Regular WUWT contributor Willis Eschenbach always goes to data when questions and issues arise, he has been plotting the official death rate data from the Coronavirus almost daily, and will continue to do so. I’ve dedicated a permanent WUWT page to this. We will continue to add to this page as needed and as Willis makes updates.
Note that it is now a menu item in the left most section of the WUWT Menu bar, right under the header image.
Friday’s graph:
See the full page of graphs here: https://wattsupwiththat.com/daily-coronavirus-covid-19-data-graph-page/
Thank you for bringing some rational sanity to this issue Willis. Some of the graphs and statistics being shown in the British media (and this is no doubt a world-wide phenomenon) don’t stand up to a second of scrutiny but give rise to hysterical headlines. Personally, I have more faith in the facts than the modelling. Many parallels with the world of CAGW it seems.
I agree, Ian.
This from this morning’s on-line front page had Mrs N worrying for my blood pressure. I’ll spare the organisation the embarrassment of giving its name!
“ The team at LSHTM (London School of Hygiene and Tropical Medicine) ran 25,000 epidemic simulations for different death and infection rate scenarios ranging from 1.5 to 10 per cent death rate in the population and someone infecting between one and three people.
For a scenario with a death rate of 1 per cent, where each infected person infects three more – which is closest to what is currently thought to be happening – the team at LSHTM found that one death points to a minimum of 37 cases, a maximum of 138,624 and a median average of 1,733.
With the current number of deaths at 167, it means that between 6,179 and 23 million people could already be infected, with an average of nearly 290,000.“
It’s totally meaningless! Great fun for those with the computing power and the time to spare but hardly of any use when it comes to making real-world decisions. Just as in climate predictions the error bars are so far apart the figures are pointless.
I’m with Willis on this and came to a similar conclusion. The Diamond Princess is the perfect test bed. We know how many people there are on board; we know how many are infected; we know how many died. Willis’ data give even better insight into the likely effect on the general population than any number of computer simulations. In my view!
Donna Laframboise’s daily figures show an increase from March 18 in the number of “closed cases” on the Diamond Princess from 463 (I think) to 534 with the number of deaths still on 7 which drops the rate from 2% to 1% in round figures. I’m not drawing any conclusions from that because we have an ongoing major disaster in Italy but I can’t avoid thinking that identifying the cause of that particular anomaly (if it is an anomaly) would be a better use of everyone’s time than playing computer games to produce figures which do less than nothing to solve the problem.
So you think the Diamond Princess figures are reassuring?
They aren’t. If we extrapolate rates from the Diamond Princess to the UK population (66 million) we have 13% (according to Willis – I think its more like 18% but I’m not clear if the 3.7k passengers are just passengers or include).
Anyway, 13% of 66 million = 8.6 million get infected
of those 1% will die = 86,000
It’s also possible that infection transmission was halted or slowed during the quarantine period so there were many more potential cases. The other point to consider is that the severe cases received the critical care they needed. Once hospitals are at capacity they will need to prioritise as happened in Italy.
Willis is pretty good at this stuff but he seems to be overlooking the fact that a small percentage of a very large number is still a large number.
The figure of 3,700 includes crew and passengers.
So far there have been 534 “closed cases”, ie people who have developed an infection and now are clear of it — either recovered (527) or died (7) — which is a mortality rate of 1%.
Willis’ own figures show that the numbers are skewed toward the more vulnerable group (age 65+) which is what you would expect on a cruise liner. No extrapolation is perfect but the Diamond Princess is as close as you will get to a scientific experiment and 1% (down from 2%) is less than many of the scarier projections that have been around.
And I don’t recall mentioning the word “re-assuring”. What I did suggest is that the DP figures should give us better information on the progress of the epidemic and its likely course than computer models that are throwing up figures which are so wide-ranging as to be meaningless.
I saw a study from Japan in which some days they tested over 4,000 people. Not sure why it is higher than the reported 3,700 passengers and crew. Maybe it included lots of healthcare worksers?
8, not 7, have died as of yesterday.
the Diamond Princess is as close as you will get to a scientific experiment and 1% (down from 2%) is less than many of the scarier projections that have been around.
And it shows that the UK is going to have a significant problem in the next 2 weeks – unless the rate of infections can be slowed. Chris Whitty (Chief Medical Officer) had already made it clear that he thought the fatality rate was below 1% but that’s still a problem if a large number of people contract the virus.
Passengers on the Diamond Princess received the medical treatment they needed. That’s not going to happen for every patient in the UK if the numbers continue to rise as rapidly as they are at present.
The models do not assume high fatality rates. I have my own very basic model which is tracking the ‘true’ UK figures pretty closely and the outlook is horrible.
What happens to fatality rates once hospitals fill up and they start having to triage new cases?
John
“ 1% will die =86000”…..Stop to consider that in a population of 66 million, statistically 800,000 will die of something or other every year…..
Does not seem that worrying…
Here are the weekly totals of all Deaths in the U.K. you will need to download the file,
https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/weeklyprovisionalfiguresondeathsregisteredinenglandandwales
In the first week in January 2,141 died of Respiratory illness, this fell to 1,517 by the end of February. This will be one to watch!
About half a million die in the UK every year. 86k is a significant increase above normal. The real problem concerns the fact that these deaths will occur within a period of a few months.
Are you not aware of the situation in Lombardy. This is an affluent part of Italy with a first rate healthcare system. It’s been like a war zone for the past few weeks. For context 67k civilians died as a result of WWII
True, you will live long enough to die of something.
John Finn,
If this novel virus had never materialized, most of those 86,000 would have still died as part of the total annual deaths. They would have died from other viruses that are just as deadly to people with already compromised health. (Look up the medical term, comorbidity.)
One of the comorbidities is high blood pressure.
Another is diabetes.
I was wondering if they count it as a comorbidity if it is someone who has a minor case and it is well controlled with one of the many drugs which control that condition?
In either case, hardly anyone ever dies just because they have hypertension.
Tens of millions of people live with it for many decades.
Same with diabetes.
Millions have it from childhood and it does not appreciably shorten their lives if they control it.
If anyone who has any degree of any of the list of ailments I saw that they are counting as comorbidities (is being overweight one of them?), then basically they are listing the vast majority of people who are over 50 or so.
I do not know the exact numbers, but my sense of it is that very few people reach age 60 without one single issue that requires taking some medicine.
Controlling all of the numerous things that go wrong is one of the main reasons why turns 60 today can expect an average of 23.1 (men) to 26 (women) more years of life.
(That is the bulk average for the whole age cohort. It includes smokers, morbidly obese, alcoholics, drug addicts, sky divers, spelunkers, crab fishermen, etc)
IMO, they should only be counting as a comorbidity those conditions that are an imminent threat to a person life…IOW the people who are as you say…likely to die soon anyhow.
But I do not think they are, and at the very least I doubt very much they are figuring it the same way in different places.
Source…social security longevity calculator:
https://www.ssa.gov/cgi-bin/longevity.cgi
Thank you John
– Well said DMacKenzie. If you had not said this I was going to.
I think all news agencies should be required to juxtapose the “normal” fatality rate with the current COVID fatality rate so we can get some perspective. When you do that with Italy – the posterchild for bad COVID – you see that their fatality rate has increased by something like 30% (i.e. in a town where 10 people died in March last year, 13 will die this year). It is always sad when people die, but let’s not turn this into a Monty Python Sketch “Bring out your dead…”,
“Anyway, 13% of 66 million = 8.6 million get infected
of those 1% will die = 86,000”
Yes, and about 27,000 die in automobile accidents every year in the UK.
Now consider that your hypothetical 86,000 will probably have a median age of like 70 years old (i.e. maybe 15 years of life left, so a total of 86,000 x 15 = 1.29 million life years lost).
And the 27,000 actual deaths in automobile accidents probably average less than 35 years old (i.e. 50 years of life left, so a total of 27,000 x 50 = 1.35 million life years lost), the total number of life-years lost from your hypothetical 86,000 COVID-19 deaths will be approximately equal to the actual life years lost *every year* in road accidents in the U.K.
P.S. I’d be happy to bet you $40 that at least 10,000 *more* people will die on roads (including pedestrians and vehicle occupants) in the U.K. in 2020 than will die from COVID-19, as recorded by the Johns Hopkins coronavirus tracking website:
https://coronavirus.jhu.edu/map.html
Oops! I misread this report:
https://www.gov.uk/government/statistics/reported-road-casualties-in-great-britain-provisional-estimates-year-ending-june-2018
It was 26,600 people “killed or seriously injured.” I should have thought more about it, since road deaths in the U.S. are about 37,000, and the U.S. has a much greater population driving many more miles per capita. But I’ll still be very happy to bet you that less than 8,600 people (i.e. 1/10th of your 86,000 people estimate) die from COVID-19 in the U.K. in 2020, according to the Johns Hopkins coronavirus tracking website.
Mark Bahner
March 21, 2020 at 6:55 pm
(…)
Yes, and about 27,000 die in automobile accidents every year in the UK.
That’s out by more than order of magnitude. 1770 road deaths Great Britain 2018. 55 road deaths NI 2018, so 1825 road deaths total for UK.
https://www.gov.uk/government/statistics/reported-road-casualties-in-great-britain-provisional-estimates-year-ending-june-2018
https://www.nidirect.gov.uk/articles/ni-road-safety-partnership
Yes, and about 27,000 die in automobile accidents every year in the UK.
No they don’t. The numbers for the last 6 or 7 years have all been under 2000.
P.S. I’d be happy to bet you $40 that at least 10,000 *more* people will die on roads (including pedestrians and vehicle occupants) in the U.K. in 2020 than will die from COVID-19, as recorded by the Johns Hopkins coronavirus tracking website:
I will happily take that bet knowing that UK deaths from traffic accidents have NEVER been above 10k in any year. In fact I’ll even go double or quits to give you a chance to get your money back
I’ll bet you that deaths from CovID-19 exceed RTA deaths by more than 10,000.
Wouldn’t you rather take my second bet offer (after I realized I’d misread the deaths and injuries as deaths alone)?
My second bet offer was:
Would you like to take that ($40) bet offer?
These are interesting bets, but like bets on what would the GAST be if no human had ever burned a fossil fuel, we will never know what might have happened if we had not closed the world and gone home for a few months…or however long it will be, for the first time in the history of the planet, which would, IMO, be the number we might be wishing to ponder on.
Mark Bahner March 22, 2020 at 7:41 pm
Re: the bet
The UK has just introduced some strict measures since Friday which will possibly work. Italy has been in lockdown for a couple of weeks and there are signs that they are reaching their peak. The UK probably has another 1500 deaths in the pipeline but the rate might start to decline after that.
The real concern is a second wave but it is possible we’ll keep below 8000 during this wave. But don’t under-estimate this threat. Only London is seriously affected at the moment and several of their hospitals are starting to struggle even at this early stage. If the virus takes hold in other cities we’re screwed.
It seems that Italy is defining deaths from the virus differently to other countries such as china and South Korea I believe their definition is that anyone that has died and has some trace of the corona virus is class as a death from the virus even though they may have died from other causes such as an accident in treatment. I read somewhere that the true death rate may only be half of that reported.
Personally, I have more faith in the facts than the modelling.
You’re more reassured by the facts are you? I have to disagree. The current rate in the UK is more alarming than the models suggest.
The average length of time between symptoms showing and death is about 17 days. That means the patients that died would have been ‘new’ cases 17 days ago (March 4th) I don’t have March 4th figures but i do have March 5th which shows 115 cases. We now have 9 times as many confirmed cases (after adjusting for test numbers). This means cases are doubling every 3 or 4 days.
This matches the death rate which was just over 100 on Wednesday and will be probably exceed 200 later to-day. We can expect it to be heading towards 2000 within the next 2 weeks and unless the recent measures have taken effect we’ll overtake China within a month.
From Italy a large portion of the people who died would have died soon anyway.
Average age 81 and 2.7 other factors on average.
1900 die each day from H1N1 on average anyway so we approach that number, this will kill far more due to induced poverty by the response, we need some balance it’s all about the age and data adjusted historical data.
One time I offered my vegetarian girlfriend a plateful of a food which is popular in Philadelphia called Scrapple.
She asked me what was in it, and I told her it was mostly corn meal.
She looked at me askance and asked again what was in it, and the second time I told her the list of ingredients, read right off the label, which I had strangely enough never once read prior to that moment in all my born days.
Then I repeated…but mostly corn meal.
She was not impressed (a figure of speech meaning she would be serving me a lot more cold shoulder than hot tongue for the foreseeable future), and I had to react quickly to avoid having the plateful of tasty yumminess spilt asunder.
>
>
>
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Oh…by the way…the ingredients for Scrapple are just what it sounds like they might be.
Plus tongues.
Everything but the oink, basically.
Best served hot.
No shoulder…whatsoever.
What makes you think that the people that die from this would have mostly died soon anyway?
And as in the above anecdote, how much is “mostly” is not only a mathematical question, it is a qualitative one.
No one wants to die a day sooner than they would have otherwise, even if that statistic was verifiable.
But in fact it sounds like something someone just made up to try to prove a point for which no actual factual support is to be found.
Mostly can be anything over 50%, and what counts as “soon”?
The stat of 1900 people dying every day from H1N1 sounds like malarkey squared and on steroid as told by Paul Bunyan to his blue ox named Babe.
Is that for the whole world?
It comes to 693,500 per year, which is about 1% of all deaths per year in the whole world.
https://www.medindia.net/patients/calculators/world-death-clock.asp
Making stuff up is bad.
Scrapple is good, and it is mostly corn meal.
Apple sounds good. Scrap sounds like that which which it rhymes.
I’m not as concerned by the number of cases as I am the number of hospitalizations.
If you test everyone and find that 30% have the virus but only 1% need hospitalization what have you learned?
