Guest Post by Willis Eschenbach [Note updates at the end]
Since the earliest days of the current pandemic, Italy has been the scary member of the family that you absolutely don’t want to emulate, the one cousin that gets into really bad trouble. The Italians have the highest rate of deaths from the COVID-19 coronavirus, and their numbers continue to climb. Here’s the situation today.
Figure 1. Deaths from the COVID-19 coronavirus expressed as deaths per ten million of the country population. Percentages of the total population are shown at the right in blue. All countries are aligned at the date of their first reported death. Most recent daily chart and charts of previous days are available by going here and scrolling down.
Italy, with over six thousand dead, is up well into the blue range. This is the range of annual deaths from the flu in the US. If the US coronavirus patients were dying at the same rate as in Italy, we’d have 38,000 coronavirus deaths by now in addition to the same number of flu deaths …
As a result, there has been much debate about why the Italian death rate is so high. People have suggested that it’s because they have one of the older populations in Europe. Others have noted that they often live in extended families. Some say it’s high numbers of smokers and polluted air. And some have pointed to their social habits that involve touching, kissing cheeks, personal contact during church rituals, and the like.
But we haven’t had good data to take a hard look at the question, or at least I hadn’t seen any.
In the comments to my post entitled END THE AMERICAN LOCKDOWN, wherein I passionately advocate just exactly that, I was given a link by a web friend, Mary Ballon, hat tip to her. It’s a report by a Swiss medical doctor about the COVID-19 deaths in Italy, well worth reading.
And in that document, there’s a further link to an Italian Government report. It’s in Italian of course, I have it on good authority that’s what they actually speak over there, who knew? They reported on the statistics of a large sample of the Italian deaths (355 out of 2003 total deaths at the time of the report). I got it, and the numbers are very revealing.
Let me start with the age distribution of the 2,003 Italians who had died at the time of the report. Figure 2 shows that it’s almost entirely old people.
Figure 2. Age of 2,003 Italians who had COVID-19 at the time of death.
Out of the 2,003 deaths, seventeen were people under fifty, and only 5 people under thirty died, while almost two hundred deaths were of people over 90. I’d read that the people dying in Italy were old, but I didn’t realize quite how old they actually are …
One thing I learned on this voyage was that the Italians distinguished between dying FROM the virus on the one hand, and dying WITH the virus on the other. Once I looked at the state of health of the Italian victims, however, I could see why they had to do that. Figure 3 shows the generous apportionment of serious diseases and conditions among the unfortunates.
Figure 3. Numbers of diseases in the sample of 355 Italians who had COVID-19 at the time of their death.
WOW! Yeah, they all had COVID-19. But three-quarters of them also had hypertension, a third had diabetes, a third had ischemic heart disease, a quarter of them had atrial fibrillation tossing clots into the bloodstream, and so on down the list.
As you can see from Figure 3, some people must have had more than one other disease besides COVID-19. Figure 4 shows the breakdown of the number of other diseases per patient.
Figure 4. Other diseases (comorbidities) of a sample of 355 of the 2,003 Italians who had COVID-19 at the time of their death.
For me, this was the most surprising finding of the entire study. Of all 355 people who died, only three did not have any of the diseases listed above. Three!
Looking at all of this as a whole picture, I had a curious thought about who they were representing. I thought … consider the characteristics of the people who died:
- More of the patients were over 90 than were under 60.
- The average age was 79 years.
- All but three of them had at least one other disease, so basically all of them were already sick.
- Three-quarters of them had two other diseases, and half of them had three or more other diseases. Half!
My thought was … that’s not a sample of the people in the street. That’s not a sample of an Italian family.
That’s a sample of a totally different population.
I was forced to a curious conclusion, both discouraging and encouraging. It is that most of these diseases were probably not community-acquired. Instead, I would hazard a guess that most of them go by the curious name of “nosocomial” infections, viz:
nos·o·co·mi·al
/ˌnōzōˈkōmēəl/
adjective MEDICINE
(of a disease) originating in a hospital.
Here’s what I suspect. I think that the COVID-19 disease got established in a couple of areas in Italy well before anyone even knew the disease was there, perhaps even before the Chinese recognized it as a novel disease.
And in some fashion, it got into the medical system. Doesn’t matter how. But once there, it was spread invisibly to other patients, in particular the oldest and weakest of the patients. It went from patient to patient, from patient to visitor and back again, and it was also spread by everyone in the hospital from administrators to doctors and nurses to janitors. In many, perhaps most cases, they didn’t even know they were sick, but they were indeed infectious.
And that’s why the pattern of the Italian deaths is so curious, and their number is so much larger than the rest of the world. It’s not a cross-section of the general population. It’s a cross-section of people who were already quite sick, sick enough that they were already visiting doctors and having procedures or being bedridden in hospitals. It was 85-year-olds with three diseases.
And it’s also why the death rate in Italy is so high—these people were already very ill. I can see why the Italians are distinguishing between dying FROM the virus and dying WITH the virus.
DISCUSSION AND CONCLUSIONS
As I said, this is both discouraging and encouraging. It’s discouraging because getting the virus out of a modern medical facility and a dispersed medical system isn’t easy. Italy has a big job ahead. And it’s discouraging because it means that the medical personnel who are so needed for the fight are getting the disease as well. Very likely they won’t die from it, but they will be hors de combat for three weeks or so. No bueno.
On the other hand, it is encouraging in a couple of aspects.
First, it lets us know what we need to do to prevent the Italian outcome. We have to, must, keep the virus out the medical system.
- We need to seriously quarantine the sufferers away from other sick people.
- We need to set up testing facilities at all medical centers and test the medical personnel daily.
- In areas with a number of COVID-19 infections, we need to set up separate field hospitals. There are a number of commercial versions of these that are expandable by adding modules, and are pathogen-tight, with airlocks at the doors, HEPA exhaust filters and negative air pressure maintained throughout. We know how to do this stuff, we’ve just got to do it.
- We need to test in-hospital patients at the time of their arrival and continue to test them at intervals during their stay.
- We’ll have to be very careful with visitors to patients in the hospitals
It’s a big job, and we absolutely have to do it.
Second, it cautions us to not claim that everyone who tests positively for COVID-19 after death actually died FROM the disease. They may very well have died WITH the disease.
Finally, the other reason it’s encouraging that Italy’s infection is likely nosocomial is that it removes Italy as the mysterious bogeyman of the COVID-19 pandemic. In addition, it points to just what we have to do.
IF (and it’s a big if) we take the proper precautions to protect our vulnerable medical system and personnel, I don’t think that the US will get as high a death rate as Italy has today.
Note that this makes me seriously question the idea of “flattening the curve” … if you let the virus into your hospitals and medical system you’re toast, no matter how flat the curve is.
So let’s end this crazy American lockdown, there’s a whole raft of work to be done shoring up our medical sector to withstand the coming wave, and it can’t be done at home with our heads in the sand, hundreds of thousands of people not working, jobs disappearing daily, and our economy in a shambles …
My very best regards to all, stay well in these parlous times,
w.
As Usual: I ask that when you comment, QUOTE THE EXACT WORDS YOU’RE DISCUSSING. Knowing who and what you’re referring to avoids endless misunderstandings and arguments.
[UPDATE]: Just after publishing this, I was reading about loss of the senses of smell and taste being symptoms of coronavirus infection. In the article, I found this:
Hopkins says an Italian doctor shared that “he and many of his colleagues had lost their sense of smell while working in northern Italy dealing with COVID-19 patients.”
… “many of his colleagues”. Kinda support my theory of nosocomial infection in Italy.
[UPDATE 2]: In the news today, the headline Coronavirus: 4,824 Italian Health Workers Are Infected … one in ten of their coronavirus cases are health workers …
[UPDATE 3]: Here’s a graph showing just how different Italy is from the other countries with numbers of cases …
PS—Let me take this opportunity to provide a wider readership to a comment that my obstropulous (yes, it’s a real word) good friend Steve Mosher posted on my blog yesterday. He’s living in Korea and has been a close observer of just how they are succeeding in controlling the virus. He spells out the level and the details of what we have to do. His comment is below, my thanks to him.The key is changing the criteria for testing. Here [in Korea] we test and track.
An employee of a call center in Seoul, was infected.
Office had 207 people.
March 8th. he tested positive.
EVERY person in that office was tested. today 152 have tested positive, they tested floors above and below his floor. Today 3 more from the 11th floor were found and 1 contact.
They are now tracing the contact, and the contact’s contacts. All will be tested. The business was in a residential building. 553 of the people in that building were tested. floors 13-18
This little beastie lives on surfaces for up to 3 days. See that elevator button? the hand rail on the stairs? the bathroom door handle? the coffee cup that pretty girl behind the counter handed you? it’s there. Now in my building we have hand sanitizer by the elevator buttons. you get in the habit of not touching public pretty quickly. Trust me I am not a germ phobe, but the changes have been simple when they are reinforced.
Let me give you a little taste of the highly detailed info we get.
