of Covid-19. That will add another 3,778 people to the Covid-19 count since March 11 (though those have not yet been added into national statistics). However, there are another 3,000+ people who have died in the past month in New York over and above the expected average. As with the UK, it's important to understand what is driving these deaths. Unless you have some evidence of the cause of these, I think it's dangerous to assume these are the result of the disease, as opposed to the measures being taken to contain it.
I think it's almost certain there will be a balancing point where the cure does become more harmful than the disease, even if you take only the very narrow definition of deaths as your parameter. My earlier point was that, in order to better understand where that balancing point might be, it's necessary to understand what's driving the high current death rates.
I don't think it's safe to assume ALL of the unexplained excess deaths are caused by the virus, but I think it's certainly safe to assume that MOST of them are. For instance, I'm willing to bet alot of deaths that are officially being labeled as "pneumonia" or "heart attack" are, in fact, the result of COVID-19 CAUSING one of those two things to take place. So I and no one else has hard numbers, but I'd wager rather heavily that upwards of 75% of these discrepancies to past years are directly related to complications from the virus. Two weeks of eating Hungry Man dinners and not taking a walk isn't causing a massive death spike. And a suicide is going to be fairly easy to ascertain as just that. And all this does is focus on the criminal lack of testing in the US. We have no idea how many people actually have the virus. People who have the virus don't even necessarily know they have the virus. You could be fine on Tuesday and dead in your recliner on Friday afternoon.
As you say, the data is not clear at the moment and you may be right - but you may well not be as well . One thing that is clear from the progression of the disease so far is that your chance of dying is far higher if you are already vulnerable for other reasons. Another thing that is clear is that the mortality risk by age from Covid-19 tracks very closely with the standard annual mortality risk. That doesn't mean that the same people who would die within a year anyway are the only victims, but there will certainly be a significant overlap.
I would be surprised if there's not also a overlap in relation to the currently unexplained deaths for reasons other than the disease itself, i.e. people who would have died anyway over the coming weeks and months are tipped over the edge as a result of lack of care. I don't think it's far-fetched at all to suggest that many already vulnerable people will die as a result of things like lack of exercise (if you've never tried doing no exercise for several weeks, give it a go - it makes a huge difference to your body even if you start off as a healthy person), poor nutrition, not taking medicines and lack of medical help.
In the UK we're currently seeing high death rates in care homes for the elderly. Much of that is undoubtedly due to Covid-19 infections, but that doesn't appear to be the only cause. In too many cases standards of care have slipped as a result of staff shortages and staff fears about going to work - and those same sorts of factors will also apply to some vulnerable people in the community more generally.
Comments
Total cases can be misleading sometimes. Spain has a higher infection per population compared to the US for example. However, as JJ pointed out, the US outbreak is literally just starting in some highly populated areas compared to other countries.
Of course, this doesn't mean we can afford to open up and return to "normal" yet. There are still enough sick people out there, and infected people who don't know it, that the epidemic would come roaring back. Washington has been better than most parts of the USA with testing, but we still can't afford to contact-trace everyone that's infected and really squash it.
*The number of hospitals reporting varies day to day, but the two days I quoted had the same number. They should be comparable enough.
But that's Seattle.
In Hidalgo County in Texas, we had 113 positive cases on 4/6 and 181 on 4/10. +35 JUST on the 10th, more than twice the second highest daily increase (+17) since I've been recording the daily updates starting March 30th. Fortunately, 4/11 was just +7. 8 of the last 11 days since it first hit double digit new cases have been double digit days. The first case in the county was May 21st. First death April 7th (128 cases). The numbers here are trending up and it's accelerating.
We have no statewide shelter-in-place order. We have a county-by-county. Some counties, like my birth county in central Texas, have nothing except closing non-essential businesses.
This is not going to be done by the end of April because of the staggered time it takes to get from the cities to the suburbs to the towns to the villages.
I've started a journal (a text document actually), where I take my temperature more or less daily, record when and where I leave my house, along with the daily county test results.