The number of respiratory deaths is 15% lower than last year at this time and 35% lower than the beginning of the year.
Unless there is a huge spike it seems like the panic exceeds the data.
I’m thinking the same thing. The most troubling thing I have heard was an interview with Governor Cuomo. When asked why this reaction is different from other pandemics he said “I don’t know.” I wonder how many others in government “don’t know.” This world wide reaction seems a little disproportionate but maybe it’s just me. This isn’t the freaking black plague.
Governor Cuomo probably doesn’t understand exponential growth.
Why is Britain “overtaking China”? That is not a comment on the virus, but on Britain.
The error of believing all trends continue to infinity is involved here. In Britain, as elsewhere, social distancing will work to slow infections. Various treatments, eg remdesivir, chloroquine, are evolving. The spring is coming; most respiratory viruses, including past coronavirus epidemics (SARS, MERS) improved with the end of the flu season. Fewer Brits will die than a straight line projection of current rates predict.
Meanwhile, Italy is clearly an anomaly worth studying. My theory is that Northern Italians are anarchists by culture….and they do the opposite of social distancing. By nature, they like to be very close, they hug, they kiss, they are intensely and passionately social. The Spanish, too.
How many Brits die annually of the flu? In the US, it is tens of thousands, despite there being vaccines and treatments. Yet people are not in a panic about it…something peculiar is going on societally with this coronavirus.
The error of believing all trends continue to infinity is involved here.
I don’t believe all trends continue to infinity while there are a large number of susceptible (non-immune) people in the population. The rate of new infections is a function of the number of susceptible & infected people S(t) & I(t). Once the R0 number* is known the speed of infection is fairly predictable.
* R0 is effectively the ratio between the transmission rate & recovery rate.
Absolutely – but don’t forget that the USA has anti-vaxxers.
Just saying…
Yes, finally some sanity. We should test 100 or 1000 persons randomly to find out the real level of Corona contamination in the population. It can now be done in 45 minutes. Retest every day and we have a very good trend that we can use to see if the draconian social isolations has any effect.
The Diamond Princess is not an In Vivo experiment! The extrapolation is meaningless in my opinion.
Sanity in any statistical paper would to compare a similar cruise ship doing the same cruise over the last number of years.
How many were sick on each cruise and how many died on the cruise or in the two months after disembarking. Mind you the Diamond Princess passengers were subjected to a lock down and a high level of stress. These numbers would make more sense than comparing the artifact of suddenly producing and undertaking a specific test.
The only reason positive results in both infection and death would not increase is if the virus did not exist in the community in any proportion. It would be zero.
Sorry to highlight the testing artifact again. Too many years of reading this Blog and Climate Audit have fine tuned my bull sh*t detector.
‘Sorry to highlight the testing artifact again. Too many years of reading this Blog and Climate Audit have fine tuned my bull sh*t detector.’
Sorry Stephen, Anthony , Willis and other contributors. I mean this as having read your posts to aid my understanding of reliable data to help me identify the bullsh*t.
This is driving me mad, this might actually kill me yet I’m not the one panicking.
How are people extrapolating this to infinity? Why? It makes no sense at all.
Why are we comparing anything to Italy?
Italy have the oldest population in Europe.
Italians are typically the opposite of social distancing, they eat together, they live together generationally, they hug, they kiss neighbours for God’s sake.
There are well over 100,000 Chinese workers in the Italian fashion trade, many of which originate from Wuhan, a lot of whom went home for chinese new year.
Flights were never stopped between the two countries for residents and workers, it’s essentially an open border.
1st of February was “hug a Chinese” day in response to the rising racism being displayed due to the kungflu.
There’s no doubt other factors at play, but there really isn’t a comparable situation to Italy anywhere else in the world and the Italian figures aren’t playing out anywhere else either.
Everywhere you look, estimates are falling.
Now, I turn to WUWT for my daily dose of sanity and it seems even some in here are succumbing to mass fear and panic.
This isn’t the WUWT comment section I’ve grown to love.
Data is hard to come by but you can do better than this
Italy is an outlier.
Consensus means nothing
Government shutting everything down means nothing but their own job preservation.
The diamond princess holds a lot of clues but it’s a tiny sample.
If I’m going to die from a poxy bloody virus I want to know the real story before I do.
(I’ve just finished chemo for lymphoma, I’ve got damaged lungs and I can’t be given oxygen therapy.)
The Diamond Princess is Italy with life boats – both are dodgy as extrapolations of how WuFlu will go.
1000 persons wouldn’t be enough. It would be like sampling 0.001% of the earth’s surface (pre satellite) and claiming to have the global average temperature.
By the way, at your suggestion, I wrote to worldometer and suggested that they include deaths per million and guess what? Presto! https://www.worldometers.info/coronavirus/#countries
Main stream media uses linear graphs that they stretch vertically. This causes panic and increased sales of newspapers and up tick of TV ratings.
The chart is incomplete and deceptive without data on all flu related deaths, far higher than covid19 deaths alone.
I don’t think deaths/million is the statistic to be plotting, it is deaths/day.
At Ialy’s current daily rate you are talking about 621/day, 18,810/month or 228,855/year if nothing changes, hence their lockdown.
ACO,
Deaths per million is a logical statistic to plot in order to compare countries. I agree that some other, carefully thought-out charts and statistics would be useful but there’s only so many (unpaid) hours in the day and this is a good analysis not available from the likes of the BBC.
Deaths per day for a country is a great statistic if you’re a headline writer paid on clicks. Deaths per million population is what a scientist, epidemiologist or other rational human being wants to know.
Even with deaths per day, which you can find individual graphs of at https://www.worldometers.info/coronavirus/, you can only sensibly compare countries if you take their population into account.
But it is not population that counts it is the reaction of country’s governments.
Compare Singapore with Italy, Spain France & the UK.
Even Germany has a drasically reduced death rate to the other European countries, they have a far higher IC beds/ population than other countries in Europe and have not been overwhelmed like Italy.
Germany doesn’t test the deceased. The real rate must be higher.
They are likely over counting the infected, though some combination of under counting the dead could also account for the seemingly incorrect statistics out of Germany.
The number of critical patients in Germany makes no sense at all.
It is like they have a different disease, or “critical” means something else for them and to a lesser extent Austria that for every other country all around them.
Germany has 22, 213 cases, two people in serious or critical condition.
Every other country has between 5 and 10% of cases in critical or serious condition.
Maybe they bootlegged some remdesivir and are giving it to everyone.
It could be some of the countries on the low end of the % of serious or critical range have mostly new infections that have not progressed to pneumonia yet, but over 22,000 cases, and a fraction of the deaths, and a total of two serious or critical patients, but 16 new deaths, and 2.365 news cases…Not really buying it.
Luxembourg, Andorra, and Liechtenstein have more than 2 critical patients each.
This is definitely about what countries have sufficient margin to deal with a period outbreak and those which have cut back resources to a level where they struggle to keep a breast of demand on an average day.
The numbers in Italy are much higher that the official ones.
Nobody counts dead in the nursings
That would be amazing for a modern healthcare system.
This Virus is amazing for “a modern healthcare system”.
Maybe the people that do the counting and statistics are home trying not to get sick too.
In the middle of a crisis is very rarely when good and complete information can be had.
And this is unprecedented, whatever else it is.
“ if nothing changes ”
Of course nothing can or will change! Right?
– – winking smiley face – – Poe’s Law
Every time a person dies, something changes.
Sorry, but those are “dead” statistics. I am frustrated that we are receiving zero DETAILS about the vectors and the branches of infections. Who, where, how, when, and why each patient contracted the virus. I want to know what the most dangerous activities are (OK … cruise ships are OFF my list) … and whom I should most avoid. We do this for bacterial outbreaks such as e-coli. We RAPIDLY go to work determining WHERE and WHAT people ate? WHERE they were infected with the bug. Was it a meal at Chipotle? Or the romaine lettuce from your supermarket? Why aren’t we doing this for the Coronavirus? We certainly did this for Ebola.
Sorry, but the Coronavirus appears to being treated as a “politically-correct” infection. Hush, hush. Don’t speak names, places, or situations. It feels like some Federal rules for “profiling terrorism” … profile everyone, randomly, so a certain group doesn’t feeeeel bad. So grandma gets pulled out of line for a strip search. No, I’m NOT saying “Chinese-looking” people should be feared … but rather I want to learn where the vectors and branches of this infection are originating. Should I FEAR going to my grocery store and buying fresh produce? Should I FEAR every shopkeeper trying to stay in business? I understand the “shotgun” approach to FORCE everyone, everywhere, to keep to themselves … but I want INFORMATION and DETAIL … not shallow, broad, dull, statistics and scary-looking hockey stick charts.
So, I’m told that Contra Costa County (my Home County) has 45 “cases” of infection. That’s USELESS information for me. Please tell me more! Are these cases in any way related? Have they been traced back to a single carrier? Are the cases diffuse … occurring across the whole county, or are they focused in one city? How many of these cases are medical workers?
Again, if someone contracts an STD (can I still use that non-PC term?) they are immediately instructed to inform ALL their sexual contacts. Why aren’t we getting this sort of data from Coronavirus patients? Or more likely, why aren’t we being given this information? We are SHUTTING DOWN our entire world … our entire economies … with only the most superficial charts and graphs … humps … of data! Where is the REAL information?
+100 Kenji. But I would say we are getting deliberate misleading and missing info. Do ‘cases’ mean illness, or just tested positive? Only the elderly and those with underlying health issues are vulnerable. Not the general population. Why aren’t JUST the care homes and hospitals being locked down, and the vulnerable staying home? Everyone who enters these institutions must test negative for this coronavirus. Why is all of Society and the Economy being being shut down? Influenza kills massively more people than Covid-19 will, but Society isn’t shut down for that. Something isn’t right; I think this whole crisis is being driven by irrational fear.
“Only the elderly and those with underlying health issues are vulnerable. Not the general population.”
The word “only” has a specific meaning.
The definition of ‘only” makes your statement and your premise, false, Holly.
“Mostly” might be close to a true statement.
“Mostly” only old people die of anything.
Does that mean other people, who “mostly” do not die, have no reason to fear death, or viral pneumonia?
There is no where near the manpower to trace all the connections, and it would only do any good if the connections could all be found. And if anyone knew where and when they got it.
The latency period is far too long, the people who are symptom-less spreaders make it impossible all by itself. But it has to be considered that someone passing it in a public place, or a casual encounter with a stranger, or the guy next to you in line at the store, cannot be traced even theoretically.
Ebola was a few people in our country, the latency period was extremely short, anyone who got exposed got eye-bleedingly sick, and anyone can spot it when you have Ebola. And only people with symptoms shed virus, mostly in the later stages of the infection.
This is completely different, even if it was just some known number of people traceable to a specific day and place each.
The method you speak of takes a small army of epidemiologists tracking down and dealing with contacts even when the elapsed time is a few days and the index patient is known and can tell them exactly where he was every minute since showing symptoms.
Ebola is not contagious prior to showing symptoms, and it is not airborne…it takes bodily fluid getting on you, or touching the skin of someone with it, or fomites that are wet with bodily fluid.
Ebola cannot transmit through air water or food. So no one with Ebola is walking around spreading it for days to weeks with no outward sign of illness whatsoever.
AIDS takes even more intimate contact. Same as STDS…and even very promiscuous people can typically name everyone who they might have gotten or given it to…or at least where to find them or what they looked like.
Did you just wake up from a month long sound sleep, Mr. Van Winkle?
Almost none of the people who have had it have any idea where they got it.
There are probably many tens if not many hundreds of thousands who have it now. It did not get from one end of the country to the other in a few weeks with no know carriers by osmosis.
How did it get so widespread?
Did someone or a bunch of someones get sent out to pass it around the world as widely as they could, stating back in February?
Was it maybe like that guy from the movie 12 Monkeys?
Not the origin of it, but after the outbreak started?
We know one guy in Korea did that.
Did the communists decide to make sure they were not the only one’s affected and send out a bunch of people with a wad of cash and plane tickets and tell them to find crowded places and cough a lot? I have no idea, but I am surprised it is not the main theory for how it got everywhere so quickly in some circles. Hopefully somewhere, some detectives are working out the math and figuring out if it could have just been one or two people that happened to be standing at the base of a big wobbly Jenga tower of contacts, or whatever an appropriate analogy would be.
It is way to late to do anything about it by that method, unless the whole country gets a lot more astute and cooperative in a giant hurry.
And without 350,000,000 rapid answer and never wrong test kits…what good would it do to trace contacts?
We are all six degrees from Tom Hanks, even when he is on the antipode of the planet.
Wait!? If someone I had contact with presents with the virus … I shouldn’t want to know that? It’s too hard, so don’t try? And what exactly are all our highly paid government employees at t(e CDC, NIH, NCIRD, NCHS, CSELS, NIAID … doing? Sending out missives DEMANDING an end to Spring Breakers sunning themselves on FL beaches?
I found this article most illuminating …
https://medium.com/six-four-six-nine/evidence-over-hysteria-covid-19-1b767def5894
Are you demanding an army of investigators go start knocking on doors, to trace how you might have gotten it?
Tens of thousands have it, maybe upwards of a million in the US alone.
Did you read a word I said?
If you got it from the guy behind you at the store two weeks ago, how is anyone gonna trace that?
Who are the people gonna do it?
Should they do it for just you, or only people who scream real loud?
Why?
If you do not know who you got it from, or when, how should anyone else know?
Do the police try to track down every burglar or pickpocket?
Some things are just logistically impossible.
Not theoretically impossible…logistically: It is a practical impossibility, given resources, manpower, time constraints, and competing concerns.
And meanwhile it is spreading.
Is the answer to your questions the nations top priority?
Is finding out an unanswerable and ultimately irrelevant question really how you want public health officials spending their time?