Info that is shared daily in one spot, I will include some of the earlier call center case snippits
“In Daegu, every person at high-risk facilities is being tested. 87 percent completed testing and 192 (0.8 percent) out of 25,493 were confirmed positive. From Daesil Covalescent Hospital in Dalseong-gun, 54 additional cases were confirmed, which brings the current total to 64. In-patients on 6th and 7th floors are under cohort-quarantine.”
“From Guro-gu call center in Seoul, 7 additional cases (11th floor = 2; contacts = 5) were confirmed. The current total is 146 confirmed cases since 8 March. (11th floor = 89; 10th floor = 1; 9th floor = 1; contacts = 54)”
“From Bundang Jesaeng Hospital in Gyeonggi Province, 4 additional cases were confirmed. The current total of 35 confirmed cases since 5 March (20 staff, 5 patients in inpatient care, 2 discharged patients, 4 guardians of patients, 4 contacts outside the hospital). The 144 staff members who were found to have visited the hospital’s Wing no. 81 (where many confirmed cases emerged) were tested, 3 of whom tested positive.”
“Five additional confirmed cases have been reported from the call center located in Guro-gu, Seoul, amounting to a current total of 129 confirmed cases from the call center since 8 March. As of now, 14 confirmed cases in Gyeonggi Province has been traced to have come in contact with a confirmed patient who is a worker at the 11th floor call center at a religious gathering. Further investigation and tracing are underway.”
Test, Trace, Test more.
A random test in Iceland found 1% infected. 50% asymptomatic.
If the US persists in only testing the symptomatic you won’t squash this bug.
Our cases are going up in Seoul. So we will have 15 days of voluntary social distancing.
go to work
stay away from crowds
wash your hands
wear a mask
don’t touch your face
This entire episode looks like the “climate crisis” in full blown BS mode…Deaths per 10 million? Really?
Not sure what your objection to “deaths per 10 million” is, Ron. It’s common to measure a variety of things as occurrences per some unit of populations.
Regards,
w.
Willis,
I’m well aware of that.
Thanks,
If the data is to be believed, then 66% of americans with hypertension and one or two other conditions are likely VERY susceptible to death by coronavirus?
Deaths are calculated on a per 100,000 basis in most statistics. Putting numbers to a per 10,000,000 makes your typical low information person, the vast majority, think the death rates are extremely high by multiplying the number by 100 over what it would be based on typical per 100,000 basis.
Willis, while it’s common in epidemiology to report incidences per 100,000 of the population of interest, which would divide each of the vertical scale numbers by 100 on your graph and this would place Italian coronavirus deaths to date at 10 per 100,000 population (which by the way just happens to approximate the best case maternal mortality among 100,000 obstetric deliveries), the 10,000,000 denominator you’ve chosen instead places most of those graphed ordinate numbers above unity where they are easier to relate to than the decimal fractions that would result from a denominator of 100,000 and thus recommends your usage here.
Doc,
Note that the numbers about a month ago was rows of goose eggs.
Good job Willis – thank you for all your hard work.
Best, Allan
Willis! Thanks for your excellent work, as always…..much appreciated.
However, the following statement may be a little misleading.
“If the US coronavirus patients were dying at the same rate as in Italy, we’d have 38,000 coronavirus deaths by now in addition to the same number of flu deaths …“
Isn’t it likely that some of the “annual flu death” victims (with their various co-existing medical conditions) would have already been felled by the rather more challenging Corona virus? If so, we would be very unlikely to have 38000 corona virus deaths ON TOP OF 38000 flu deaths. Rather, we’d have many of the annual flu death toll already counted in the corona virus casualties. Just thinking out loud……thanks!
The flu would already have taken out most of the weak. Maybe they had less normal flu deaths in Italy this year so more weak people available to die from corona. In 1900 less people would have died from corona because only few got old enough?
Deaths pr million is the only sensible number. It combines risk of being contaminated withthe risk of dying from Corona when you are from a certain country. You could also search for death pr million for the age group within the country or diagnosis group death or million e.g. ACE inhibitor users e.g. in the US
Somebody shoud do a fingerprick antibody test of at lest 100 random persons to check how many are already immune e.g. from a very mild infection.
we are weeks away from this
https://www.postbulletin.com/life/health/mayo-clinic-working-on-antibody-test/article_31df2fb8-68ad-11ea-b5cd-e305c4d9bd7e.html
SO, you have to decide.
do you feel lucky?
Dirty harry wants to knows
Willis, you are a competent mathematician. Right now the Italian deaths skew heavily old, because it kills the old and weak first, but the Wuhan data suggests a roughly 6 day incubation period, sigma a little less than 2 days, and a mean time from symptoms to death of over 2 weeks. So you must compare the deaths to infections 3+ weeks earlier to get meaningful results. And the death rate for the old climbs when the medical system collapses, because the old get triaged and don’t receive care, so not surprisingly they die. I read that nobody over 65 was getting a respirator, hard stop, and that was a week or two ago.
My bet is your pie chart will look a lot different a month from now. If New York ends its lockdown, the results will not be pretty, and I’m a little too close to NYC to be happy with that.
Also
If your random test shows 1% infected that really doesn’t help you
UNLESS the R0 is 1.
tough decisions, uncertain data
The best available data (global) about testing Covid 19 IMO: https://ourworldindata.org/covid-testing
We could do 100 random swans every day to get a snapshot of percentage infected in the population. When we do swabs on selected individuals, the result has no statistical value.
If the people who have it are highly clustered, as they surely are, how can anyone tell what it means to test a small number of people at random?
I would not be surprised if the testing is actually infecting some people, in at least some of the places it is being done.
“We could do 100 random swans every day to get a snapshot of percentage infected in the population. When we do swabs on selected individuals, the result has no statistical value.”
It helps to set an upper limit
Where containment cannot be judged to have abjectly failed, testing has value is does not have in the places that have abjectly failed at containment.
None of the steps taken will have much effect if they are haphazard and not part of a lucid and logical plan.
Testing, but no masks?
Here in teh US, even someone like me who has a full face respirator, and numerous masks from various projects (painting, insulation, mixing peat moss-based potting soil, etc), are being told specifically NOT to wear one.
It is insane.
There is no big picture plan.
Thx for the good reporting/analysis Willis.
Worldometer uses per 1MM.
On that basis Canada at time of writing, with 26 dead has a death rate/1MM of 0.7
Going to /10MM merely changes the decimal.
RE: the Seoul call center outbreak- the International Federation of Red Cross Red Crescent, on COVID-19 handout, state in addition to coughing/sneezing, speaking can transmit it. Also, Dr Peter Plot(Co-discoverer of Ebola) on CNN, states,” this virus concentrates in upper respiratory tract, so the simple act of breathing transmits it ” Too obvious a reason for transmission in close proximity to others like elevators or President Trump’s press briefings.
Interesting analysis Willis and I totally agree that we need to stop the spread in the hospital system. My wife is a GP in the UK running a community practice with 5 doctors. 3 of them have the disease, as has their senior nurse and two of the office staff. Once it is in the hospital system it is devastating. However, I think you are complacent in thinking that a lockdown will kill more than the disease. Yes, it will be highly stressful and businesses will go under. However, I have always admired the American capacity for bouncing back from bankruptcy and hardship. Yes, current businesses may go under, but new ones will spring up in their place once the danger has passed.
If you don’t lock down the US, you need to start digging the mass graves you will need for the many millions of your older citizens who will die in the next six months.
I also take issue with the point you make about people dying WiTH rather than OF the disease. There is a brilliant BBC podcast here called “More or Less” about statistics, presented by Tim Harford, a statistical commentator from the Financial Times. He had a statistician on their Covid-19 special, David Spiegelhalter, who said that the curve of the graph of Covid-19 death rates by age was an amazing match to the actual annual death rate graph.
In summary he said that what Covid-19 does is bring forward a death that would have happened in the next year anyway. In other words you are compressing a whole year of deaths into about 3-4 months. About 2.8 million people die in the USA each year. Un-checked Covid-19 will probably affect 60-70% of the population. Therefore you can expect in the region of 1.8 million people to die of Covid-19 in the USA, probably spread over the next 3-6 months.
Even though most of the people who would have died in the next year will die in the pandemic, it does not mean that all the rest will survive a further 12 months! How many extra deaths you can expect is something for further research. Podcast is here
https://www.bbc.co.uk/programmes/p087n42r
re: “If you don’t lock down the US”
Makes no sense; you cannot “lock down” a modern society.
“Lock down” is just the generally used shorthand for the restrictions on movement undertaken in China and Europe.
We in the UK are currently asked to stay at home if we possibly can. Practically all office based workers are on laptops at home. Shops, bars, restaurants, cinemas, clubs, gyms and other places where people gather have all closed to avoid rapid transmission. Factories and warehouses are practising strict hygiene and social distancing policies. This is, of course, totally unenforceable without the agreement and cooperation of the population. In the UK, Italy, France, Spain, Germany and most other European states this policy has strong support from the people. The Governments of those countries have rewarded and enabled that by providing massive financial support for employers and incomes. This will only work if the disease can be effectively halted in the next 3 months – allowing a gradual lifting of the restrictions alongside massive testing and information systems using the Korean model. Any longer than 6 months and the economy is bust. This is a 3 month war that we have to win!