Just for transparency's sake, at no point did I suggest that we should "return to normal."
Yeah, that's kind of the point. Washington state in general and King County in particular were slow to institute shelter in place or stay at home orders but now that they're in place and largely being maintained, it seems things are slowing down. That is, that taking countermeasures does work.
That's because the US is spread out. There's a lot of empty land with outsized electoral power but few people in the US. We'll catch up to per population yet.
Supposedly on Friday, Trump was wrestling with some big decision that he was going to announce soon.
It's probably going to be him declaring the crisis over and that everyone get out of the hospital and go back to work which would be the opposite of taking countermeasures.
I guess we'll see.
I mean, I don't want to dream but the announcement could be him resigning and walk away which is the thing he did 6 times to his businesses when he declared bankruptcy.
TR
Statistical anomaly. False positives testing positive again. Or the virus wasn't completely eradicated. Nothing ominous unless it happens in greater numbers.
A new study:
https://www.medrxiv.org/content/10.1101/2020.04.08.20056929v1
summarized well here
So according to a new (small) study there's been three different strains identified. This might explain some of the reinfections. There's a type A, B, C
So there is a very good chance that, as @Balrog99 said above, that those who are seemingly now testing positive is down to that 30% of inaccuracy (assuming that the tests are at least near identical in different countries).
@smeagolheart While interesting that chart doesn't show the whole picture. I do know that here in the UK we have cases amongst people who have returned from both Spain and Italy. So the picture is a whole lot messier than that infographic shows.
TR
@TarotRedhand
Yes it will be messier than it shows. I believe the intent is to show a big picture overview.
For example, America is listed as Type A however this is mainly on the West Coast. The East Coast which has more New York and way more fatalities has more cases of Type B.
No, I'm pretty sure the rate of false positives on this one is very low. Nearly all positive tests are people that have the virus in them.
No matter how low the false positive rate is, when you do millions of tests there are going to be a significant number of them. False positives are also going to show up more in countries that are screening the entire population, instead of of only the symptomatic. Probably why this is happening more in South Korea.
A high false negative rate is actually a bad thing, worse than false positive. Means that LOTS people might be walking around thinking and claiming they're disease free, when they're infected. Furthermore, if they're sick enough to be treated professionally, doctors might misdiagnose it as some other disease, hence why the assumption that in the absence of a positive test, COVID-like symptoms that aren't explained by other diseases are PRESUMED COVID.
To me, it's unclear if false positives are really a big thing or false positives are people with the virus but with minor or no outward symptoms who can still infect others.
Intermediate versions of this do not exist
3,500 of those deaths are attributable to Covid-19. That includes deaths in the community where the death certificate refers to the likelihood that Covid-19 was present (whether or not a test was carried out). However, that still leaves a significant unexplained increase over the average and it's important that an explanation is found.
It seems likely that part of the difference is due to under-reporting of Covid-19 in the absence of test data, but it's not clear whether that accounts for the bulk of the difference. It's possible there are also significant numbers of additional deaths as a result of the current lockdown. There are various factors that could explain that, e.g.
- people not calling the emergency services as quickly as they should do, either due to not wanting to bother them or fear of infection (separate data confirms that A&E services have been much less busy than expected recently).
- there is a government list of particularly vulnerable people and arrangements to support those, but it's likely there are at least a few who have fallen through cracks in this new system and may not be getting required support such as medicines delivery.
- the requirements for social distancing may have an impact on both mental and physical health.
I don't think there was an option to introducing severe restrictions due to the sheer scale of the potential deaths from Covid-19, but it's important that we get a better understanding of the wider impacts of those restrictions as soon as possible to help plan for the best possible outcome. At present there's no guarantee there will ever be an effective treatment for the disease, but even if there is that's likely to be quite a few months away, leaving social distancing as the only real way to protect against the disease for some time. Balancing the benefits and harms from that in the longer term means we need to be studying the impacts of social distancing as well as the impacts from Covid-19.