In one day of tracing contacts, won’t they all be sick and at that point spreading it themselves?
What part of this are you not getting?
BTW that link does not work.
Thanks Willis! A mystery for me is the spread in the death rate:
Here in Germany (D) the death rate is only 0.3% and in France ( the same “age” of the outbrake) it’s 12 fold higher, and I coul not find a proper explanantion for this. Also in the US the death rate 5 time higher. Any thoughts?
I suspect it is all down to the level of testing – the more you test then I suspect the lower the rate will be and of course in the UK testing is currently at ludicrously low levels.
I’ve added a post which should appear below about my wife and daughter both having this but we can’t get them tested and so they won’t appear in any stats anywhere. Ditto two other acquaintance who have both recently had Covid 19 – or at least had the full range of symptoms.
frankclimate: “Any thoughts?”
WR: from a very good analysis:
“This is what you can conclude:
….. countries that are prepared will see a fatality rate of ~0.5% (South Korea) to 0.9% (rest of China).
Countries that are overwhelmed will have a fatality rate between ~3%-5%
Put in another way: Countries that act fast can reduce the number of deaths by a factor of ten. And that’s just counting the fatality rate. Acting fast also drastically reduces the cases, making this even more of a no-brainer.”
Full analysis: https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca
This!
Those countries that recently experienced epidemics like SARS, MERS and Dengue fever were much better prepared than those that haven’t and recated quicker.
Based on official figures. Does anyone genuinely believe the numbers from China?
Not me.
Especially based on the non official data that escaped on the internet.
I find the resent data from China very puzzling, ‘three days no new infection cases’.
There are number of reasons why that could be, but none I considered can explain logic of total disappearance of new infections if the above is factually correct.
No. Either they are lying or they have a way of suppressing the virus.
It is sad in a time of world emergency and they cannot stop their propaganda machine.
China suppressed the bad news from the beginning leading to loss of life in China and most of the bad effects that we are seeing today.
China normal mortality rate is 7/1000, this calculates to more than 20,000 dead every day. So few extra one or two hundred dead /day are not much of a concern to the totalitarian regime, at least not as it may have been for the damage done to the economy caused by the shut down. Chinese industry is slowly getting back into gear, while the other industrial nations USA, Germany, UK, France and Italy are cutting back, world economy is being rebalanced in China’s favour, whether we like it or not.
It is ironic that the USA, the bastion of capitalism and free market forces, followed by the UK and France are faced with no other choice but to employ methods of socialist type interventionism in order to protect economy’s stability.
I do hope China doesn’t come out of all this triumphant, since after this is all over many in the west may question capacity of the western democracies to deal with the catastrophic events affecting majority if not all of their citizens.
Sorry about long rant.
Vuk,
The single most difficult thing to understand is how it is humanly possible that China went from 77,000 cases, to exactly zero new cases.
In any time frame, it does not make sense.
Unless it is the masks.
Even ignoring Wuhan and that whole province, it does not compute. What about all the people who do not have any symptoms but are carrying and spreading the virus in every other places in the world? Even if they had an all points alert that was strictly followed by everyone in the country to report anyone with a sniffle, and that person was grabbed up and put in a box and warehoused, it can not explain the people not showing symptoms but pass it along to someone else who then get’s sick.
So is it under the radar?
Are people dying at home instead of going to hospitals?
I mean…1500 million people…
Masks…
What are the chances of everyone in Europe and the US wearing a mask when ever out of the house, even if walking down the street by yourself.
Maybe they wear them at home too…
How do they have enough?
How many per day does a person need?
They have to be changed is my understanding.
Although it has to also be said that our guidelines on masks makes zero logical sense.
Even if it is 100% an always-true-fact that they only do any good to keep infected people from spreading the germs, no one knows they are infected until they have been spreading t around for anywhere from days to weeks, and many people have no idea they are infected because they have no symptoms.
So logically the solution is what they do in China…everyone wears a mask, all the time.
Putting one on once you are tested and diagnosed is the ultimate closing the barn door after the horses have escaped inanity.
I read that earlier this week. There is not much in the way of identifying the data sources which were used. The author has no background in health, other than psychology and storytelling.
Dear Old England, how do you know that your wife and daughter are infected ? In Belgium for 2 weeks now only hospitalised people are tested and amongst those tested only 10% are positive to coronavirus.
A lot of people are hypochondriac now, which make senses.
The most obvious thing is quality of hospital care. We now have a world wide experiment to find out who has effective healthcare systems in place, for the population as a whole, rather than just those who can afford high quality care.
Germans are very rigorous by culture , French and Italians are laisser-faire mediterranean cultures.
France has average 9000 ordinary flu fatalities in an AVERAGE year and hospital infection kills about another 4000 / year. Neither of those figures have been a reason to cripple the national economy. For some reason the current 450 deaths is.
Initial spread in Germany was a lot slower too, which gives them a lower total at this time. Again probably cultural differences.
Like the climate “crisis” this one is largely artificial in terms of the hysterical reaction to the relatively minor death toll.
Hey MODS, is there any chance we can remove the K-word from the automatic moderation. It is pretty hard to talk about a global pandemic without mentioning the fact that it k-i-l-l-s people.
+1,000,000
But I know the answer…WordPress has it’s own lists of words, and it is not subject to modification by the person who runs a specific blog.
Or so i have been led to believe.
There is a separate parallel experiment going on: Who has the self discipline to avoid all contacts and follow all precautions and guidelines to avoid becoming infected?
So far at least…I am working very diligently on that last one, once the time period passed in which I considered it would be better to get exposed sooner rather than later.
At this point I expect it may be the worst possible time to become exposed.
This current phase will end once an effective antiviral regimen has been identified, approved, and produced in sufficient quantity to be enough for everyone who needs it.
Also at this point, we need a blood test to identify people who are immune due to being infected and getting sick and then overcoming it, or not getting sick and overcoming it, or getting a subinfective dose and becoming immune without ever becoming a virus shedder.
All such people can:
-Go back to work and mingle freely, being now and likely forever immune, especially if they have multiple subsequent exposures.
– Give blood from which immunoglobulins can be isolated and used to treat the gravely ill.
If they are not doing this…I would like to know why…and if they are not I am also gonna be extremely pissed off and disappointed.
When this is over, we need to find out who in important public health positions have utterly failed us, tar and feather them and run ’em out of town on a rail…or at the very least fire them unceremoniously.
Nicholas, the “likely forever immune”. “Likely”. Immunity for covid19 after you restored is today more hope than science. It will take time before there is sufficient proof for how good and how long.
As far as I know the how long also depends a lot on the disease or vaccine. Sometimes live long, sometimes a few years and sometimes not at all (the common cold..)
I share your thought on the parallel experiment. It will learn us a lot on how disciplined populations are. Stereotypes might become proven facts!
Immunity to the cold is not existent because there are many viruses that cause “the” common cold, and also because some of them constantly mutate. So it may be one never gets the same cold again.
We really do not know if this virus will be like that, although I would not doubt it…but we just do not know.
Much of what I have read about diseases like measles, having been contracted once then provides lifelong immunity is that, prior to it being widely vaccinated for it, everyone who got it once had frequent re-exposure while they were immune, and this restrengthened the immunity, renewed the memory cells, and reupped the antibody titers.
It is not precisely known how many such exposures would have strengthened the immunity to a point it will be “lifelong”.
But it is fairly well established the most people never got such diseases twice.
Although it is also true for some of these diseases, a few people did get them again.
Germany does not so postmortem testing, so that likely reduces the number.
Since the actual cause of death is rarely the virus itself but other complications, that probably is not important. They almost certainly are testing hospital admissions.
It’s the same as excluding postmortem positive tests; the number will go down by some unknown amount either way, whether positive postmortem tests are excluded, or whether no postmortem tests are done. It’s the same thing.
It is, as others said, down to the level of testing and the honesty of the government. I’ve also been slightly mystified by it, but it makes some sense. It’s hard to look at statistics that show Germany and Iran having had the same number of cases, yet Iran shows 1500 deaths compared to 70 in Germany. Also the UK, with 1/5th the number of confirmed cases as Germany, has 2.5x the number of deaths and, as you say, the USA numbers are ‘interesting’. Unfortunately, without everyone being tested, it seems almost impossible to actually estimate a reliable range for the death rate.
Germany have 28000 IC beds, the UK have 4000, So beds/population is very important where system overload is concerned.
see
https://www.euronews.com/2020/03/19/covid-19-how-many-intensive-care-beds-do-member-states-have
How many in the US?
For one thing, Iran is under severe sanctions, and so their healthcare system can in no way compare to Germany’s
Does it matter since China produces the world’s medicines and probably ignores any sanctions?
No restrictions on humanitarian supplies to Iran. They have enough money to fund a war in Syria and Yemen so not like they don’t have money for it.
Another thing which is happening is that the virus is mutating as it spreads.
This may also reduce it’s virulence
Here is an interactive map of the Genomic epidemiology of novel coronavirus. Makes it extremely easy to trace any patient zero in your area. Fascinating Open Science.
https://nextstrain.org/ncov
Wow.
Here is an overview article on the Nextstrain site:
https://www.designweek.co.uk/issues/24-february-1-march-2020/how-service-design-can-promote-an-open-science-solution-in-light-of-coronavirus/
There are different theories regarding the evolution of virulence.
Some have theorized that an infectious organism should evolve towards decreasing virulence, and yet it is known that many infectious diseases had/have no such trend.
Some habits favor virulence, such as sexual promiscuity favoring more virulent strains of venereal disease-causing infectious organism, at least the way I have understood the evidence.
Germany tests more people who have none or low symptoms
Testing explains most of the inconsistencies (as Old England suggests below)
https://ourworldindata.org/covid-testing
Germany 167k tests
France ~37k tests
Germany is picking up a much bigger proportion of the mild cases. I suspect France has a lot more cases than Germany in reality.
The deaths in Germany are far lower because, where there are serious underlying conditions, they are given as the cause of death (not unreasonably), not Covid-19. That highlights a problem with the deaths stats. As it is the already sick who die quickly that gives Germany a very low number. Those who start out healthy have more resources to fight the virus and last longer before the succumb. If that is correct, the German CFR will increase in the coming weeks
It does mean that the German stat gives us deaths of people without major health issues.
Saw the same thing when analyzing longevity statistics. Many countries with exceptional longevity numbers do so by excluding deaths of newborns in the first year of life. After trying to put together an apples-to-apples comparison for several months, I finally gave up. The data were irreconcilable. It turns out no one counts births and deaths the same way.
Yes ! By far the most likely day to die in your life is your first day of being alive !
Many even before that.
I’m not going to die until the last day of my life.
Probiotics in Sauerkraut? During the SARS outbreak, Korea said it was the probiotics in their dish of Kimchi, that protected them.
For me it was my lucky socks that I bought while on vacation one time in Key West with this girl I dated in college.
Must have been, oh, 38 years ago I’d say.
Best durn socks evah!
AC Osborn
That is surely an extrapolation too far? it is a little like saying that as yesterday was 1 degree warmer than today then in a years time it will be 365 Degrrees warmer than today
I think deaths is the only criteria unfortunately as the number of cases depends on the level of testing which varies wildly
However even that needs putting into context as it is overwhelmingly the over 70’s and especially the over 80’s with several severe existing illnesses which comprise the most deaths, of which a statistically high proportion would have died of one cause or other in the current year.
Most developed countries have the awful sounding ‘ excess winter mortality’ stats and whether that shifts upwards in 2020 remains to be seen, as here in the UK for example we have had a light flu season which in 2017 caused 28000 deaths and in 2014 caused 48000 deaths’
tonyb
Except that they are real numbers and are still climbing.
That is why I added the point about lockdown, that death rate is from cases infected before the lock down when it was allowed to spread.
Without the lockdown those rates would have continued to climb.
Many of the deaths are being caused by overloaded medical facilities and do not include those patients who die because they can’t get in to an ICU.
What we need to see in Italy is a major change in increase and then a fall away due to the lockdown.
Spain, France & the UK are all following the Italian curve.
Countries that experienced SARS & MERS epidemics have handled this much better with either zero or very low cases and death rates.
Singapore is a classic example of how it should be done, strangely the first town in Italy to be infected and the patient died has eradicated the virus by Testing and isolation, classic Quarantine.
See
https://www.ft.com/content/0dba7ea8-6713-11ea-800d-da70cff6e4d3
More information on Asian reaction to COVID19.
https://www.bbc.co.uk/news/world-asia-51970379
THe only country I disagree with is China, they did not react quickly and allowed it to spread for about 2 months.
China lied to everyone, including its own citizens.
At present, examination of the logarithmic plot of case numbers shows that the exponent in the function of time is declining in Italy, France and Spain. It’s not in the U.S. or Germany yet. It possibly is in the U.K. There is still a lot of suffering ahead, however.
Italy will gain control when discharged cases equals new cases.
On the worldometer page check out the data for
Hong Kong
Singapore
South Korea
Indonesea
Japan
Compared to what is happening in Europe.
It would be interesting to chart mortality against number of ICU beds. I suspect that this whole episode is the most persuasive argument against socialized medicine.
They showed the chart for Italy for ICU beds and deaths on one graph.
When ICU beds get full, deaths spike way up.
If beds become available, deaths go down…until the beds fill up.
Viral pneumonia takes close attention and round the clock supportive care…oxygen, ventilator, someone watching, IV fluids, and medications.
When they start putting old people with pneumonia on cots in the basement, so they can give the ventilators to the younger and healthier people…guess what happens.
Ans THAT is why this is being done the way it is.
A lot of old people in charge of stuff like governments and businesses saw the numbers and the demographics and that is how we got here.
If older people were mostly not affected, especially the older they were, and the very young were the ones dying…would this have played out the same?
Who has all the money and power?