We all envy what the Koreans have done – and it should have been the case everywhere. Too late for us now, and too late for the US. You can only do what the Koreans have done if you knock the infection rate down to a very low level. You can then track every single affected person and all their contacts. Once new cases are back to a few tens or hundreds a day we could introduce that. But it is impossible while infection rates are thousands every day.
re: ““Lock down” is just the generally used shorthand for …”
WORDS have MEANINGS. Please LEARN to USE them PROPERLY.
I’m presently living in an area with ‘travel and association limitations’ – and it’s NOT a “Lock down” that we are under – the term the authorities use is “social distancing”. We can still shop for groceries and walk the streets, buy gasoline etc. I don’t need a 301 lecture to get the point driven home! This was in an area that had an Ebola patient attempt to check into a hospital, was told to go home, subsequently he worsened, returned to the same hospital and several staff members (nurses) ultimately became infected. We are NOT unaware of the consequences of highly-impacting contagion in this area.
NEWSFLASH (b/c I don’t think you go the memo): The ‘curve’ is going to be flattened (best guess estimate based on successful use of) through use of (most likely) Hydroxychloroquine (and perhaps an associated drug or two.)
Caveat: Callous, willful disregard and negligent use of the language will likely result in ‘flagging’ in the future.
Ummmm… AIUI, none of these drugs are a cure, they’re a treatment. The difference? A treatment merely addresses the symptoms, the patient still has the disease. So if one still has the disease but is feeling better, are they more tempted to get up and go to the grocery store for that one last item on their prepper checklist even though they have never used that product before and aren’t sure how to use it even if they have it? In other words, increasing their mobility, that then could increase R0? (Unless I’m completely misunderstanding how to use R0, but it doesn’t change my point even if I used the wrong terminology.)
re: ” AIUI, none of these drugs are a cure, they’re a treatment.”
Look, dude, you’re stupid! NOWHERE did I call it a cure! Get outa here!
Red94ViperRT10: I would like to chime in regarding: “A treatment merely addresses the symptoms,”
First, I largely agree with your posts. Do you agree that though Hydroxychloroquine may indirectly address symptoms, that is not what it is purported to do. It’s mechanism is that as an ionophore it helps Zn enter into the cells, which allegedly harms the virus’ ability to multiply. An aspirin treats symptoms as a fever reducers and pain reliever, whereas this treatment helps kill the virus’ ability to spread, so that hopefully your immune system has a much easier time getting rid of it.
So I would not put it in the category that it treats symptoms per se.
Most respectfully,
Mario
Ummmm… AIUI, none of these drugs are a cure, they’re a treatment. The difference? A treatment merely addresses the symptoms, the patient still has the disease. So if one still has the disease but is feeling better, are they more tempted to get up and go to the grocery store for that one last item on their prepper checklist even though they have never used that product before and aren’t sure how to use it even if they have? In other words, increasing their mobility, that then could increase R0? (Unless I’m completely misunderstanding how to use R0
No – this episode looks like an extremely serious pandemic.
I have a great deal of respect for Willis’s expertise in analyzing climate data, a subject in which he is obviously learned more than most.
However, accepting Willis’s expertise in epidemiology is like accepting on the basis of having stayed at a Holiday Inn Express last night. Sorry, Willis, you are no expert on epidemiology or public health.
Sorry not only to Willis but to the extremist right wing Fox News crowd – but you are all hopelessly wrong and mired in wishful yet destructive magical thinking for purely political and ideological reasons. The experts are in fact right and you are all wrong.
As to why Italy has had a more serious result than many nations is likely something that the experts will be analyzing for years and likely decades to come. What we don’t know now would fill all the world’s electronic memory banks.
As for ending the so-called “national lockdown”, there isn’t one in the US. The President has no power to order one, and the Congress has not enacted any laws to order one. What there are are fifty states and three territories all making their own individual calls, depending upon the known severity of the outbreak in their respective jurisdictions, and according to the ideology and the sane, intelligent responsibility and competence of the respective political leaders which varies all over the map.
Governor Cuomo is doing a great job. Governor DeSantis is doing a terrible job, emulating his terrible mentor, the lying destructive self-dealing Trumpster.
Since Trump never ordered a lockdown, and does not have the Constitutional power to order one, he cannot order a non-lockdown either, for the same reason – he does not have the Constitutional power.
What all the experts are saying is, given that we have rotten data (no testing to speak of) the only sane and practical method of preventing a complete meltdown of our health care system and the deaths of millions of Americans is to social distance for at least the next several more weeks, then continually reassess as we gain more knowledge, and more supplies, and better data.
Only a destructive idiot driven by stupid ideology – like Trumpism – would dare demand an unlockdown.
Duane March 24, 2020 at 1:38 pm
We’re wrong about WHAT, you most unpleasant jerkwagon? This kind of meaningless but ugly handwaving BS is why I say QUOTE THE EXACT WORDS THAT YOU ARE DISCUSSING!
But noooo, Duane the expert can’t be bothered to follow simple instructions. He can’t be bothered to tell us what we’re wrong about. He just gives us vicious spittle-flecked rant.
He goes on:
No, Duane, that’s what SOME of the epidemiologists are saying. Other experts who actually look at the larger picture are saying that the damage from the lockdown is going to be much larger than the damage from the virus. And to date, there is no sign at all that the “shelter-in-place” regulations are having any effect. Deaths in both New York and California are going at an unaltered exponential pace. And meanwhile, the human cost is so high that the Government is proposing a trillion dollar stimulus to pay for the costs of the ONE WEEK of shutdowns to date. People are out of jobs, businesses are closing, and you want to listen to some “virus expert” in an ivory tower with no idea of the economic costs? Headline in the WSJ, from economic experts, says:
and from the Telegraph:
Is it dangerous? Absolutely. I’ve never denied that. I’m simply trying to understand how to best fight it. And with time as short as it is, trying to do it with our economy collapsing and hundreds of thousands of people not going to work is madness …
Gosh … dueling experts. Dial it back, Duane, unbridled arrogance is not a good look on you.
w.
Willis, thank you for representing my thoughts which I could not post in response nearly as eloquently as you just did. Also, I have less faith that Duane will learn anything based on his ‘telling’ diatribe. Social distancing from Duane is highly recommended. But I just mentioned his name and failed. I hope now that I am infected with his poison… my immunity will save me!
Don’t sell yourself short Mario.
When you said, “No” to Robert, that was as perfectly eloquent as it gets.
Well, thank you again. However, after the wack a mole “No”, Willis gave him a lecture full of reason that was satisfying indeed!
I would like to endorse what mario lento said – “Willis, thank you for representing my thoughts which I could not post in response nearly as eloquently as you just did.“.
Duane – Please note that (1) experts get things wrong sometimes, that’s why Argument from Authority doesn’t work and why we keep an open mind about all information, and (2) Willis is an expert in data analysis and statistics, which is what he is writing about in this article. He has provided some very interesting food for thought, and some of what he has covered (from other sources as well as his own analysis) may be very useful to those responsible for solving this major problem. That doesn’t mean we all must just blindly accept what Willis says – on the contrary we and others would be well advised to check it carefully to make sure that it makes sense, and to work out where it could be most (and least) helpful. I do regard this article by Willis as being a valuable addition to the mix.
I like the addition of “typical US flu deaths” region on you chart.
Please, if possible, add a typical fly deaths curve (by day like the others) to your chart.
Thanks
JK
“No, Duane, that’s what SOME of the epidemiologists are saying. Other experts who actually look at the larger picture are saying that the damage from the lockdown is going to be much larger than the damage from the virus. And to date, there is no sign at all that the “shelter-in-place” regulations are having any effect. Deaths in both New York and California are going at an unaltered exponential pace. ”
have not seen any of these experts you cite.
Also As any expert will tell you There is NO expectation that the death rate will drop
1 week after the lockdown. Quite the opposite
Death rate LAGS from the imposition of a “lock down”
it’s not a quick death.
it is a death that takes a couple of weeks.
In a month you will be able to see if the lockdown had an impact
AND
you will never know what the case would have been Absent a lockdown.
So you wont really know ( without modelling) how effective the lock down
was as there is no simple control case
We have a fairly large flu surveillance system. If the actions undertaken are worthy would the flu incidence rate be a reasonable proxy?
I don’t know, just asking.
It would if the flu were not naturally declining.
BTW if you look at flu cases you can see an UPTICK
misdiagnosed covid 19
Indeed, a few links:
https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/?fbclid=IwAR2ZVEsUT7vBgzJ6xRdQKH0XM6gftGDtik-VWZH7OWkBznHhzRb6WTvikoc REF
https://dnyuz.com/2020/03/24/coronavirus-turning-point-in-us-will-be-earlier-than-predicted-nobel-laureate-says/?fbclid=IwAR3KdwGqe0qKYqMo9YGLdWni-p6N4M7_mqV6bQJMSY82l1VBa4-zd3Pcyn4 REF
https://news.yahoo.com/why-nobel-laureate-predicts-quicker-210318391.html REF
https://nationalpost.com/opinion/why-draconian-measures-may-not-work-two-experts-say-we-should-prioritize-those-at-risk-from-covid-19-than-to-try-to-contain-the-uncontainable
I’m dealing with the Corona Virus Panic (more panic than pandemic) in Australia. We are progressively being locked down, crippling the livelihoods of millions of people. I’m lucky (or maybe I prepared for such eventualities) in that my work is largely unaffected and I also live outside of a major city and grow a substantial amount of my own food, others are not so lucky.