Seeing that the Canadian government is behind it fully has my spidey sense tingling. This is a time I hope I am wrong. This would be a game changer.
https://nationalpost.com/pmn/news-pmn/canada-news-pmn/health-canada-approves-spartan-biosciences-portable-covid-19-test
I also watched an interview with Paul Lem CEO of Spartan Bioscience and the interviewer kept hammering about 'until we can get a vaccine' I guess the nxt convo people will be having is 'should the vac be mandatory for travel, work etc'.
TR
A common refrain here in the US is that the economic hardship will cause as many deaths as the virus. There is no evidence of this. In fact, it's the opposite. There was no spike in mortality rates in 2008-2009. It actually went DOWN in the Great Depression. It's a cute phrase and nothing more.
It's not just economic hardship though, it's the wider impacts of social distancing. For instance, although I haven't seen specific figures, there have been references to suicide helplines being much busier in the US - and there are lots of less direct potential methods to increase the chance of death (like lack of people to help with accidents, poor nutrition, lack of exercise, more unwillingness than usual to call an ambulance etc).
New York has now changed their method of accounting for deaths to include a separate category for people whose death was probably the result of Covid-19. That will add another 3,778 people to the Covid-19 count since March 11 (though those have not yet been added into national statistics). However, there are another 3,000+ people who have died in the past month in New York over and above the expected average. As with the UK, it's important to understand what is driving these deaths. Unless you have some evidence of the cause of these, I think it's dangerous to assume these are the result of the disease, as opposed to the measures being taken to contain it.
I think it's almost certain there will be a balancing point where the cure does become more harmful than the disease, even if you take only the very narrow definition of deaths as your parameter. My earlier point was that, in order to better understand where that balancing point might be, it's necessary to understand what's driving the high current death rates.
My question was not the textbook definition but more how much of an issue each situation was in the real world.
Are there a lot of false positives? (does not have the virus) or are they positive test results that show an infection but the person shows no symptoms. That person feels fine, says they are fine. But they are still infectious. Will cases like this be dismissed as a false positive in the wild? Surely they might be dismissed as false positives.
TR
In essence the false positive and false negative rates are tested in the lab. You do a certain number of cell growths, infect a set number, then test your actual test and determine the rates. You can probably validate in vivo but that is rarely done because you need to do swab and growth per patient and then check for secondary responses (other cells that the test does not check).
I don't think it's safe to assume ALL of the unexplained excess deaths are caused by the virus, but I think it's certainly safe to assume that MOST of them are. For instance, I'm willing to bet alot of deaths that are officially being labeled as "pneumonia" or "heart attack" are, in fact, the result of COVID-19 CAUSING one of those two things to take place. So I and no one else has hard numbers, but I'd wager rather heavily that upwards of 75% of these discrepancies to past years are directly related to complications from the virus. Two weeks of eating Hungry Man dinners and not taking a walk isn't causing a massive death spike. And a suicide is going to be fairly easy to ascertain as just that. And all this does is focus on the criminal lack of testing in the US. We have no idea how many people actually have the virus. People who have the virus don't even necessarily know they have the virus. You could be fine on Tuesday and dead in your recliner on Friday afternoon.
As you say, the data is not clear at the moment and you may be right - but you may well not be as well
I would be surprised if there's not also a overlap in relation to the currently unexplained deaths for reasons other than the disease itself, i.e. people who would have died anyway over the coming weeks and months are tipped over the edge as a result of lack of care. I don't think it's far-fetched at all to suggest that many already vulnerable people will die as a result of things like lack of exercise (if you've never tried doing no exercise for several weeks, give it a go - it makes a huge difference to your body even if you start off as a healthy person), poor nutrition, not taking medicines and lack of medical help.
In the UK we're currently seeing high death rates in care homes for the elderly. Much of that is undoubtedly due to Covid-19 infections, but that doesn't appear to be the only cause. In too many cases standards of care have slipped as a result of staff shortages and staff fears about going to work - and those same sorts of factors will also apply to some vulnerable people in the community more generally.