There is no lockdown. The park is full parents, garndparents and children. The lads are playing football, people are out walking their dogs. I would say it’s down about 30% on normal sunny Spring Saturday.
A colleague went to the chemists on Wednesday to get her prescription. None of the rather long queue were observing distance, all chatting, she was mocked for wearing a mask (and she was very glad she did).
That is no kind of ‘lockdown’ at all.
… and the virus will spread as it requires a real lock down to suppress.
The question is how low can a country get with segregation. I do not believe China’s three days of zero cases.
It is interesting how different countries respond.
In Canada the restaurants and bars have all closed because people are not going out except to get essentials.
Here there is peer pressure to do what is right and there was real concern for staff.
The streets and parks are empty.
It happened in a day last week.
How precisely do you eradicate the virus by testing? If you have positives, do you just ship them out to some other town?
You isolate (quarantine) and treat them and test again, repeat the last 2 until dead or clear..
The world seems to have forgotten 2000 years of history since the first Leper colony.
Have you read about the Italian Town of 3300 people?
Could you link to this story?
Criteria is a plural. The singular is criterion.
Great work!
Is there enough information out there to graph number of tests performed per million. It may explain the difference between France and Germany if France is only testing the obviously ill.
Also which countries endured a particularly severe flu season before commencing testing.
The average number of deaths from ‘ordinary’ flu in the UK over the last 10 years is around 17,000 each winter although the last 2 years have seen very much lower figures in the 2-3,000 range in some years it approached 30,000.
Due to very limited testing availability in the UK we have no background data on how many people have suffered and recovered from Covid 19. Both my wife and daughter have had it, their symptoms were exactly as described by medical professionals who have had, been tested and recovered from it. Bad headache, throat so sore and swollen that eating was impossible, dry cough, completely knocked out and unable to lift arms anywhere near to shoulder height and sleeping for 16-18 hours a day. Lasted 3-4 days for each of them. They both described it as the worst they had ever felt in their lives – something repeated to me this week by two other people I know locally who have had and recovered from exactly the same in the last 3 weeks.
My daughter had just returned to the UK from Tampa, Florida in early February after a week long company conference bringing hundreds from around the globe. People began going down with what they thought was “extreme flu” towards the end of that week. Of the 9 from her office here in Berkshire, UK who flew back together 7 went down with the same and a couple were off sick for 10 and 14 days.
Despite both wife and daughter being very ill for 3-4 days neither felt it to be in any way life-threatening and neither I nor our son who still lives at home went down with anything. I had a couple of days when I felt a headache trying to develop and took aciclovir tablets because I get the occasional cold sore by an eye and it can’t be treated with cream and I thought it might have been that. If I get one headache in 5 years that’s about it and these did not develop into headaches. Whether aciclovir had anything to do with that I have no idea, I suspect not although it is an anti-viral drug.
I don’t want to downplay concerns about Covid 19 but the lack of data on the actual level of infection and recovery rate in the UK means policies are being made blind. We simply don’t know what the mortality rate is in healthy adults and so risk assessments cannot be made. The British government seems to be making policies with the prime aim of ensuring that the NHS – with very few ICU beds – is not overwhelmed and I wonder if the ‘cure’ (in policy terms) will prove to be worse than the disease in social and economic terms.
I have invited the relevant bodies and researchers to test my family to see if there is any reason why some have been affected and others not – but as yet no interest in that. None of us now have any real concerns about it apart from my 97 year old (soon to be 98) mother in law who lives on her own and is instructed by the Government to go into 12 weeks isolation at home without leaving the house or having visitors! The isolation would be the problem and inability to shop etc. We’ll deal with that but there are many who won’t be able to be supported.
Be sensible, stay safe and look out for others whenever you can.
Old England, you are a person of common sense and are acting responsibility. The testing issue you mention above is certainly one of the great variables in the poor collection of factual statistics available to us. While we wait for more statistics and trial vacine results, I will consult the Willis charts several times a day, thanks, Willis.
I live in Mendoza Province, Argentina, where there is no currently identified Covid-19 infection, but several likely candidates. We are currently in quarantine with 24 listed reasons to be outside, due to the almost certainly correct idea that Person Zero is actually somewhere amongst us. It will be an interesting statistic to see how the virus eventually plays out with this head-start on the problem. Stay safe!
Old England, I too am in the UK and the lack of preparedness, quarantine of visitors and testing is a national disgrace.
I don’t remember if they have ever instituted mass flu testing in the UK, so that is another case of nobody knows how many cases we have actually had in the past.
Also many people will not know if they have had a bad cold, the flu or COVID19 without being tested and therefore do not know if they were spreading it or not.
“Whether aciclovir had anything to do with that I have no idea, I suspect not although it is an anti-viral drug….”
I always thought that acilovir was very specific to the herpes simplex virus – but a specialist in viral activity might know differently…
Old England,
It’s interesting to hear about events from Englanders under any circumstances. Too bad it has to be on such a topic. Thanks for your personal account and hope you too remain safe. From a statistical standpoint… sorry to ask, but wonder if it’s possible you and your son were infected – clearly you were exposed – and that your immune system just fought it to a standstill.
I want to surmise that millions of “infected” people will experience a mild headache with no further symptoms, but are not being – and will not be – accounted for in any compilation of data. If this event is anything like other epidemics or even for seasonal flu (from perspective of testing in the States) I have to wonder how they come up with even rough estimates of the numbers of affected.
Does anyone know where to find a break down of deaths by age, sex, income, location….?
Lots of charts and links here.
https://www.worldometers.info/coronavirus/
In addition to those, I’d like to see lifestyle behaviors (e.g., smoking, drinking, vaping), immigration status (latent TB), pharmaceutical drug use (e.g., ACE inhibitors, ARBs, ibuprofen, flu vaccine)
Another variable would be how many infections were acquired within an institution eg home for the frail elderly or hospital and how many were genuinely community acquired. The initial dose of virus might also influence severity.
Within an institution the route of infection is more likely due to inhalation into the lungs where the cells are best supplied with Ace-2 receptors to provide a dock for the virus to enter and duplicate, probably enhanced by lack of fresh air because of the weather.
Community acquired is more likely to be transmitted by hand to mouth or eye from contaminated surfaces in which case, the virus would be slower to reach the lungs by which time the body would have commenced its defence and may manifest by gastric symptoms first.
Could this explain the italian death rate??
https://www.bloomberg.com/news/articles/2020-03-18/99-of-those-who-died-from-virus-had-other-illness-italy-says
Sunny: “Could this explain the italian death rate??”
WR: The Italian death rate is what you get as soon as hospitals are ‘overwhelmed’. When there are no more IC beds, not enough care and no ventilators left, than many patients will die.
The Netherlands is running out of regular IC beds next week and I expect parts of the US the week after. This will affect the fatality rate enormously.
For actual situations of the different countries: compare the country graphics (click on the name of country in the general overview) at https://www.worldometers.info/coronavirus/
“I expect parts of the US the week after.”
Does this speculation include locations.
Washington State (Seattle area) is the location of most deaths in the USA so far (may have changed) and there is no claim of lack of beds.
Not even close, NY is highest by far, over 30,000 cases, 270+ deaths, and they are being overwhelmed in the hospitals (doesn’t happen during flu outbreaks).
After Japan, Italy has the highest percentage 65+ (23%). Italy typically has multiple generations living in the same household. The younger ones come back from school, never exhibit any symptoms and then grandma and grandpa are goners.
This is the latest report -2020 03 20- on a sample of 3200 deaths in Italy
https://www.epicentro.iss.it/coronavirus/bollettino/Report-COVID-2019_20_marzo_eng.pdf
Please, use the standard international codes
China (CN) is NOT Switzerland (CH)
Spain (S) ist not SP
I was surprised to see on your graph Switzerland being saturated at that high level
es is not especially self-apparent to most (EFL) people as the (inet) ‘code’ for Spain either …
Alex, I used the first two letters for two reasons.
First, because I figured many, many more people out there, many of whom don’t have English as a first language, would not know that CH is Switzerland.
Second, there are only a few countries on the graph, so even people knowing absolutely nothing about standard international codes could figure it out, by comparing the abbreviations to the legend. Each of the abbreviations is the first two letters of the name of the country.
Best regards,
w.
Looking at the International vehicle registration code – Spain has E, Germany D
Perhaps you could go to the CDC page(s) titled “Weekly Influenza Surveillance Report” where lab confirmed flu cases and flu caused pneumonia cases are reported?
Then compare the lab confirmed cases of Wuhan to the lab confirmed cases of Influenza.
It would be very helpful to have this comparison so people have a yardstick that uses the same scientific set definition. I.E., comparing what everyone has experienced – the annual flu (and cold) contagions, to the “novel” Wuhan cold virus might reassure those stressed into near panic.
cedarhill
March 21, 2020 at 5:17 am
And South Korea too… 🙂
cheers
UK data in more detail
http://www.vukcevic.co.uk/UK-COVID-19.htm
Testing explains most of the inconsistencies (as Old England suggests below)
https://ourworldindata.org/covid-testing
Germany 167k tests
France ~37k tests
Germany is picking up a much bigger proportion of the mild cases. I suspect France has a lot more cases than Germany in reality.
It is the rapid rise in number of dead that is of the concern.
That is what I was trying to explain
Any country following the Italian curve is at some point going to reach saturation of their health system, unless the introduce many tests, total tracing and/or lock down.
Those with the most IC beds per 1000 population are best placed to keep the death toll very low as long as they act.
Too many people think of this as “just another flu” when it is definitely not, in fact that is one probelm with identification.
Flu tests using mouth & nose swabs is not very accurate for COVID19 because it replicates in the throat and lungs. It is not an upper respiratory illness.
Here in the US the test is done by inserting the stick-swab right up into the nasal passages (unpleasant) and way into the throat (not mouth) which is also unpleasant, especially if you have a strong gag reflex. However, an unpleasant test is better than rigor mortis.
These comments only relate to the UK data bu I am sure the same issues will apply elsewhere.
In the UK they only test individuals who have symptoms of possible COV infection, thus the testing sample is not random and obviously biased. It does however suggest that the diagnosis method used to select individual for testing is very poor as only about 5-6% of those tested are positive. Secondly, the reported deaths must also biased since it only reports those who died who have been tested for COV. It is therefore not easy to assess the progress of the epidemic- you have no idea about those individuals who have been infected and recovered nor of those individuals who have died from COV without being tested. As I noted in a previous post it seems to me that a proportion of the population is immune to COV possibly as a result of infection by a related virus ie cross reactivity. This is not an uncommon occurrence if fact the discovery of vaccination by Jenner relied on this phenomenon … using cow pox to vaccinate against small pox
I think we should be very skeptical about infection rates and data
I can’t find the link, but I read where the median age of people that died in Italy was 80 and the average underlying medical conditions of those that died was 2.7. The number of deaths of people under 30 was 0.
This is a re-post as the last may have got lost on moderation.
These comments relate to the UK data although I sure the must apply elsewhere
The number of individuals tested for corona virus is obviously biased as patients are selected for testing based on their diagnosed symptoms (ie it is not randomly selected sample). This diagnostic selection seems to be poor as only about 5-6% of those tested show a positive result for COV. Similarly, the reported deaths are of those who have tested positive for COV is therefore also biased. So these data only reports those infected and of those who have died and have previously been tested. It does not take into account those individuals who were infected and recovered without medical intervention nor does it report on individuals who might have died from COV infection but were never tested. So the data is unreliable at best.
As I suggested in a previous post the low rate of diagnosed infection in cruise ships suggests that there may be a significant proportion of the population who are immune to new COV infection due to cross reactivity with other related COV viruses. An example of cross-reactivity is the discovery by Jenner that vaccination with cow-pox virus protected against infection by small pox. To get a complete picture there is a need to develop a antibody test to confirm immunity.
The most reliable(though not perfect) is the incidence per 10 million population exactly as Willis has done, assuming that the cause of death is accurately reported as being due to CV. All other stats are subject to huge errors, mostly due to the number and cohort tested. Based on the experience and Gompertz curve from China, the expectation is that the incidence will level off in approx 3 week from now (As Fauci has said) and will be Less than the mortality rate of influenza in the US (which he hasn’t said but which is evident from the respective curves) which is 200/10 million pop US.
The Future Number of Deaths.
The number of deaths to expect in the next week is easy to estimate. Go to the New Daily Cases graphic and look at the number of new cases 8 or 9 days ago. Eight or nine days is about the number of days that a person who died did stay alive after testing. When the actual number of new daily cases since 8 or 9 days ago multiplied by five, it may be expected that 8 or 9 days from now the number of deaths also will be multiplied by 5. This number also shows the enormous extra pression the medical sector will experience: in this example five fold in 8 or 9 days.
(but changing the way of testing changes the outcome)
Data: https://www.worldometers.info/coronavirus/country/us/
I have just prepared an email with a link to this page, for a number of friends.
On trying to send it, the mail server rejected it – due to ‘SPAM’.
Is WUWT being incorrectly (possibly maliciously) specified as a spam/fake news site to the various checking databases?
Have you tried encoding it as a tinylink?
https://tinylink.net/
It’s WUWT’s email server rejecting your message as spam, not your mail server preventing you from sending.
Could you be a little bit more clear on the mechanism which could cause that to happen?
I can’t imagine any scenario where another site’s email server could possibly reject a message sent from another ISP to another recipient as it not even on the path.
Very curious as to your understanding of what’s happening here.
Ignore confirmed cases they are meaningless. The only reliable UP-TO-DATE figures are the number of deaths. The UK as of yesterday had recorded 177 deaths. If the fatality rate is 1% that implies 17,700 actual cases. BUT WAIT. ….
That’s not 17.7 cases now – it’s 17.7k cases at the time the person who died last contracted the virus. Think about a plane crash. The death rate will involve all those involved at the time even if deaths occurred 6 months later.