I would hazard a guess that by the end of all of this, the death toll as a result of suicide by the owners and staff of formerly productive small businesses who have had their lifes’ work tossed into a skip by government edict will dwarf the number of deaths attributable to the virus itself.
This is something that seems fairly obvious to me, but I haven’t heard it being discussed by anyone in government or the MSM.
death by suicide is a national pastime in Korea.
Not seeing any surges here.
Suicide is of course a choice.
viral transmission, not so much a choice.
“viral transmission, not so much a choice.”
Wouldn’t you think if you wore an N95 respirator, safety glasses, and cloth gloves, you’d have a much better chance of avoiding COVID-19 infection?
Mosher pleads we must consider the lag from time of infection to death. Fair. But when it comes to the prospect of small business owners committing suicide from the unfolding economic disaster, he looks around and says ‘nothing to see here folks’. What a Sophist.
Surely in order to assess spread we need to know when it started. Taiwan said the first reports darte from Nov 17th and they informed WHO in mid December. WHO was denying the importance in January and the modelling starts in early January. The similarities between Italy and Wuhan are large numbers of Chinese and very bad smog. Northern Italy has the worst smog in Europe( due to Industry and perhaps the Alps blocking air flow) and heavy smoking. What was the health of the lungs of people in both areas? If we take infection day zero as 17 th November with a doubling every 5 days , then 2 to then power 43/8 gives about 256 or say 250.
The modelling is using the 1918/19 Infection Fatality Ratio which is very high.
What governments have to assess is whether the medical resources are adequate. Once a
mathematical model gets the rate of spread far too high and uses the 1918/19 IFR , then one reaches deaths of 100s of thousands of people which is unacceptable. It is highly likely that the Chinese Government hid the spread of the disease for at least 6 weeks , perhaps 8 weeks.
I would like to see modelling where the start date was from 1st November at weekly intervals and using 1957, 1968, 2009 and Cruise Ship IFRs and looking at age and comorbidities. To prevent people dying one needs to make sure the most vulnerable have the medical equipment.
If Taiwan was reporting cases on Nov 17, and the virus truly originated in the Wuhan Province, then infection day zero was clearly before Nov 17. Give 14-24 days of infectious-but-asymptomatic that the researchers are now reporting, for Patient 0 in Wuhan, plus another 14-24 days for the patient that brought it to Taiwan, and you need to begin your modeling at Sep 30. And probably before that, using a location backward tracker like Stephen Mosher described for the S. Korea testing protocols, and who knows what date you’ll get to.
It should be read carefully.
Taiwan has said that first reports date from November 17th, not that Taiwan was reporting them then.
The context is a retrospective analysis of the situation, not a claim they knew all about it way back then.
Willis wrote: “Other experts who actually look at the larger picture are saying that the damage from the lockdown is going to be much larger than the damage from the virus. And to date, there is no sign at all that the “shelter-in-place” regulations are having any effect.”
The equivalent of “shelter-in-place” regulations have reduced the number of new cases in China to near zero. There are now more COVID-19 cases in the US than in China or anywhere else in the world.
I suspect – but certainly don’t know – that Willis is right a lock-down being more costly than letting the disease burn itself out. However, this is totally irrelevant. IMO, no government can survive letting an epidemic spread until the number of cases overwhelms the capacity of their health care system to deal with them. Mathematically, an exponentially growing epidemic (doubling in less than a week) always will overwhelm the fixed local resources available to deal with the number of patients. In Wuhan, patients were lying in hospital hallways and waiting areas and dying due to lack of medical staff and equipment. The available medical staff was shrinking as some got sick and even died. Shelves in grocery stores and the streets were empty. On TV today, we saw the same scenario at a NYC hospital – more than 100 people standing in line waiting to enter the emergency room and apparently a few patients died while waiting. Any government (democratic or authoritarian) that fails to even attempt to interrupt exponential growth is committing suicide.
Of course, a lockdown may also be economic suicide, but that process will take time. The most important element in any political cost-benefit analysis is remaining in power.
The worst scenario would be to commit economic suicide by lock-down and then fail to halt the exponential growth of cases. It is absolutely essential that our governments succeed in reducing the average number of new patients infected by each existing patient to 1 or less and that new outbreaks are contained. That will take leadership, resources, effective systems for preventing the spread of infection, rapid responses, and discipline.
Of course, all my talk about “suicide” and “a breakdown in civilization” may be an exaggeration. However, a comparison with influenza is scaring me. In an average year, 30 million Americans (1 in 11) get influenza. When a new avian influenza arrived in 1918 and no one was immune, 1 in 3 Americans contracted influenza. According to the chart linked below, COVID-19 is almost as easily transmitted as the 1918 flu, making 1 in 3 is a worst case scenario. Despite effective drugs and a 50% effective vaccine, about 500,000 Americans (about 1 in 60 of those with flu) are hospitalized, perhaps as 50,000 in a peak week. I made it to the emergency room. About 10,000 patients die (about 1 in 50 of those hospitalized). Since roughly 1 in 100 Americans (3 million) die every year, no one pays any attention to the death toll from influenza. And since we have 1,000,000 hospital beds and 100,000 ICU beds, a peak incidence of 50,000 cases a week isn’t likely to overwhelm our health care system. So what if 1 in 12 of those with COVID-19 need to be hospitalized and 1 in 6 Americans get infected. That’s 5,000,000 patients needing hospitalization and perhaps 500,000 in a peak week in a country with only 1,000,000 hospital beds. These numbers tell me why the Chinese government needed to built two new crude hospitals in Wuhan in about 10 days and why NYC is taking over their convention center.
https://www.nature.com/articles/d41586-020-00758-2?WT.ec_id=NATURE-20200326&utm_source=nature_etoc&utm_medium=email&utm_campaign=20200326&sap-outbound-id=1DD87619E7642D6B5AD4D208EA9740444915E8DB&mkt-key=005056B0331B1EE889E65CD925312883
When someone makes a strong argument, I don’t find “you’re not an expert” a great counter-argument. Either the data and the logic is flawed or it isn’t. I’m not sure either one is here.
I don’t find “you’re not an expert”:
Exactly, what authority does Duane have in determining who is the Expert? His thoughts have been implanted based on his rant, so he can not explain in his own words why he thinks what he claims to think. Social distances from Duane is best.
Anyone else suspect that it would be a good idea if Clinton was president?
No
Mario says, “No”.
This response to the question posited, is about the most perfect, and perfectly succinct, answer to any question I have ever heard in my entire life.
Nicholas.
Anything that dilutes the absolute power of No was not needed!
You just put a big grin on my face!
Thank you!
Of all the things I have ever been sure of in my life, that one, Clinton being President = not a good idea, may be the single one thing I am absolutely certain of such an incredibly high degree of mathematical exactitude, that I shall have to ponder long and hard to think of a way to express even a semblance of how incredibly much of a sure thing it is.
So thanks for asking.
Is she was, the media wouldn’t be attacking her and her response and we wouldn’t have nightly bodycounts.
Is the whole world acting as they are because of who is president of the US?
Seems very unlikely.
If she was we would not have an economy to destroy… she would have succeeded in that already. HRC is poison to the core.
StandupPhilospher is correct.
I have thought of that a number of times and Marlo’s answer is wholly accurate.
Thank you! took me like 1ms…
That The idea Trump had would be a good one if it was Hilary’s.
Thanks for the ad hominem analysis. Would you like to try again, using the data Willis presented and explain your specific objections to his hypothesis? No? Thought not.
That guy Duane has been rubbing me the wrong way for a very long time.
A thoroughly detestable sort of person, IMO.
If 77% of the people who had coronavirus died, then 66% of americans with coronavirus and one or two other underlying conditions will also die, yes?
So like 6 million people?
Duane what color is the sky in your world?
It is whatever color the experts say it is.
The ones on the tax paywrs doll, anways. Since, in Duanxe’s world, all others are just paid oil grifters. Michael Mann, one Duane’s priests, er I mean experts, told him so.
“What we don’t know now would fill all the world’s electronic memory banks.”
This sentence could be used in 300 years by Kirk and Spock to drive an evil robot crazy, and make it short out, and thus they save the Universe from total destruction.
Your prose is quite funny. Some experts such as Dr. Didier Raoult, top-of-the-line virologist, says exactly the opposite of the catastrophe narrative of your so-called experts.
It is a pandemic…as for serious one needs to assign criteria to determine that. What exactly distinguishes a “serious” pandemic from a non-serious one? How many potential deaths distinguish one from the other? Given incomplete information, one should error on the side of safety – at least until better information is available.
The so-called “Lock Down” which is really just social distancing and avoiding non-critical contact is designed to slow the spread of the disease down. The impact of this has to be measured against the economic damage it is inflicting. Like it or not, all decisions have to be looked at from a factual perspective – “what are the pros and cons?” is the usual way to put this. When the cons outweigh the pros, it’s a bad decision. If the economic damage will lead to more people dying (possibly over a much greater time) than the disease inflicts, then “Lock Down” is a bad decision and needs to be at least modified. The economy keeps people healthy and alive, and happy if they work hard.
I myself think it was a good idea to try to slow the progression of the disease down given the data we had. This disease is terribly contagious and it’s death rate appeared to be much higher than it does now. When you have to act without complete information and lives are at stake, it is generally a good idea to go the safer path.
What any of this has to do with FOX News or Trump is completely irrelevant. Why you bring your own political convictions into this makes people wonder if you are so fragile and shallow in your beliefs that you cannot defend them using data or at least a coherent argument.
Thank you Willis for another great look at the data…and I respect your opinion even if I disagree.
Can we label cars as a cause for a pandemic, with supposedly nearly 1.25 million people are killed in car accidents each year? On average, auto accidents cause 3,287 deaths per day globally. An additional 20-50 million people are injured or disabled.
car accidents are not contagious
They don’t overwhelm hospitals.
its not about the death rate.
True, and you’re always on to something. Seems, and this is a guess, that what you say is related to concentrations of an outbreak being quite potent. Good on you! Good job!
simple model for a small town
https://www.youtube.com/watch?v=jqgINxGQB5w
its not about the death rate.
Mosher,
“car accidents are not contagious”, yet the CDC has investigated the “gun epidemic”. What about the “drug epidemic”, the “fill in the blank” epidemic. Every time I turn around a democrat or gov’t official is calling something an epidemic and sometimes literally saying should be treated like one, i.e. we also loss freedom and choice.
To all, I should have used a sarc/ tag. I instruct, coach and volunteer, as well as race cars in competition. To be clear, I do not want any more restrictions on cars. They are pretty safe, especially today’s cars.
Car accidents are contagious –
You get them from people that hit you.
You give them to people you hit.
They can spread rapidly in congestion (multi-car pileups).
To bad we haven’t found a vaccine to prevent them, so I guess social distancing (not tailgating) is the only way to slow down the spread.
Good news is there is a prophylactic to prevent serious harm; buckle up everyone.
Australia’s and the US’s systems are I think similar, in that the Supreme Leader has no authority when it comes to Coronavirus and the response to it. All the authority is in the states, not federal. Another similarity is that the current Supreme Leader in each of these two countries recently committed a heinous crime for which they will never be forgiven: they won the last federal election. Every available stick will be used to beat them up until they are gone, and Coronavirus is such a stick. So the states will get all available credit, and the Supreme Leader will get all available blame. It would be a fun game if it wasn’t so serious.
Robert, I’ve heard this several times, “If the economic damage will lead to more people dying (possibly over a much greater time) than the disease inflicts, ” but I don’t understand..many people said that multitudes died in the great depression, but actually that was not factual. Reading “Life and death during the Great Depression” by José A. Tapia Granadosa and Ana V. Diez Roux, will demonstrate the only noticeable increase of mortality was suicide, with a noticeable decline of mortality in every other category.
So what, actually, would people die of if we have “great economic damage?”
Crime i.e. more murders. War. If one degree temp changes causes more war why wouldn’t economies collapsing?
I always wondered why everyone keeps saying we need a gov’t safety net(welfare, social security) because people were “starving” during great depression. Yet, I always wondered why I never saw pictures of dead people who had starved to death. Lots of soup line pictures, but no one actually starving to death. Churches and people helped each other out without needing gov’t.
I might need to check out that book to get more knowledge. Thanks.
Shelly,
It’s theoretical at this point but the logic is easy to follow.
-Shut down businesses and products that are produced become more dear hence more expensive.
-Out of work people can’t afford food, shelter or medical so become a more vulnerable population to all sorts of diseases including COVID-19.
-Domestic violence would likely go up with in the out of work population. More injuries and death.
-Crime increases as people become more desperate for basic needs, violent crime would certainly increase which leads to more victims hurt or killed. People with the means to protect themselves will be more willing to use lethal force as crime increases.
-Already strained medical system will have even a larger burden put on them by increased disease and injury brought on by the vary policies put in place to save the population. This leads to having to prioritize who gets care, who doesn’t and the level of that care.
I’m sure we can sit here and brainstorm a lengthy lists of what could happen with economic collapse leading to more deaths. But if you think that last point isn’t already happening you’re wrong. Locally we’ve had it reported that a woman diagnosed with breast cancer and was told she needed immediate surgery. She called to set up her surgery and was denied by the hospital, she was told that state wide no surgeries were being scheduled until after the emergency was over. We all know with cancer that time is of the essence, waiting can be a real killer. Luckily for her a doctor heard the report, called and said our facility will take care of you.
When you understand the numerous different positions of experts, and the vast level of uncertainties on both sides of the equation, it is immature, unhelpful and unreflective to make such crazy comments like ‘Only a destructive idiot driven by stupid ideology – like Trumpism – would dare demand an unlockdown.’
Grow up or shut up
Here in Prince William County, VA, we have a population of 463,023. As of today, there have been 23 confirmed cases. In all of Virginia today (population 8.54 million) there are 290 confirmed cases out of 4,470 people tested, and 7 deaths. A death rate of 2.4% is less than many places, more by far than Germany (the gold standard).
The wife and I did our weekend shopping last Saturday, starting at Costco. Their website listed 9:30 am as the opening time, but when we arrived at 9:25, there were already people streaming out with their shopping done. Entry was managed in order to keep the number density of people inside low enough to assure 6 foot spacing, with the bottleneck being checkout. Employees stationed at typically high-density spots had a quick, concise, well-practiced spiel encouraging people to maintain 6 foot spacing.
They did an astonishingly good job of keeping a steady flow of customers going through. We had about a 30 minute wait to get in, but that was amazing to me given the number of cars in the parking lot.
My wife had wisely deduced that getting there early, coupled with Costco’s stupendous volume of food purchase for sale, gave us good odds of getting any meat we needed. A whiteboard at the entrance listed items out of stock. The only meat I saw was lamb. Given the demographics of this store’s customer base, and the religious holidays going on, that was not a surprise. I got a four-pack of very nice ribeye steaks, and a four-pack of lobster tails with no problems.
Toilet paper was still available, though paper towels were not. It has been gratifying to see that produce of all kinds is available in almost unlimited quantities (true at every grocery outlet we visited that day). It tells me that people in general maintain a virtuous disdain of fruits and vegetables, giving me hope for humanity.
That Costco had developed this system – and it is a genuine system – so quickly and competently should be a lesson to everyone on how smart people in the private sector can keep things going while reducing health risks to the public. Governments everywhere could learn something from them.
And, yes, I trust my fellow sovereign individual to safeguard himself, and will do what it takes to safeguard myself and wife – but without stopping living. I’ve seen it in spades last Saturday (we did a lot of shopping). People are dealing with this in a rational manner, IMHO.
I live in Culpeper County VA. I went to the Costco in Charlottesville and the number of people shopping was less than normal. At the Lowes in Ruckersville, they had a teenager spraying alcohol onto the shopping cart handles. Small towns and rural areas are much less affected than large metropolitan areas.
Most people here in Central VA practice reasonable social distancing. My point is what may be required for NYC, Lombardy Italy, Spain etc. doesn’t make any sense for much of the country. National lockdowns are simple and destructive. Common sense guidance works much better. People like Duane are terminally filled with hate and can’t think clearly.
Two other causes that should be looked at are:
– Mass transit in large cities where many people touch the same surface and spread the disease (E.G. NYC subway)
– Areas that have large populations that travel back and forth to disease center (Wuhan, Northern Italy) NYC has the largest Chinese population outside of asia and large number of people who travel to Italy.
Willis is doing a great objective job of rational analysis. I don’t care if he watches Fox, MSNBC, or CNN.
Tom, here is what can happen when it is applied to small towns.
https://www.dailymail.co.uk/health/article-8126899/Small-Italian-town-cuts-coronavirus-cases-zero-population-tested.html
Michael Kelly says:
It tells me that people in general maintain a virtuous disdain of fruits and vegetables, giving me hope for humanity.
Thanks, made me laugh, tho I have recently developed a taste for avocados, prb’ly because they taste good w/alot of salt.
I quit reading at your ” the lying destructive self-dealing Trumpster.” Because you re obviously NOT unbiased.
Governor Cuomo is doing a great job? He had the forethought to reject stockpiling 16,000 ventilators. Great job.
https://www.realclearpolitics.com/articles/2020/03/18/new_yorks_ventilator_rationing_plan_142685.html
I had a sense of deja vu when I read this: “Sorry not only to Willis but to the extremist right wing Fox News crowd – but you are all hopelessly wrong and mired in wishful yet destructive magical thinking for purely political and ideological reasons. The experts are in fact right and you are all wrong.” It reads almost like ‘boiler plate,’ used by someone with an agenda, who needs words to convey their inner anguish.