The average time between onset of symptoms and death is ~17 days. So the 17.7k figure would be the true number of cases 17 days ago. After adjusting for testing numbers confirmed cases are about 9 times as much as they were on March 5th (earliest date I have).
The true number of cases in the UK is probably around 150k. There are probably many more deaths in the pipeline.
Doubling every five days. 1% surv rate. 20 days till infection and death. 1 death = 400 cases. This is the formula I use. Once you run out of equipment, you can trow it out of the window. Also complete lockdown should slow the doubling rate after average incubation time, deathrate follows later. Typed from phone with autocorrect in other language, sorry
1 death = 400 cases.
Shouldn’t that be 1 death = 1600 cases or have I misunderstood your reasoning.
doubling every 5 days for 20 days gives 5, 10, 15 20 days. (i.e. 2,4,8, 16)
Yes you are correct. My mistake.
There is, I think, a parallel between how to handle COVID-19 and lessons from the quality improvement initiatives that many organizations have undertaken.
Broadly speaking, the quality of a process is a function of the quality of each step and the number steps. It turned out that reducing the number of steps in a process had a far greater quality benefit than trying to significantly improve the quality of each step. I suspect the same thing is true with the virus. Better to reduce interactions dramatically (isolation) than to try to reduce the likelihood of catching the virus during an interaction/ trip outside (gloves, masks, sanitizers, etc).
Good lesson to remember.
An Indian doctor just popped up on the British TV and said ‘if you have suddenly lost sense of taste and smell you are most likely infected, despite not showing any other symptoms’.
True or not, I don’t know, but worth remembering.
Would this be a feature of ANY upper respiratory or nasal infection?
When I get a cold I certainly can’t smell or taste well – but that doesn’t mean that I have Covid-19…
COVID19 is not an upper respiratory infection, it is a lower respiratory infection.
Obviously however there are body wide symptoms depending on how infected you are.
I read earlier on from the Chinese data that the lower your Immune system is the longer it takes the body to show syptoms and the deeper it goes.
It both damages the lungs and other organs and quickly leads to Pnuemonia if allowed to.
Even the young between 20 & 40 can develop Pnuemonia.
Willis,
I don’t agree with your statement at the bottom of your graph: “IF (big if) the US follows China/Korea, that will be ~ 670 US death.” Especially the (big if), but I hope you’re right.
My difficulty is especially with the death rate in China due associated with COVID-19.
Death Rate = # Deaths/Population of China = 3248/1,386 Million X 10 Million = 23.4 Deaths/10 Million.
Then using China’s death rate you multiply it by the US population to get ~ 670 deaths.
Here’s the problem: Most of the cases in China were in the restricted Hubei Province (specifically in the capital Wuhan), therefore, shouldn’t you use that population (Hubei Province: 58,500,000 souls) to estimate the death rate due to COVID-19 in China? That’s the population that was exposed at that point in time.
Death Rate = 3248/58.5 Million X 10 Million = 555 Deaths/10 Million. I often see death rates as per 100,000 so that would give us 5.55 per 100,000.
US deaths at 555 Deaths/10 Million X 327.2 Million = 18,160 deaths.
Don’t forget that the Hubei Province outbreak was slowed down by Draconian means. What would have happen the outbreak would be left to its demise? Who knows…
Best Wishes,
Chuck
I have seen a lot of what I think of as amateur statistics by people without any training in epidemiology. For example, social isolating is going to drastically drop that R0 (number of people that one person passes the virus on to.) There is a one-two week lag after adding a factor like social isolation affecting the R0 no one seems to be considering with. Some of the newer data on treatments indicated both the mortality rate and the length of time to recovery can be dramatically reduced which would then reuse the impact on our health care system. Comparing data across populations is confounding because of different standards of testing and definition of the disease. I have seen everything from projections of half the world population dying to this is nothing, a huge conspiracy of globalists to bankrupt the western world and there isn’t even a real virus.
The main thing to keep in mind is modelling and extrapolating is generally a really stupid thing to do because factors going into the modelling change so rapidly. Smart people just don’t do extrapolations and ignore the nonsense that others out out there. The only exception to that rule is modelling to make sure we have enough of things like masks and ventilators and ICU beds, just in case.
Computer models backed by a political agenda are the real plague facing our country and the world. Governor Gavin Newsom claims 56% of Californians will become infected and closes the state. The New York Times splashes scary graphics on its front page showing what happens when 75% of Americans become infected with scary numbers of deaths.
Sharyl Attkisson writes an article “Death Rate Drops: Better Math, Treatment or More Testing?” and is attacked in the main stream media. Trump is attacked first for cancelling flights from China and later for not closing everything.
This site especially this one by Willis is an attempt at rational analysis. An excellent article in Medium also sticks with the data. (https://medium.com/six-four-six-nine/evidence-over-hysteria-covid-19-1b767def5894)
There is some hope Governor Cuomo is praising Trump’s efforts. Michael Shellenberger also believes Trump is following the guidance of experts.(https://quillette.com/2020/03/19/winning-the-war-on-coronavirus/)
Someone needs to stop this insanity of fake panics driven by so called “computer models”!
Forget the computer models work it out for yourself based on real data.
The worst case scenario is currently Italy, look at their case & death rate which is doubling every couple of days. With Spain, France & the UK a few days to a week behind the curve.
The whole world statistic will never show just how bad it can be, because other countries have acted very quickly to contain the outbreaks.
Unfortunately many countries haven’t, China let them out and we foolishly let them in.
The medium.com article is great. Opening the schools will lower the infection rates of kids based on actual evidence. The real group at risk is the over 60 with serious medical conditions. The VAST majority of people out of this group will just have anywhere from no real symptoms to a bad case of the flu.
At this time here in North Carolina, a state with 10M people, we have 4 people hospitalized. That’s 4/10000000. And the number of deaths is 0/10000000. We need to get a grip.
As mentioned in the medium.com article, the biggest fear the population has is what will the government do next, not what will happen if I get COVID-19.
I think opening schools and quarantining anyone over 60 or that has underlying health issues would cut death rate and provide herd immunity in not much time. Plus the economy would not be destroyed.
It makes some sense, perhaps open school for at least the younger grades and the older grades can do their coursework online. It would be a problem to overcome this “out of an abundance of caution” mentality.
I know a number of households containing one or more people who are at high risk of serious complications because of medical conditions. Most can present as completely “normal” to the world at large. I know a larger number of households with people who are at high risk of serious complications due to age related reduced functioning that doesn’t really qualify them as being “sick”.
It isn’t practical, and most certainly not possible, to test everyone. In a world of normal activity, anyone who tested non-positive today might contact the virus tomorrow. The child I currently know best brings home some kind of infection from school, primarily minor colds, at least half a dozen times each school year. It is absolutely not possible to test everyone every day.
So how does the suggestion to get the economy functioning normally again, actually work?
Speaking of data.
How many of the sick and dead passed on the annual flu shot?
Every year it covers different strains, and, no it didn’t include this particular “novel” (nonsense) Coronavirus variation.
But my seven decades of getting through a dozen flu bouts, annual vaccinations, excellent health might have built enough general immunity to defeat COVID-19.
Now I don’t know a lot about medicine or viruses or pandemics, but I know a lot about lying weasels when I see and hear them.
Coronavirus is not the same as the flu virus. Totally different bug.
Per US DOD study, the flu shot may increase risk of coronavirus infection.
https://www.sciencedirect.com/science/article/pii/S0264410X19313647?via%3Dihub
A comment in the link below says the actual risk increase is 7%, not 36%
Flu Vaccine Increases Coronavirus Risk 36% Says Military Study
https://www.disabledveterans.org/2020/03/11/flu-vaccine-increases-coronavirus-risk/
I don’t think I would have found this anywhere else. Thank you.
icisil
March 21, 2020 at 8:42 am
————–
And the places more likely you get one these days…. hospitals.
Kinda of hospitals and doctors factoring in the equation.
With all their good, vaccines do force the immune system response to rely on the vaccine
parameters, at least for a while… something that may degrade the immune response to another
viral infection due to mismatching with it and also due to mismatching with default response parameters.
Making things worse in certain given circumstances.
cheers
Graphing deaths is not very useful.
1. There are two, maybe three, or even four fatality rates involved. As I see it, there is: fatality rate below ICU capacity, below hospital capacity, above hospital capacity, and after supplies (and staff) run out.
2. Deaths, by their very nature, are a lagging indicator, by about ten days, give or take. This is particularly problematic when the doubling rate is estimated at 6 days.
3. A far better, but much more difficult graph would be available hospital beds per thousand people. I’m sure that epidemiologists will be using such a graph by 2030.
Yeah, and some countries report death by Corona when the patient had the virus, regardless if he died of that, and others don’t even bother to test the deceased.
Willis’ plots and his analysis of the Diamond Princess gave me another angle on the likely endgame case fatality rate (CFR), using ‘personal’ information from a doctor in Wuhan.
The ultimate tested Diamond Princess result was 705 infected out of a starting total of 3711 passengers and crew. 19%. That is likely a bit skewed high by the ‘experimental’ circumstances— more elderly passengers, higher viral titer in the confined conditions.
Of the 705, 392 had symptoms defined as fever >100.4F. 10.6%.
The Wuhan doctor said 81% of his patients recovered after about 10 days, and 19% worsened. Of the 19%, 14% became serious (needing supplemental oxygen. 5% became critical, needing a ventilator. (These facts are the apparent source of Cuomo’s NY ventilator requirement estimate of ~27000 when the state only has ~3000–hence the need to ‘bend the curve’.)
The Wuhan doctor said that in his hospital’s experience, about 20% of serious and 80% of critical die, so about 6.8% of those admitted.
Now a 0.19 infection rate*0.106 symptoms*0.19 not recovering naturally*0.068 fatalities among those is (worst case) in the end 2 fatalities per 10000 people. UNLESS the curve is bent by social distancing, frequent hand washing, and not touching mouth, nose, eyes.
I think your math is messed up. Your are applying the 10.6 symptom rate of the total population to the infected population. The symptom rate of the infected population on DP was 392/705 or 55%. What am I missing here?
Is the “critical” percentage 5% of the “serious”, or 5% of who “worsened”?
I’ve written that question three different ways, and I’m still not happy with it, but it’ll have to do.
Using those numbers in various ways, if the ventilator requirement estimate is 0.19 x 0.14 x 0.05 = 0.00133, then 27,000 ventilators means 20,300,000 “worsening” cases. If it’s 0.019 x 0.05, then the number of “worsening” cases becomes 2,800,000.
Since ~ 19% of all cases “worsen”, then 20,300,000 of them means a total infected population of 20,300,000/0.019 = 107,000,000 total. If the number is 2,800,000 “critical” cases, then the total infected population wold be 2,800,000/0.019 = 14,700,000 total cases.
If this bug truly has an R0 of 2, those thresholds would have long been passed, wouldn’t they?
I’m over 60 with no underlying conditions. I’m happy to self-quarantine for as long as the government wants, along with all others of any age advised by their personal doctors to do so because they have underlying conditions. But, given the numbers that are coming out as we get more data, for goodness sakes, the rest of the population needs to get out there and work and have some fun. This is getting ridiculous.
It seems that some of the increase in mortality is associated with increased testing. This is counter-intuitive unless clearing the backlog of samples is being used post-mortem to re-classify deaths as Covid19. If that is the case, the numbers should be adjusted for actual date and not just included in “new” deaths. This may reshape the curve.
An absolutely sensational graph. Great work, Willis!
I’d love to see Germany added to this graph. They’re a large country, comparable to the U.S. in technology, and close to Italy and Spain, which are already on the graph.
I know the graph starts to get busy when adding another country, but if so, my suggestion would be to add Germany, and drop Iran. The U.S. and Australia, U.K., Canada, etc. are so different from Iran, that I think the situation in Iran provides no useful information as to where we (in the U.S. and the other countries I mentioned) are possibly headed.
In light of the recent WUWT story about the inverse correlation between coronavirus and malaria, I noticed another correlation, IQ.
Coronavirus struck first in countries with high IQ. So, what’s the experience been like in countries with low IQ? If we look at countries with an average IQ of 67 or lower, there are only 33 confirmed cases and 20 of those are in Cameroon. IQ by country Half of those countries had zero confirmed cases.
You could object that Equatorial Guinea has a tiny population but Iceland, with a quarter of that population, has 473 confirmed cases. Cameroon, with a population of 24 million is doing much better than Canada with a somewhat larger population.
So, is low IQ protective against coronavirus? LOL Maybe there’s a lurking variable.
I personally think it has to do with how tall you are.
Yes taller you are the higher mortality rate. This due to vast majority of children recovering, and children tend to be shorter than adults.
I’ve read that there’s a correlation between IQ and wealth. More wealthy, more tests, maybe?
As your IQ increases, more lucrative careers are available. link The graphs are at the very end of the paper.
On average, your MD is probably smarter than you. Having said that, I’m guessing that there are a few WUWT denizens who are smarter than the average MD, averages and distributions being what they are.
Most informative, Willis. The rise on the curve for the U.S. is quite variable. I would love to take the graph apart and compare it to factors, such as the weather in the places of highest death rate growth, some four to seven days prior to those wiggles that flatten out.
It also suggests that another 10 days of isolation will indicate pretty clearly whether the present strategy is succeeding, and hopefully the ultimate rate would be about 2 per million.
I also wondered about the strange shape of the US curve. Is it a matter of low initial testing and recent increase reducing the number of previously undetected cases? Or possibly a blending of multiple epidemics with different start dates?
I live in Canada and I follow WUWT daily. Would it be possible to provide a way for other countries to see the deaths versus days graphic? When this is all over, I think that these curves will be a key measure of how well each country reacted to the situation.