There are enormously divergent opinions among epidemiological experts. Take Imperial College London vs. Oxford University for a pair of extremes. The latter estimate that the UK may already be not so far from herd immunity. The former were forecasting 250,000 deaths. Until today, when they now say they think peak infections will be inside health system capacity.
There is no right view absent data, much of which we still lack. But watch the direction of travel of expert opinion. And watch the data that inform them, including the data that suggest Italy is through its peak of the current epidemic.
Duane post reflect the ravings of an ideologically subverted fanatic whose surrendered crotival thinking for the warmth and ease of collectivist mimicry.
The moment you degenerated into the familiar Trump/Fox News derangement rant, you negated anything else in your post. To quote Socrates: ” when a debater resorts to insults, his argument is lost.” Contrast Trump with Obama – l’ll pause for a moment while you get over the thrill up your leg … OK now? The first confirmed Vovid-19 case in the US, someone returning from China, was Jan. 21. At the time, China was insisting that the virus was not spread person-to-person. Ten days later Trump placed essentially a ban on travelers from China, and issues a national emergency. Next he assembled a task force of top virologists, epidemiologists and infectious disease experts. And extended the travel ban to 12 more countries. What was the Democrat response in support? They continued their impeachment hoax, lodging two unconstitutional Articles of lmpeachment.
Now go back to 2009. When the H1N1 “Swine flu” hit in April, Obozo didn’t issue a national emergency declaration for 6 MONTHS, by which time 1,000 Americans were already dead, a number that would climb to (estimates vary) up to 18,000, including over 1,000 children. Obozo, Pelosi, Schumer & co were much more busy with passing Obamacare. Swine flu was just an annoying distraction.
Duane, it’s important right now to keep one’s self-control. Maybe time to self-lockdown.
If someone comes forward with insults combined with ignorance, without evidence of a scientific background, you get a result like above. Apparently knowledgeable scientists disagree. I quote the Indian/german scientist https://www.youtube.com/watch?v=MARVdS-pHdQ&feature=share&fbclid=IwAR30dpi_oElW51cmlewfEXn-loJnoC-bVDXO5gVHWh0BNiXyl5upeDJMWj4 who is even more critical about Corona-alarmism.
WF
I agree. Most people myself included want to know where we are on the curve before infections slow. A previous post showed how the Gompertz curve replicated both China and Korea cases. To me this is more telling in addition to to cases per unit of population.
“A previous post showed how the Gompertz curve replicated both China and Korea cases. To me this is more telling in addition to to cases per unit of population.”
except the curve for Korea was wrong as I pointed out at the time.
Obviously wrong if you looked at the local data and looked at cases in the pipeline
The prediction for Cases was 8100, we passed 9100 today and will blow past 10000 I think
the prediction for Deaths was 100, we are at 120, and head to 150 Minimum based on the
the daily death rate of those under care.
The problem with Gompertz and Farr’s law is they are non mechanistic.
For a mechanistic model you want SIR compartmental models
https://www.youtube.com/watch?v=NKMHhm2Zbkw
Thanks very informative. would like to see these plotted as well to give a more predictive picture.
In fluseason 2017-2018 there was 61.000 deaths in USA. Use those numbers and we had 1.4 million dead worldwide. In a normal season between 10-30.000 in USA dies, not 6.000 as this article says. https://www.cdc.gov/flu/about/burden/past-seasons.html
1.4 million dead and no panic, closed borders or economic collapse then…
the green shift seems to have control over this panic-creating virus. The world closes down and a new will arise? The crowning og a new world order after 20 years with fear. 9/11, financial crisis, SARS, MERS, ZIKA, Swine-flue, Ebola, refugees and a wave of terror the world never seen before (all hyped 90% of media) followed by climate-crisis and doomsday prophesies. Is this “The New Global Revolution”?
The politicians today talk about the need for a new world order, for even in spite of all these events there is total chaos and no one knows what to do…
This is not about Corona and saving lifes, and if it was, they could have saved 10 millions with part of the money the corona measures cost. 2,3 million has starved to death so far this year. 2,9 have died from other infectious diseases. About 200.000 from water-related diseases, and it`s a lot more. (Worldometer)
And don’t forget 70 million refugees from 20 years of western bombing of Afghanistan, Irak, Libya, Syria, Yemen, and many more. (With an open corridor to west) Of course, it’s not about saving lives. it also shows how powerful the monopolized media has become.
“We are what we eat” and fear is the most powerful weapon for changes. Important to control the food-plate.
When are you going to realise that COVID19 is NOT the flu.
The “flu is made up of 4 flu viruses, not just 1.
This morning I got a message from the firm I use to keep my computer virus-free. It warned of scams linked to the coronavirus. It gave a strong warning against clicking on any attachments that came from unknown or suspicious sources. It probably was unconnected to the coronavirus-type scams but later in the day I got an email about my WUWT subscription. Fortunately I was on the alert because of my earlier email and also I was suspicious because there is no such thing as a WUWT subscription. So I did not click on the bit it asked me to click on. However, I wondered how somebody could know that I visit the WUWT website. Then I remembered that some days ago, when I wanted to submit a comment to an article on WUWT something came up which does not usually come up. Maybe I should have been more suspicious but I just assumed that WUWT had decided to introduce an extra step that commenters had to go through. I can’t remember now exactly what I did but I probably supplied my email address and that’s how these people were able to email me.
I recall getting that pop-up too.
Mr.
Apart from the fact that these people now have my email address and I will need to be extra vigilant in future whenever I get an email, do you think that there might be any other problems this could lead to?
Dunno Alba.
Maybe it was a hack of my WordPress user account?
I have the Avast virus/malware/spam protection on my devices, so I’m hoping that’s sufficient to keep the barbarians from my digital door.
when you get an unusual mail
right click DONT open it
then select properties and see if the senders supposed addy matches the claime one you see on the inbox
they tend to be wildy different
I use this with ebay and paypal mails every time theyre very often scammed
as is Auspost by email and fake sms as well
WUWT is unusable with MS edge on my home system. Literally unusable. Within seconds of an article being clicked I get pop up phishing links. The ones you can’t close w/o closing the window. It is repeatable and consistent. I have told both MS and WUWT. No response from either. Annoyed me enough I downloaded Firefox on my home system. Apparently my work computer already knows how to block them as does Firefox.
Just be glad if you can get the extra health advice about toenail fungus, earwax removal and “how to completely evacuate your bowels daily”. I’m amazed that WUWT knows these things about me!
This analysis makes sense.
Something on the order of 10% of Italian cases involved medical personnel. They weren’t using PPE in the beginning and now are faced with shortages. Sadly, numerous older Italian physicians came out of retirement to help and already several have died.
New York is the American Italy. I hope and pray that the Wuhan virus hasn’t infected hospitals there to the extent of northern Italy.
Possibly encouraging news today, however. New cases in the US dropped from over 10,100 yesterday to, at the moment (after 1 PM EDT) 5800, of which about 4800 are in NY. We’ll see where we end up at midnight GMT, but the curve might be flattening. If more people are being tested at the same time, then all the better.
The two deaths here in Chile are an 83 year-old, sickly lady and a cancer patient in his 90s.
Here you go, John …
w.
Willis, I appreciate your continued effort so shed light on this “crisis”. I would suggest you look at cases as well as deaths when looking for indicators of change. Deaths are the “bottom line” but cases are weeks ahead of a “closed case”.
Also looking at daily new cases ( or deaths ) will make any change much more apparent. The graphs of cumulative totals just look like distress flares going up. (The Guardian loves them. ) Even final results like China just flatten off gently with no clear turning point.
Take a look at my graphs on Climate Etc. yesterday for examples of daily case graphs.
https://judithcurry.com/2020/03/23/cov-discussion-thread/
The turning points in China and S.K. cases are clearly defined. I even detect a slowing of the exponential growth in Italy. Though it clearly is still in the exponential phase.
Also regular flu is reckoned to have a fatality rate of about 0.1% . France has average 9000 deaths per year, that suggests 9million infections. March is still “flu season”. How many cases attributed to COVID are in fact just “flu like symptoms”. We know they are not testing all admissions in Italy.
Also France has about 3000 nosocomial deaths per year, without COVID. Currently claiming 865 COVID deaths.
Cases AND deaths stats just about doubled overnight in France the day before enhanced “lockdown” rule were announced. I do not believe that is clinically credible. There is an accounting change / error here. Accidental coincidence ? Can’t say. Sure helps to silence opposition to draconian measures though.
Greg, the problem with looking at cases is that cases are inter alia a function of the number of tests done. If you double the number of tests, as many countries are doing, you’ll find something like twice as many cases even if there is no change in disease prevalence.
That’s why I look at deaths instead of cases.
w.
Yes Willis that’s exactly what I’ve been doing for the same reason .
Looking at your Fig. 1 I’d say that Spain and France are on similar trajectories to Italy, Spain in particular.