Steve Rowland
Willis … Please do a breakout on your new page separating out Hot spots like NY WA from the rest of US. WA state and NY are driving the curve for US. Would be comforting to the rest of the US showing how well we are actually doing.
Completely agree that breaking out the hotspot states would be very helpful. I’ve played around with this a bit and it looks like Washington has started to plateau whereas other states have not yet. The outbreaks are clearly regional and using stats from the entire US muddles the picture a bit.
That being said this looks like the best format I’ve seen by far. Deaths is the only meaningful statistic as number of cases is hopelessly confounded by testing disparities. Per capita deaths is also much more meaningful the absolute deaths.
One other note is that the increased slope of deaths in the last few days is also likely due to increased testing availability rather than being real. Almost certainly some deaths we being misclassified. Not to downplay the personal costs for those who lost loved ones but 250 deaths in a country of 330 million is a microscopic fraction. A dozen misclassified deaths could significantly change the apparent trend.C
Doc, the problem is the lack of data. The Worldometer has current data for the number of deaths by state here, but no historical data.
You are right about the skew, however. Of the current 281 US deaths, 163 (585) are in New York/Washington/California, which have 20% of the US population.
If you have historical data by state I’d take a look.
w.
Now 791 total, 271 NY, 44 NJ, 55 CA, 123 WA.
Diamond Princess is probably one useful source and should be very encouraging. 100% of people on that ship had to have had constant, close, extensive contact with the virus, yet less than 10% actually developed a symptomatic infection. That is basically the same as the estimate of flu cases in an average year in the US and lower than the swine flu rate. If you adjust the population characteristics of the ship for the population characteristics of the US, you get a mortality rate of .5% or less, and again that would assume that 100% of the population had the same close, extensive and constant exposure to the virus, which is obviously not the case. At the end of the day, when we have more actual data, there is absolutely no reason to think that this virus will have a fatality rate substantially higher than influenza viruses. That is the typical course of fatality estimates. Meanwhile we are destroying our economy, which in itself will cause in worse health harms, among other things. #thecureisworsethanthedisease
You think?
As soon as it became apparent that COVID19 was on the ship all of the passengers were put in to Isolation in their cabins ie quarantined.
Since when has that ever been done to the general public for the Flu?
Then they had air piped in to their rooms from other parts of the ship, and ate meal cooked and delivered by the likely infected crew …
Steven Mosher tweeted a link to a good study of the Princess, I reposted it on that thread … hang on … OK, it’s here.
w.
That is a very nice study.
However the serious patients were removed to Japanese hospitals that were not in a state of being overwhelmed like Italy.
The ship patients received the very best of care, those in Italy are IN ICU, open wards, on trolleys and on the floor. With life & death decisions being made on who they save.
The medics are now patients and dying, this was 2 days ago and it is much worse there now than then.
https://www.dailymail.co.uk/news/article-8129499/More-2-600-medical-workers-infected-coronavirus-Italy.html
Were you aware of how bad it actually is in Italy?
ps the Italian daily mortality rate has increased again today and now stands at 793.
They are desparate for the lockdown to start working, but they still have so many in the system from before the lockdown.
Other small towns are in a much better situation.
Anyone attempting to parse the disease or the epidemiology by using available data is bound to be wrong by the time anyone else can even read what they wrote, both because of incomplete or outdated info, or because of the rapidly changing situation.
No one can use math to prove anything when the numbers are bad and rapidly changing.
JMO.
This situation is too fluid to stand up to conventional analytical techniques, or so it seems to me.
Read what we were saying two weeks ago, one week ago.
People were talking about how except for one nursing home, there was not much of a problem.
Bill DeBlasio refused to close NYC schools until last week, even though schools are where diseases go to spread.
Public health authorities were still opining until recently that asymptomatic transmission was unlikely to be occurring.
Hardly anyone, possibly exactly no one, has a clear picture of the current real time situation, regarding any number of parameters.
We still have people right here who might have been considered fine logical thinkers, making statements that are in direct opposition to reality.
Public health officials are in many cases people who are vastly under qualified who are in positions due to political sinecure…or whatever the proper terminology is for people who only have a job due to supporting the right person in an election, or knowing someone who is in the position to make public job appointments.
One take away, for me, or this whole unfinished episode is…this was the time that our progression towards living in an Idiocracy really bit us in the @$$ hard for the first time.
For Brits
Daily Telegraph published (behind paywall) longish article
Coronavirus: The unintended consequences of the UK lockdown and why millions of people could already be infected
Article is discussing what various models say, they are presented to the UK government to consider when policy is formulated. I put it on my webpage strictly for my own use. OK!. Anyone who intends to read please obtain proper authorisation from the publisher. OK!
The international numbers, not all of which qualify as data, aren’t fit for comparative purposes. Even in countries with honest reporting of deaths, procedures vary. For instance, Germany doesn’t test the dead, while France, Italy and Spain do. There are no doubt other reasons as well for Germany’s lower death figures, but testing is a big part of it. Some people who died of pneumonia there, or other apparent causes, had the Wuhan virus.
Good summary.
Glad you liked it. Could have said even more about testing of the living as well, of course.
I’m not sure that procedures even within countries are sufficiently consistent for valid comparisons. But what are we to do, except make do.
Influenza Like Illness data probably has captured many of the early COVID-19 cases before specific testing started and indicates that the virus has been wide spread in the US since February and the peak has passed. https://www.amgreatness.com/2020/03/19/dangerous-curves/
That’s a very interesting article (and some good comments). One sentence especially caught my eye:
“But since the disease originated in China in December at the latest,
it’s highly unlikely the number of reported cases in the
United Statesall countriesbetween January 1 and late February is accurate.”
This is exactly what my bullsh!t-sensor has been telling me since the media hype started.
Willis/Anthony
Thank you for the continuing presentation of data and information.
Couple comments/questions:
Active cases appears to be highly variable data with lots of variables as to testing penetration. Lots of questions as to what the actual infection rate is at any given time.
Death Rates are all over the place. Extreme variability depending upon age/underlying condition, care provided etc. Regardless of specific treatments, as case management gets more informed, I would expect to see better outcomes (assuming there is any real chance of recovering from pneumonia). Couple this with more draconian protective measure for the most vulnerable, and I would expect the death rate to further decouple from the actual infection rate.
I am having a hard time connecting the concerns with hospital bed space, and specifically the most serious cases meriting ventilator use and actual case numbers. I see lots of comments, both “official” and MSM rumors that bed space and ventilator usage is under pressure. What I can’t find so far is actual numbers/data/statistics for actual ventilator usage for CV-19. I surmise that if we had good data for this metric, then we would have a better handle on the actual impact of CV-19. Pragmatically I understand that from a macro point of view it is somewhat of a binary concern: either you have enough ventilators or you don’t (presuming that lack of a ventilator significantly leads to worse outcome…ie death). At any rate, as I try to get some kind of coherent handle on how CV-19 is actually progressing, I’d really like to see solid data on ventilator usage….specifically how it relates to published infection rates, death rates and test results rates. I assume this data is out there…it really is the center of the most significant health impact of CV-19. Using the worldometer data (seems a decent data source), and assuming the “serious cases” include ventilator usage, I really can’t see any meaningful information. The values are all over the place.
I have been searching, reading and researching for this ventilator usage data, and I am coming up dry (expect for the pervasive…”not enough”).
At any rate I will continue to search high and low, but ask the incredibly talented wuwt community for assistance.
Specifically: What is the actual data for ventilator usage for CV-19 patients. Time and region. Duration. Demographics. Outcome.
Thanks for any help, I will keep looking.
Ethan Brand
Ethan, that is a problem, there does not seem to be any central repository for data on ICU COVID19 usage.
However one clue is to look at how many people have been infected and how many still are infected (active cases).
There is a lot of individual country’s data on ICU use including China, the Diamond Princess, plus quite a bit of anecdotal info from Medics.
Hi A C Osborn
Thank you. I can see the source of the “anecdotal” data (ie China, Diamond Princess, etc), but that is not dynamic data.
“However one clue is to look at how many people have been infected and how many still are infected (active cases).”
Same problem overall….the “have been infected” number has huge uncertainty.
I am betting the data I seek is out there…just a matter of finding it and assembling it.
Again thank you,
Ethan Brand
Followup, I found this link: “Penn Medicine – COVID-19 Hospital Impact Model for Epidemics”, https://penn-chime.phl.io/
Model (groan…:)).
It has some references, but I have not followed them yet to see what data is being used to support the default values used. I will email someone on their contact list and provide an update if I get something useful back.
Ethan Brand
I have been looking at the mortality rate since this epidemic started. What do you make of these facts. Italy: 4,032 deaths/47,021 cases= 8.6% mortality China: 3,253 deaths/81,304 cases = 4% mortality US: 260 deaths/19,624 cases = 1.3% Germany: 73 deaths/21,652 cases = 0.34% The US is late getting the infection wave but China was earliest, having the most cases. Germany and Italy were both infected at relatively the same time. There are many variables that affect susceptibility of populations to infection and death but something else is going on here. The virus should not be an order of magnitude more lethal in Italy as compared to it’s geographically close neighbor Germany. Your thoughts??
A small town in Italy (Prata) has the second largest Chinese population in Europe (Paris is first). There were regularly scheduled flights between Wuhan and Italy. Here’s an article that describes why so many Chinese are in Northern Italy https://www.newyorker.com/magazine/2018/04/16/the-chinese-workers-who-assemble-designer-bags-in-tuscany
People don’t understand graphs. Read this for more insight. Data is data.
I would like to see more comparisons to H1N1. Why is the daily data for H1N1 so hard to find. All I can find is a few months from 2009 with daily data. The final numbers are staggering for H1N1, but the daily data from mid 2009 through Obama’s emergency declaration in 2010 are missing. Anybody have the daily data for all of 2009 and 2010 for H1N1?
I became very ill with what I believe was H1N1 towards the end of 2009. The hospital had so many cases that they stopped testing people. As a result, a lot of very relevant data for epidemiological purposes is missing. Don’t trust data collection.
They may start to do the same with the WuFlu:
In hard-hit areas, testing restricted to health care workers, hospital patients
https://www.msn.com/en-us/news/us/a-new-message-on-coronavirus-in-hard-hit-areas-dont-get-tested/ar-BB11vpAa?ocid=spartandhp
As of July 2019, there were 74 countries having populations each less than 1 million people. Therefore, just a single COVID-19 death in any one of these would put that country at the 10 deaths in 10 million population mark, or at the midway point along the logarithmic ordinate axis of the graph in the above article.
It is a mathematical calculation, but not too meaningful due the error bars associated with a calculation based on a single occurrence.
Caveat emptor.
I’m trying to repost my comment.
For the latest report on italian deaths (2020 03 20), please go to this link of the italian Istituto Superiore di Sanità
https://www.epicentro.iss.it/coronavirus/bollettino/Report-COVID-2019_20_marzo_eng.pdf
This is a very bad news.
“The death toll from the coronavirus outbreak in Italy rose by 793 to 4,825 on Saturday, officials said.”
This is 1,500 more than the China’s total with 20 times more numerous population.
Only if you actually believe China’s data, which based on anectdotal data in February it is not very likely.
Things like photos of dead people in the street, people self isolating dead in their apartments, COVID19 deaths recorded as Pnuemonia, the dead being cremated 24/7 for weeks without autopsy etc.
@Derg
https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/
Willis, I have shared your chart and the link to this article and to your chart page on a couple of blogs. One commenter asked how you can be sure of your data, especially the data for China. What are you doing to ensure the accuracy and integrity of your data sources?
Today’s UK numbers are bad, update here:
http://www.vukcevic.co.uk/UK-COVID-19.htm
More pain ahead, but the UK will turn the corner.
Log scale death comparison
I’m wondering what is going to happen with the various states here in the US.
Since they can’t print money, they have to run a balanced budget.
With the economy slowing dramatically, tax revenues have to be falling. At the same time expenses are going up.
What happens with state and local governments when the rainy day funds run dry?
Hand outs from above.
If that happens, total systemic collapse of government won’t be far off.
The current round of handouts is already dangerously close to unaffordable.
The bailouts are looking to be on par with the 2008 banking crisis, maybe worse. We’ll have to see what is passed before we know what’s in store.
Unaffordable is putting it mildly. It’s especially concerning that there’s little challenge against these executive orders by the President, governors and mayors. A bad precedent is being set.
Remember what “retirement planning” meant something other than binge watching the show “Doomsday Preppers”, or “Life After People”?
Let me say that again without the typo:
Remember when “retirement planning” meant something other than binge watching the shows “Doomsday Preppers”, or “Life After People”?
I wrote this on another blog about 8 hours ago:
“But let’s not be blasé about the scale of the problem. I was idly playing around with the virus figures yesterday (as former mathematicians tend to) and started doing some “what ifs” with the figures in one of the places (outside China and South Korea) which seems closest to over the outbreak. That’s the Faeroe Islands. They have had 92 confirmed cases so far, with no deaths. That represents about 1.9 per thousand of their population. Their new cases per day had been going down until today, when there were 12 new cases, but they have been ramping up the testing hugely in recent days, so that’s not unexpected. The data comes from here – https://www.worldometers.info/coronavirus/ – a useful source if you’re into this kind of stuff.
Eyeballing their “Gompertz curve” of cumulative confirmed cases at https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_the_Faroe_Islands, I guess they’re probably around half way to their final count. Last Tuesday their chief medical officer said he thought that most of the people in the islands had by then been exposed to the infection, but I think he was probably over-optimistic. The reason the Faeroes are “ahead of the game” is that the virus seems to spread quicker among small, isolated populations. I discovered this when I idly sorted the figures by cases per population, and found that San Marino (the worst of all), Faeroes, Iceland, Andorra and Liechtenstein all came out in the top 10.
So my best guess right now at how many confirmed cases they’ll finish with is 4 per thousand population. The second part of the equation is how many of those confirmed cases die. This is a function of the quality of health care in the country more than anything else. The UK is currently running at about 4.5% of confirmed cases leading to death. That’s way below Italy, which has its own set of problems; and also below Spain, but above other European countries like France and the Netherlands. (Above China, too! And almost four times the rate in the USA.) That may be due to a low testing rate so far, or may eventually have something to say about the merits or otherwise of socialized health care.
Anyway, if I take both those numbers at face value, I guess we’re looking at 66.44M * (4/1000) * 4.5% = about 12,000 deaths when all is said and done. To put it in perspective, world-wide deaths from ordinary flu per year are between 300,000 and 600,000, and if 0.9% of those are in the UK (roughly pro-rata to world population) we’re looking at 2,700 to 5,400 flu deaths in an average year. So the COVID virus looks to be worse than normal flu by a factor of 2.2 to 4.4. Bad – which means Boris and co are right to take some action – but not the end of the world (alarmists have been bandying around figures like a quarter of a million).”
Willis, what do you think?
Willis,
Your data and curves are very useful. If all trends continue as shown, it is clear that except for some special cases, that the global death rate will roll over and drop dramatically over the next 1-2 months, and the rest is just extended treatment and cleanup for several more months. This assumes effort is maintained for a while to clean hands, cover coughs and sneezes, minimize contact. US deaths should not far exceed 1,000 by end of year! The country with greatest deaths likely will be Spain (5,000-7,000). If the world does not return to normal activity within 2 to 3 months, it will be a costly problem. If it does return to normal activity in less than 2 months, the economy will bounce back strongly, with little danger of more major issues.
Thanks Willis. You are quite a gift for us.
Willis: I’m not sure that the worldometers site is getting good data for some countries on severe COVID-19 cases. In Canada, the government web site says that ICU stats are unavailable but that the estimated number of severe COVID-19 cases is 3%. The CDC site says that as of March 16, the US had 4226 reported cases, 508 hospitalizations (~12%) and 121 in ICU (~3%). These numbers seem more plausible than those on worldometers.
In one of Willis’s graphs he asks , What does Germany know that the rest of the world doesn’t know? Well the answer could be NO 5G YET.
Is 2020 finally the year for German 5G?
https://www.dw.com/en/is-2020-finally-the-year-for-german-5g/a-51839533
re: “Well the answer could be NO 5G YET.”
Not more of this again?
THIS is how mankind will end – more and more ‘jmorpuss’ types running over and through the ‘system’ spreading stupidity (AND disinformation) since they KNOW NO BETTER! It’s the literal ‘Tower of Babel’ all over again, but this time the tower comes to you, inhabits your forum, posts idiocy, etc.
jmorpuss, you never have answered the question – what do you do for a living?
.
Apparently there is an army or troll bots and spam monsters roaming the interwebs…
Spreading rumors will get you on the organ donor short list in China…
It’s all part of the Corona Belt and Corona Road.
China figures are misleading. Deaths are compared with the total population whereas the outbreak in reality was ‘limited’ to the Hubei province with a population of 60 mio. That puts the curve way higher. More or less similar reasoning for Korea. Outbreak in other countries shown is nationwide and thus chart is correct (don’t know about Iran). Need another 5-10 days to accurately predict which curve US is following. If by then it would appear that it is way up it will be to late. Better prepare for the tornado…
Totally agree. Its an interesting chart, but its against per million of entire population, where it needs to be per million of the population of the effected geographical areas. Also , its against the day of first death, which is hugely sensitive, as the first death could easily be +/-15 days depending on the course if the illness in that particular person.
I am still just following deaths world wide and not trying to decipher infection rates. The daily increase is still more than 10% and trending up today. You can all work out what this would mean if the increase continues at more than 10% a day even for weeks. Eventually 10’s of thousands a day then 100’s. This is why extreme measures are being taken. The survivors can debate the final result eventually.
Per my comments on hospitalization for CV-19 (see Ethan Brand March 21, 2020 at 8:56 am above), I found a report that has the type of data I am looking for (this is for flu for 2006-2016). (“Specifically: What is the actual data for ventilator usage for CV-19 patients. Time and region. Duration. Demographics. Outcome.”).
I hope that some of this type of data is being collected now in real time…..I have sent one inquiry to the Penn Medicine folks, and now will try to track down how the data for the below report is garnered.
https://www.hcup-us.ahrq.gov/reports/statbriefs/sb253-Influenza-Hospitalizations-ED-Visits-2006-2016.jsp
Interesting take on why it is so bad in Italy..
https://uncoverdc.com/2020/03/20/why-italy/
See my earlier comment about close talkers, chronic huggers, and the touchy-feely types.
Twelve steppers are gonna be hit hard, now that I think about it…
They always hug each other, every night, everyone hugs everyone else.
They also ran out of protective equipment, which is especially bad for medical workers who came out of retirement to help (and several died for it).
Apparently, corruption is still rampant in Italy but the new Corona belt and Corona road initiative brings in a new kind of corruption.
Nice, unbiased reportage.
Willis,
Great work. Two suggestions: first, on your first chart where you show the actual cases at the end of the lines, maybe add the population in millions. Second a version of the worldometers table that showed all the totals scaled by population would be great
All this graph really measures is population. Smaller populations have corona throughout, while big populations have corona in only geographical parts. This is why, (with the exception of USA), the curves are stacked in descending order of population, with the smallest populations appearing worst hit. Taking this into consideration, it’s America that really has a problem much bigger than any other country.
Willis –
I suggest that you put an image of a grain of salt against the Chinese data
M
All this forecasting pretty much assumes ceteris paribus when it comes to treatment. In fact the discovery/invention of new medicines could make big differences. Anti virals to treat COVID-19 and vaccines to prevent are being worked on now but will take time. Faster more widespread testing for real time presence is possible and was started by UK govt who then backed off. Reasons unclear.(+Private self funded testing not available in UK). The current most promising drug option must be testing for antibodies and immunity. British govt has been saying this is coming down track fast and would be game changer.
One to watch is Switzerland
Total cases: 6863
New cases within last 24 hrs: 1248
Total deaths: 80
New deaths: 24
It has one of the highest rates of infection/ head population. It also has possibly the best health system in the world based around very expensive compulsory private insurance. They also tell the truth. Their rate of mortality is as accurate as we are going to get. Their testing and tracing will be state of the art.
I suggest that you add them to your graph Willis as a kind of control.
Cheers
M
M
Yesterday (or it might have been two days ago, with the time zone differences) Germany reported only two patients in critical or serious condition. The next day they reported 10 new deaths, and 23 in serious or critical condition.
I was just noting a report from Rome, Italy of a 34 year old man with no health problems at all who got sick four days ago, and then died without ever being in an ICU or in serious condition.
He got a fever after returning from Barcelona.
Re a separate issue: I am not noting any dramatically large or obvious diminution in the number of deaths in the countries in Europe that have for at least 5 days been treating everyone with one of the experimental medications, either chloroquine or remdesivir.
If we keep seeing daily deaths in the tens and hundreds, I am going to become increasingly worried.
Time to re-assess damage done by infinite human stupidity https://www.dailywire.com/news/stanford-professor-data-indicates-were-overreacting-to-coronavirus reference to Einsteins comments re human intelligence and the Universe LOL
There are a lot of factors why there are more serious / critical cases in some regions, such as progression of the illness, demographics, underlying health, available of required treatment, etc.
Italy has a high percentage of elderly people (many of whom have underlying issues), a lot of smokers and there is poor air quality in the north, where the outbreak occurred. Also, for the past couple of weeks, many hospitals have been far over capacity, resulting triage. Simply, there are not enough resources to treat all of the patients. Many who don’t get the treatment they need will die. This inflates the number of serious / critical cases and increased the mortality rate.
It’s very likely that the lack of resources will have the same effect elsewhere. I have close family in healthcare and our hospitals are already struggling to prepare for the expected case load. When the beds are full, there will be people who will not get treated, and some of them will die as a result, so you can expect that the percentage of serious / critical patients will increase.
Tracking the official numbers in the UK. This is what is actually happening.
https://www.bbc.co.uk/news/uk-51768274
Willis’ previous piece, extrapolating from the Diamond Princess, was absurd. To extrapolate more reasonably from the above numbers, do something like this. Though the parameters are subject to great uncertainty.
How to think about the numbers. You cannot rely on the confirmed cases since so far there has been very little testing of suspected cases, and no way to know whether how many mild cases followed by recoveries there have been.
To arrive at the likely numbers of cumulative infections in the population on a given day, multiply the cumulative number of deaths reported for that day by 750. That number may be wrong, and has large uncertainty. Propose a different one if you disagree.
The UK reported 233 deaths yesterday, so the cumulative number of cases in the population (if the 750 number is right) will be 175,000.
Now take the average time to death. Assume 17 days. And take the mortality rate. Assume 2%. It could be higher or lower, so you have to figure out what you think is reasonable given the international statistics.
Assuming the above numbers the forecast would be that by about April 12 there would be around 3,500 cumulative deaths in the UK.
No matter what the government has just done. That will affect the spread, and that in turn, assuming their latest measures slow or stop the spread, will have an effect on death rates after mid-April.
The measures should have an effect. On Friday the Prime Minister basically put the country into total lockdown. Probably in the nick of time.
The measures should have an effect. On Friday the Prime Minister basically put the country into total lockdown. Probably in the nick of time.
We won’t know for sure for a couple of weeks. The new cases & deaths are already in the pipeline. There will be at least 1500 deaths even if further infections stopped on Friday.
I would love to see graphs of past pandemics placed over this one. Something tells me this isn’t as unusual or as unprecedented as it is being made out to be.
Current total numbers are not reason to panic, what the most of people are concerned about it speed of propagation trough population and most of all the rapid exponential rise in number of casualties. When projected forward, the fact there is no effective treatment or vaccine, with impact of economy of the major industrial countries, there is a very good and valid reason to be very concerned indeed. I hope I am wrong, and that in six months or a year all this will be well over, but for the moment
we are now living in the post-normal democracy.
Now I’m hearing people claim that the current pandemic is not caused by a flu. They claim it isn’t a flu because the incidence and mortality is too high. I retained my hard copies of both Taber’s and Steadman’s cyclopedic medical dictionaries from when I was an SF medic and instructing in the course. This is influenza by any definition of the word. The mortality rate has absolutely nothing to do with determining if a viral infection is influenza or not. Causative agent, transmission mode(s) and signs and symptoms/pathology are what determine the definition.
“This is influenza by any definition of the word.”
Coronavirus:
Virus classification
(unranked): Virus
Realm: Riboviria
Phylum: incertae sedis
Order: Nidovirales
Family: Coronaviridae
Subfamily: Orthocoronavirinae
Influenza:
Virus classification
(unranked): Virus
Realm: Riboviria
Phylum: Negarnaviricota
Class: Insthoviricetes
Order: Articulavirales
Family: Orthomyxoviridae
They are both viruses.
Different phylum.
The second broadest grouping in viral taxonomy is the phylum, so these two are almost as far apart as two viruses can get.
Not quite, but almost.
Both viruses, both riboviria.
Beyond that…different.
If taxonomic classification is among “any definitions of the word”, this is not influenza.
It would be more true to say it is a bad cold, but it is not that either.
It is a novel corona virus.
Not the flu, and not influenza.
I have no idea what you are trying to say here.
Rewrite virology?
What I am saying is that according to the common cyclopedic medical dictionary references of Taber’s and Steadman’s, this would be an influenza even if the etiology is not an influenza virus. Transmission, signs & symptoms, and pathology, supportive care, are virtually identical even if the microbiological classifications are different. In those important aspects the microbiology is a distinction without a practical difference. That said, when it comes to developing or discovering a treatment the microbiology is where that distinction becomes practical in it’s application.
It may well be the case that this virus is spread in an identical manner as the flu.
But I have noticed that front line medical doctors and others working closely in the care of COVID patients are becoming ill and in some cases dying, in numbers I have never been aware of occurring with any other illness in recent times, and certainly not in cases of pneumonia or garden variety flu.
So a route of transmission may exist that is not known or not properly taken account of.
One possibility is the oral fecal route, one manifestation of which could be aerosol particles from toilet flushing.
In particular, I have wondered, could it be the high pressure toilets used in commercial and institutional settings are infecting people after someone who is carrying the virus uses the bathroom?
This is a speculation, but there is strong evidence to support the presence of virus in the gut and hence bowel movements of COVID carriers, and very possibly asymptomatic ones.
There is also a wealth of evidence that aerosol plumes are generated whenever a toilet is flushed, and that these aerosols can spread many meters and persist for at least several hours, as well as the virus being present in the bowl for several hours and be aerosolized by subsequent flushing.
This may be completely false, but some other method for transmission equally unappreciated or considered my be true.
Something is causing ti to spread so quickly, and to infect people who are taking precautions.
I believe SARS is strongly suspected to have been spread this way in at least one apartment building in Asia during that outbreak.
And it is reported that a large percentage of COVID patients have gastrointestinal symptoms, in particular diarrhea. The people that do have these symptoms are said to have a higher incidence of severe disease and a higher incidence of mortality. And unconsolidated fecal matter is known to produce a far more concentrated viral plume when a toilet is flushed.
The GI aspect alone may differentiate this virus from flu in at least this one important way.
Maybe.
Very likely, but that is only my opinion.
At the risk of causing people not to read my comment due to it being too darn long, i am going to raise another point here that touches on this: Small differences in viral genome…occasionally tiny differences, can have a huge effect on the virulence of a pathogen.
Similarly, a single tiny difference in the genome of a patient, in some cases that are well know it can be one single base pair substitution out of the the full 6.6 billion base pairs in our diploid set of genetic information, is sufficient for one person to not respond to a viral cure, when people with an alternate base pair are almost always cured.