I’ve been plotting U.S. data since the 11th. The plot of deaths vs cases is linear, R=0.998 and deaths = 0.012(cases) + 24. I haven’t looked at residuals but the data points are falling very close to the line with no trending so far.
It’s interesting that this is the case despite all of the testing that’s been rolled out, that deaths lag cases, etc., etc.
R=0.998 implies fabricated raw data.
Such a good correlation is not possible without a clear, uncompeted relationship and a very large sample size.
The latter – at least – is unavailable.
Willis
Around one third of Italians are resistant to anti biotics and comprise some 10000 of the 30000 deaths a year in the EU due to resistance. It is wildly over prescribed presumably due to the range of illnesses caused by the lifestyle of living in small flats, an aversion to fresh air in apartments, very poor air quality in the north, high smoking rates, intergenerational living, a high degree of tactile living and according to a report today, which may or may not be true, but tracking their mobile phones, and boy do the Italians love their mobiles, some third are not closely observing the lockdown too closely.
Probably mobiles are germ bombs themselves when put down on hard surfaces put to the ear of the young who then kisses and hugs granny
Tonyb
M Courtney, the thought of fabricated data crossed my mind. Whether artificial or not, I will continue to track this relationship.
Tonyb March 24, 2020 at 3:04 pm
“Around one third of Italians are resistant to anti biotics and comprise some 10000 of the 30000 deaths a year in the EU due to resistance.”
–
Antibiotics are for bacteria, not humans.
Possibly a third of those Italians who have cultures done and are treated with antibiotics, not a third of Italians, much less, have an infection which is resistant to some antibiotics. A much smaller figure again comprises those infections with
widespread antibiotic resistance ( superbugs).
10000 out of 60 million Italians is 1 out of 6000 people dying with a superbug or a highly resistant bug. Or 1 out of 60 deaths per year due to a superbug.
This seems extremely unlikely as far too high.
Someone is confusing bacterial resistance to some antibiotics (common) to resistance to (all) antibiotics extremely rare, usually on hospital which then gets state wide publicity as so rare and dangerous.
That is one of the main things that worries me about all this data. Jumps in cases are usually coincident with jumps in *attributed* deaths.
Willis is correct about testing but the problem is the same argument applies to deaths too. The more you test the more “COVID” attributed deaths you get.
“R=0.998 implies fabricated raw data.”
SMH.
and of course if it were .986, that would be “evidence” the data is good!
your detective skills are awesome
please go look at holocaust data and find something to deny
I agree this is very suspicious. I have already noted impossible simultaneous rises in cases and deaths in Germany and France which I intend to investigate closer.
However, I presume Scissor is using cumulative totals so they will be strongly AR1 auto-correlated. Again look at daily.
Also very few actual data points significant R would be higher any way ( but not that high! ).
Thanks!
Hope apparent incipient curve flattening pans out.
With about five hours to go until witching hour of midnight GMT, still no new cases in WA State, and US total on track to come in under yesterday’s whopping 10 grand+.
At the moment, 5621 new cases out of 7126 in US were reported from NY and NJ.
There will be no flattening out at such an early stage. don’t kid yourself. One or two dots means nothing. Germany was stable or about 5 days last week then took off.
Grey line is USA. Very straight , fixed exponential growth.
It might be flattening. It probably will within the next week if it hasn’t begun to do so.
The high density public housing in NYC is a ticking time bomb
Good luck in Chile, John. Here in Argentina there are five (5) Covid-19 deceased, and all of them got it outside Argentina. Thanks to early quarantine demands here the infection rate and distribution seem to be at lower trajectories than common elsewhere. Good posting, Willis… but who are you calling “old people”? Old people have a great accumulation of treachery, and if you want to see one look in the mirror! Ha! Protocol, everyone, protocol!
Thanks!
Here in Region V Valparaiso we’ve had only 25 cases. Despite our reliance on tourists, local mayors objected last weekend to hordes of Santiascans descending on the beaches which you so recently enjoyed (I hope).
The Santiasco Metropolitan Region is the national pesthole, no surprise, with 540 of 922 cases in the country, a higher proportion than of population. Both deaths have occurred there. Unfortunately, my wife is currently working in a clinic there, and the bus stations are closed.
Hope that Mendoza is still Wuhan-free.
John, five cases in Mendoza Province, all five contacted in other country, and five total Covid-19 deaths in all of Argentina. Wife and I enjoyed a week in Renaca late January and I returned with many cans of salmon ahumado and choritos. Good luck to all of Latin America, as we are headed into more favorable seasons for flu, covid-19 or regular.
Tienes razon. And after fall, comes winter. But I hope the contagion will have run its course by then. Maybe overly optimistic.
Note the relatively fewer cases in Chile’s Far North, but then the South got its usual hordes of tourists from Santiago last month.
One thing that distinguishes NYC from Italy is the air pollution. Lombardy, the hardest hit area in Italy, has Europe’s worst air pollution, so a similar situation to Wuhan with its horrible air quality; NYC is not so bad. Here’s something interesting I haven’t had time to go through in detail yet that examines this as possible factor in severe “Wuhan pneumonia”
https://www.eurasiareview.com/01022020-polluted-air-could-be-an-important-cause-of-wuhan-pneumonia-oped/
Also possibly fewer smokers, but don’t know.
I can’t help but wonder how the subways of NYC contribute to the spread of the disease. (Not deaths, spread)
I would think that once it gets into the subway, it’s a short step to just about every aspect of life in that city.
If the data is available, it might be interesting to see how the death rate compares to population density.
MarkW Dr Birx mentioned this in the town hall today how subway might spread it with people touching the bars you hold on to. She is apparently the expert on this stuff.
Note that NYC had city schools open until the beginning of last week, long after places with far less disease had closed schools, and DeBlasio resisted closing them for some insane reason long after he was being told to close them by everyone who had something to say about it.
If I was to point to one action by one person that may be the single worst decision to date in the…it would have to be that.
YUp.
So here in Korea we get data on which stations and trains infected people were on and when
Then you have the freedom to make an informed decision
We don’t shut shit down ( like china) or ignore shit because of “privacy”
This train, that station, your choice.
Who’s “we” … you’re an American, not a Korean citizen, so stop trying to grab some moral high ground. You do nothing there, just follow orders.
Huh, moral high ground?
you’re weird.
Hey, Mosh can self-identify as Korean if he wishes.
That was slightly tongue-in-cheek. Here in the USA, anybody can become an American. Other countries don’t have that attitude. Regarding South Korea, I have no idea.
Please do not look at worldometers’ stats for the US before California reaches 0 AM.
US cases / new cases as for 24.03.20, 22 PM GMT+1 : 52,921 / + 9,187.
When you look at e.g. 10 AM GMT+1, you obtain the definitive stat when clicking on ‘Yesterday’.
J.-P. D.
I have not seen a single discussion from the infectious disease specialists that R0 is a malleable property of the disease.
The early data was a scary R0 of 2.3 for Covid 19, which is way worse than typical seasonal influenza. Obviously, if this number is correct it does have value in showing this disease is more “contagious”, since this is pretty close to an apples-to-apples comparison.
However, the R0 value depends on many factors including number of contacts, exposure time to infected people. Our behavior has changed substantially!
Whatever the initial R0 value was for Covid 19, that number has to now be substantially decreased. Is it below 1? I don’t know, but surely we have to be driving it close to that level.
Yes exactly right. RO is partly a quality of the infecting organism and partly an outcome of the context in which it spreads. A big factor is the size of the susceptible population (i.e. how many are immune by reason of specific immunity and how many because of genetic traits). Another as mentioned is the dynamics of the population and the opportunities that exist or which are avoided for spread. Climactic and physical conditions may also play a role. A simple analogy is growth rates of human populations – they depend in inherent fertility, deliberate manipulations of fertility and human interactions (or so I am told). In addition social disruptions and stresses may interfere with the preceding points. I think we can assume from what we see that CoVID19 does have a fairly high intrinsic transmissibility. There are several clusters which show a high proportion of those present were infected. It is almost certainly not as high as measles or chicken pox among susceptible populations. All of the steps to prevent person-to-person spread are working on the human dynamic factors, and if/when a vaccine becomes available it will work on the intrinsic susceptibility of the population. I am an infectious disease physician working in the midst of this so take that for what it is worth (I don’t encourage anyone to “trust the expert”but rather ask for evidence).
R0 is also extremely hard to estimate from initial case incidence – we simply don’t know how many people are asymptomatic carriers until much later in the response phase.
Pillage
The important thing is that R0 is something that is within our orbit of control.
Indeed, R0 is specifically what clinical epidemiologists seek to control. If R0 is >1.0 the epidemic worsens, if R0 < 1.0, the epidemic decreases. So reducing contact between infected and never-infected people is the prime way to decrease R0. Hand washing, covering coughs, cleaning surfaces touched by infected….all ways to reduce R0.
Coming, though, are antivirals (eg chloroquine) which will also likely reduce R0 by decreasing the time the infected carry the virus.
“Coming, though, are antivirals (eg chloroquine) which will also likely reduce R0 by decreasing the time the infected carry the virus.”
not likely
Gotta say, sometimes your haiku-style commenting drives me mad. If we can find an effective antiviral, seems to me it would decrease the R0. But maybe I’m wrong.