Specifically, it was discovered years ago that if someone has a cytosine base at position rs12979860 on the IL28B gene in their DNA, they have a far better chance of having interferon and ribavirin cure them of hepatitis C.
If both of your #19 chromosome have a C at this position, that person was shown to be twice as likely to be cured of the virus my interferon combination therapy.
Having just one C conferred some advantage, with people having both be Thymine faring the worst of all.
( I should note that since since was first discovered, there have been rapidly increasing understandings of exactly what is going on with this SNP, and in fact the gene in question shown to be a completely separate gene, now called IFNL3, for interferon lambda. At the time however the closest known gene was that of Interleukin 28. IFNL is one of the most recently discovered genes in the human genome.)
So a difference of as little as one base pair substitution in a persons entire genome can have a drastic effect on how one is able to fight off a virus.
Similarly, tiny variations in the base pairs encoding a viral RNA genome can have a drastic effect on whether a virus is able to be quickly shrugged of by a person’s immune system, or if they develop a lifelong viremia…known as being chronically infected, and have their liver gradually destroyed day by day over many decades, eventually resulting in fibrosis, cirrhosis, and/or hepatocellular carcinoma…liver cancer.
There are 6 major and dozens more minor subgroups of the hepatitis C virus (HCV), called clades or genotypes of the virus.
Some are easily cured, genotype 3 for example, while some are very resistant, such as genotype 4.
(Amazingly some people who have been chronically infected for decades, have cleared the virus while taking a placebo during clinical trials for one of the powerful antivirals. This can greatly complicate the clinical trial and approval processes. It is rare though.)
Many, perhaps most, people who have hep C are completely unaware of it.)
Small pox can be prevented in close to 100% of people by being inoculated with vaccinia virus, a closely related but distinct virus which is harmless to people. Even after 100 years of viral mutation, this was true and eventually the world was rid of the virus by vaccination campaigns.
And yet even smaller variations in the outer proteins of the influenza virus cause vaccine against one strain to be useless against other strains, as probably almost everyone here knows.
The study of the subjects of virology, immunology, and epidemiology are among the most interesting and yet devilishly complex topics in all of science, IMO.
There is so much we have learned that so many are not aware of, even people like myself who might have been considered well informed ten years ago.
And there is so much more to learn, as we are all finding out right now, eh?
I can give references for any assertions made here if anyone would like to verify or read more.
Any search for any of these words or phrases will turn up an immense body of information.
The SARS outbreak suspected of being caused by dry floor drains allowing sewage gases to back-draft from the sewer vent stacks was in Hong Kong Amoy Gardens complex. Read that right after the first patient in Washington State was found to have the virus in his feces.
Made a vow to avoid public restrooms at that point and haven’t broken it yet.
Right there with yah!
It was easy for me to make up my mind to stay the hell out of them places.
Not to be morbid about it. But since Coronavirus kills those with existing medical problems and the elderly, a percentage of those people would die with or without the virus.
So if Coronavirus kills 86,000 Brits, a tragedy, It is not a increase of 86,000 deaths to the normal yearly fatality rate. It is hard to know how to quantify this number. But some of those who contract the virus would have passed in any case.
Willis,
I read your commentary on the perma-post nCOV stats page. Thanks for the work keeping that up!
However, I would note that the lockdowns aren’t being ordered by the US federal government – it is being ordered by the various state governments.
I fully agree that the US federal response isn’t great at all, either, but it isn’t clear to me that the federal government can even prevent the state governments from locking down – or if they had the authority, that the largely blue states that are locking down would let a Trump-led federal government in.
Nobody at any level of government seems to even be considering a South Korea style mobilization: tens of thousands, probably more, of people needed to ubiquitously track and check.
And then there’s the US health care system. Do the private owners and reapers of profit of the US health care system – from insurance companies to pharma to hospitals etc want the heavy hand of the US federal government laid upon them?
Just pointing out that there are a lot of structural issues – not just failure to do more.
Thank you Willis,
This is excellent!
Looking at the Chinese data for deaths per 10 million people, versus the data from other countries, I struck by how smooth the Chinese curve is. These is one slight inflection point, but other wise the deaths reported from China look more like the plot of a model than the plot of raw data.
I have wondered about the accuracy of the infections and deaths reported by China based on videos from Wuhan that I have seen. A recent one showed 30+ people queued outside a Wuhan hospital last week as China was reporting no new cases of infection. Now, looking at your graphs I have even greater concerns about what China is reporting.
China implemented lockdowns in stages. First Wuhan was in lockdown and later other cities were locked down. Wuhan built several new hospitals in record time. If these efforts were effective at slowing the spread of infection, and treating those who were infected, then their data should have some bumps as the impacts of these efforts became evident. Their smooth data does not show this. In my opinion, this indicates that China is releasing data that shows the result which they want to achieve.
“…The US government is about to spend a trillion dollars of your and my tax money to prop up the economy whose wheels have just been taken off by the insane shelter-in-place orders of the US government…”
The US gov’t didn’t implement any “shelter-in-place orders.” Some states basically have. Other states have instituted policies that aren’t to the degree of “shelter-in-place.”
More followup on my quest for real time/dynamic data for ICU/Ventilator CV-19 demand.
See previous “Ethan Brand March 21, 2020 at 3:35 pm”
Some progress in my quest for data:
See:
https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm?s_cid=mm6912e2_w
Title of the report:
“Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12–March 16, 2020”
One key paragraph:
“This report describes the current epidemiology of COVID-19 in the United States, using preliminary data. The findings in this report are subject to at least five limitations. First, data were missing for key variables of interest. Data on age and outcomes, including hospitalization, ICU admission, and death, were missing for 9%–53% of cases, which likely resulted in an underestimation of these outcomes. Second, further time for follow-up is needed to ascertain outcomes among active cases. Third, the initial approach to testing was to identify patients among those with travel histories or persons with more severe disease, and these data might overestimate the prevalence of severe disease. Fourth, data on other risk factors, including serious underlying health conditions that could increase risk for complications and severe illness, were unavailable at the time of this analysis. Finally, limited testing to date underscores the importance of ongoing surveillance of COVID-19 cases. Additional investigation will increase the understanding about persons who are at risk for severe illness and death from COVID-19 and inform clinical guidance and community-based mitigation measures.*”
Please note the very important statement above “data is missing….9%–53% of cases”. Please carefully read the report before making any tentative analysis. For example:
“Data on these cases are preliminary and are missing for some key characteristics of interest, including hospitalization status (1,514), ICU admission (2,253), death (2,001), and age (386).
Based on the incomplete, but perhaps well distributed data (?), we can derive one of the real time (up to a week ago) ICU utilization:
As of March 16, 2019 the report includes 4226 reported cases of Covid-19. Out of the 2253, “121 patients known to have been admitted to an ICU”.
For the reported ICU cases, we have 121/2253 = .054, or 5.4%. I will strongly speculate that any patient requiring a ventilator will be in ICU, so we can perhaps bound the ventilator usage at 5.4% for reported cases.
Now for some reality checks:
The current reported cases in the USA is 38,167 (worldometer 1428 EST 3.22.2020). A grossly conservative estimate of current ICU cases would be .052 x 38167 = 2052. Note that this is likely grossly conservative (off by a factor or 2 or more) as the 38167 includes new daily cases…and we have increased testing over the past several days. From what I understand, it takes on the order of 5-10 days from testing positive to going into ICU…IF you are that sick. Worldometer reports 708 serious cases (as of 3/21 as far as I can tell). The number of reported cases 5 days ago was 9259 (on 3/18). 9259 x .052 = 482…hmm this approximately “smells” plausible.
Important observation: The 5.2% ICU rate is derived from data before March 16. Due to testing bottlenecks, it may be reasonable to conclude that the reported cases were a smaller subset of all actual infections than today or tomorrow…due to more readily available testing.
More speculation: (AGW adherents please pay attention :)). I am going to further build on this very tentative foundation to speculate for future numbers. Going from maybe decent informed guesstimate to speculative guesstimate. Each step away from any good data gets more crappy really fast.
I have seen values (ala Diamond Princess) that perhaps 50% or so of actual infections show no symptoms. This number appears to be reasonable on my reading of data the past month or so. No symptoms (<<>>), no test (usable approximation…conservative at any rate).
IF we surmise that ALL CV-19 infections with symptoms are tested (likely grossly conservative), we could cut the ICU per infection to 2.5%.
I previously noted “Penn Medicine – COVID-19 Hospital Impact Model for Epidemics”, https://penn-chime.phl.io/“. This model defaults to 2% ICU, 1% Ventilator of total infections.
Ok, I like this. When you can independently derive a target value and get reasonably close to another independently derived value my confidence goes up.
Working conclusion:
Approximately 1% of total Covid-19 infections may require use of a ventilator.
Note that this has a very important implication for overall death rate. Out of 2001 cases with outcome data, 44 died, a 2.2% rate, again divide by 2, and you get a 1.1% death rate. Note that in reality you are probably put on ventilator before progressing to death…so I would speculate that the death rate is actually well below 1%…which seems to be well supported by data coming in around the world. Note that this is using speculative TOTAL infections (a guessed value at this time).
At any rate, I conclude that using a rate of approximately 1% require ventilator of total infections (NOT reported infections) is reasonably supportable.
This analysis may provide a reality check on ICU/Ventilator demand as the virus infections progress.
For example, if we were to speculate that in 20 days we have a 20% daily rate, we would 36 x the current number of infections, ie about 1, 368,000 reported cases…x 2 for actual cases = 2.7 million infections (20 raised to 1.2 then times 38,167). This might require 27000 ventilators. Given that the numbers being tossed around is to order and have on hand 10’s of thousands of ventilators, we can see why those numbers may be viable.
I vote for:
Warm weather peak (ie virus because much less viable as temps go up)
Anti Malaria drug efficacy (and any thing else that we can dream up)
Social distancing (or draconian South Korea case followup)
Virus mutation (toward a weaker virus).
Being wrong (ie my approximation is 5-10 times too high).
The next few weeks are really critical. I hope the heck the curves start to go down. Next week would be really nice…..
Ethan Brand
We can vote on those things?
Can we protest the elections if the vote does not go the way we want?
Correlation vs. causation. I assume the COVID19 deaths refer to people who have died who tested positively for COVID19 either while alive or post-mortem. So there is a correlation. To what extent does that correlation reflect causation? Suppose there is a person so critically ill that they are under hospice care, and their care worker unintentionally infects them with COVID19, and they die. Does that prove that COVID19 was the principle cause of death? To what extent are doctors citing COVID19 as cause of death when there are other comorbidities involved? If someone with advanced heart disease contracts COVID19 and then dies of a heart attack, is the cause of death COVID19 or heart disease? Such a person would appear in the graphs, would they not? I would say something to check is whether the overall death rate of a population has increased. In the USA the number of COVID19 deaths is so small as to be no more than statistical noise, unless one focuses on a single municipality. Northern Italy might be a good example.
we are seeing the same flawed statistics of the Global Warming crowd played out in real time … some journalist takes 3 days of data and a ruler and forecasts that 112% of the population will get corona and 57% will die … in 2 years …
Thanks for adding Hubei and CA, not that Chinese “data” are to be trusted.
It looks as if US and RoK curves just might be on incipient stability track, but need at least a week without accelerating losses to know. Italy also appears to be stabilizing, but more than two days required.
Willis: Thank you for updating the graphs so we can see the relative changes as this progresses. With the US naturally lagged ramping of our testing / counting, the measurement of the bending of the curve will be pushed out.
The link you posted here was helpful:
See the full page of graphs here: https://wattsupwiththat.com/daily-coronavirus-covid-19-data-graph-page/
The latest bar graph that I just looked at has Iceland at the top, above one other country with low counts. It’s in the top position of most cases with a long scarlet bar. This is an error in graphing, right?
Oh, okay, I see now — it’s a percentage of the population, but, visually, this is sort of confusing.
Willis, as I watch the global economic collapse expand into North America, I’m coming to the viewpoint that you are probably correct that the current measures to contain covid are likely to be more destructive than covid itself. There already has been a staggering amount of economic destruction and more carnage is yet to come in the weeks and months ahead. The economy will continue to bleed for as long as the lock-down is kept in place. If people can’t work, they won’t get paid. If they aren’t getting paid, how will they pay for food and shelter? If people and industry are bankrupt, there will not be sufficient liquidity for the economy to restart. This situation has the potential to the worst economic calamity since the depression, if not even worse than the depression.
As of right now, here are the numbers:
Coronavirus Cases: 378,842
Deaths: 16,510
Recovered: 102,064
In other words, the only beneficial outcome from the attempt to contain the virus is ~102k of herd immunity – world wide. Compared to the global population of ~7.8 billion people, 379k people is not even a rounding error. If the world remains locked down for as long as it takes for the pandemic to burn out, we could be waiting a long time.
Only time will tell if the pandemic burns out or if it will continue to flare up until there is sufficient herd immunity to block its spread. Unless we see evidence that it will burn out, the only firewall that won’t inhibit the economy is a vaccine. Of course, the virus is mutating, so no one knows how long herd immunity will last or if a vaccine will provide lasting immunity.
New York state is in 7th place in the list of countries and it will be in 6th place by tomorrow. You should include it in your graph.
New cases way down today in the US, from about 10,100 to 2400, with vast majority in NY.
If you’re basing that on http://www.worldometers.info/coronavirus/, as of right now, there have 7248 new cases and there are almost 6 hours left in the day. In the list of countries, New York State is #6.
Just to show how difficult it is to get a handle on this any analysis of the Diamond Princess must be redone. Now not 7 deaths but 10 and could be more. Worldwide deaths still increasing more than 10% a day and now 2000 plus today. Unless curbed will be 4000 in a few days and then 8000 a day etc.. This is why extreme measures applied.
Just for comparison, what would the graph look like for a regular seasonal flu?