However, if I am, your comment does nothing but make me want to curse your name. You’re a wicked-smart guy, so I have to assume you’ve based your comment on something … but what?
So let me suggest that you put a word limit on your comments … but not a maximum limit.
A minimum limit. No comments under a hundred words, or fifty words, or something.
Because I gotta tell you, your two-word comments are not helping your reputation … they just make you look like an insouciant fool who doesn’t care and just wants to see his name in print …
w.
““Coming, though, are antivirals (eg chloroquine) which will also likely reduce R0 by decreasing the time the infected carry the virus.”
Willis. Think.
1 gets the virus.
2. Starts spreading
3. Gets symptoms.
4. Keeps spreading
5. Seeks Medical attention
6. Diagnosed and gets isolated
_________________________________________________
7. gets Anti viral
8. It works.
An anti viral applied after you have the disease and have been spreading is not likely to reduce R0.
Unless everyone starts taking it before they are diagnosed. Which is not likely.
especially for chloroquine which the USA medical community seems to have a
“thing” against. heck Nevada governor wont allow it to be used.
I sent you a video on the Stanford approach to clinical trials on remdesiver.
quite shocking that they wont even consider chloroquine. And more shocking because
their approach will takes weeks.
Can You imagine? I cant imagine being a doctor and enrolling folks in a clinical trial
as a “control” group while others get a treatment.
I may do a Post on Post Normal science
facts uncertain
Value in Conflict
Stakes High
Fast Decisions needed
kwinterkorn
The practical effects of curing the patient or keeping the patient quarantined are the same. They are then not responsible for new infections. The difference between the two is that curing allows the patients to leave the hospital and make room for newly identified cases. Curing may abort the progress of the disease and reduce the number of deaths. However, either quarantine or curing will reduce R0.
I keep coming back to a day in mid-November or so, perhaps a cloudy day, slightly breezy, rather warm, at a bustling fish market in a busy part of town in a city in China that almost no one in the world was aware of who has no business there and is not Chinese…and in that market, some animals in cages whiled away the hours of their last days.
In one of those cages…just one random animal in one random cage in one random market in one random city in one random country…was a pangolin, that had a virus. Just one animal.
That virus is now one of the most successful life forms to have ever existed on the planet in billions of years…having spread it genetic material all over an entire world in only a few months.
Decreased R sub 0?
Maybe.
Warren Buffet is probably not increasing his wealth as rapidly as he did at one time or another in his life too.
“I have not seen a single discussion from the infectious disease specialists that R0 is a malleable property of the disease”
read more.
https://www.worldometers.info/coronavirus/country/us/
Source for my comment.
From the worldometer reference by John Tillman
Coronavirus Cases:
68,421
Deaths:
1,032
Recovered:
394
What is the meaning of the Recovered line? Surely in the entire United States there are more than 394 people who got the Coronavirus in the past few months and are no longer sick.
What specifically are the rules for designating someone as recovered?
Thanks Willis, thanks Steve. Stay healthy.
Willis, the data are sobering.
Reminds me , I need a drink !
Greg
Try Bacardi Overproof rum, if you can find it. You can sterilize your mouth and throat if you drink it straight.
Today’s (Tuesday) UK Covid-19 update in more detail
http://www.vukcevic.co.uk/UK-COVID-19.htm
It’s really hard to make any sense of UK data since testing are reporting seems almost arbitrary and certainly so inconsistent you can not draw any conclusions from what we are given.
I generally don’t even bother plotting UK data since as you as you do you are likely to think it means something, even if you try to remember the data is a pile of crap. Best not to look, quite literally !
Hi Greg
During the last week or even going back some ten days, only the seriously ill are hospitalised and tested. Test data combined with the death data gives a hospitals mortality rate of about 3% some ten days ago, 4% in the early part of the past week and 5% in the last four days.
This shows that either the hospitals across the country have uneven success rate or more concerning that virus is mutating and becoming more potent, or both.
Or that the hospitals are running out of resources and are unable to save lives they first did.
Remember, “flattening the curve” does not prevent illness but it does prevent the NHS from being overwhelmed.
Hopefully.
Nor do I trust the Chinese data either.
Despite initial attempts to suppress the problem , I think their data is better than most western sources. At least they clearly signalled their change in sampling criteria and it made a one day spike. EU countries like Germany have clearly non medical jumps and spikes which must be related to inconsistent testing/classification if it is not outright manipulation.
I do not believe the number of cases jumps by a factor of 5x in 24h, on the same day there was a massive jump in COVID attributed deaths !
“At least they clearly signalled their change in sampling criteria and it made a one day spike.”
The one day spike may be due to Chinese officials deciding to take an immediate hit to lower the case backlog quickly, attributing the jump to the changed reporting methodology. They could still be working off old cases not logged previously or even stockpiling new cases.
This is similar to UK casualty statistics in WWI, where disastrous battles were presented as victories by citing estimated German losses all at once and distributing UK deaths over several weeks or months.
What is the data on those dying with one co-morbidity? Is it just any one of the top three or four, or is it always the same disease? Is it always hypertension? (I’ve been wondering whether blood pressure medication might be connected to who gets the serious symptoms of the virus)
It would also help to know the distribution of those diseases in the general population of the aged. I wouldn’t be surprised to find 30+ % of old folks have diabetes, for example.
Sorry, Rhoda, don’t have any data on that …
w.
I have heard that 65% of people over 45 are insulin resistant which is pre diabetic.
Apparently this is from US stats.
Bill
You are correct. Insulin resistance most commonly is seen in people that are diabetic. Many people that are diabetic also have hypertension and respiratory issues. I’ve read that insulin is one powerful hormone that can be the cause for many health issues and that diabetes and pre-diabetes or insulin resistance is a massive issue for most countries. Link is to Virta a company that works with patients to resolve their diabetes through diet and intense support. Checking the positive outcomes lists the number of meds that patients have now dropped.
https://www.virtahealth.com/outcomes
There are a couple of relevant graphics here, dated though it may be:
https://informationisbeautiful.net/visualizations/covid-19-coronavirus-infographic-datapack/
A minimum of 52% of Italian patients who died took ACE inhibitors and ARBs. That number is probably low because the dataset is incomplete. I found this in a comment that I won’t link to at the moment that seems to indicate Italy’s ACEi and ARB treatment rate is high, comparatively. Notice that Taiwan’s is much lower, and they don’t have high morbidities and deaths.
Another drug to consider is ibuprofen that the elderly use frequently for arthritis. The Lancet paper mentioned that it increases ACE2 expression.
Regarding ibuprofen, have you seen this information?
http://endoftheamericandream.com/archives/do-you-want-to-know-why-so-many-people-in-italy-are-dying-of-the-coronavirus
If I did my calculations right, looks like about 16% of the Italian population age 65 and over have diabetes, compared to 36% of overall deaths from coronovirus, which are heavily weighted to people over 60 (96% were over 60). Not a perfect comparison, but suggests elderly folks with diabetes have roughly twice the risk of dying from the coronavirus as those who don’t (ignoring any other comorbidities.)
Sources:
https://www.populationpyramid.net/italy/
(added up the numbers on the pyramid 65 and over — 23.3% of the Italian population of 60.5M or 14.1M people in this age group)
https://www.statista.com/statistics/581711/individuals-with-diabetes-italy/
“In 2018, over one million people aged 65 to 74 years and about 1.3 million aged 75 years and over were affected by diabetes mellitus in Italy.” (2.3/14.1 = 0.163)
https://www.cebm.net/global-covid-19-case-fatality-rates/?fbclid=IwAR2INiTyxcBtDDCVlH_NQRoH24zbeKl0ZxHQktWdDJXthIXaUP5V26-BWlU
No mention of the Smoking rate of men and women in Italy. Smokers are a risk group by themselves as the lungs are already inflamed and clogged.
Added …
w.
As well as clogged lungs, I think an important factor is that regular smokers have up to 60% of their haemoglobin definitively bound to CO molecules, making it useless for oxygen transport. They are already running on reserve capacity.
When hit with additional damage they start to need pure oxygen and a ventilator just to stay alive.
Most of the CV cases are in Lombardy, which is heavily polluted; worst in Europe. Wuhan is also heavily polluted. So in both cases heavy toxic oxidative load on lung tissue.
Wow. Hospitals are dangerous places.
In NZ we have not being doing any where near enough testing. I assume this is because there is not sufficient capacity.
We are in the process of going into lockdown. It starts tonight. All to stay at home but allowed to go out for food, of medicines. Yesterday I went shopping. At one store I had to wait outside while they went and got what I wanted.
At the Hunting and Fishing store they allowed me in but they had run out of the subsonic ammunition I wanted. ( We have a plague of rabbits at the moment.)
I am hoping this lockdown will slow the spread enough to give the system time to ramp up testing and tracing.
NZ is in a very good place at the moment but I am concerned most here think the restrictions do not apply to them.
So overblown> Yes, of course this virus is serious, but so have many other viruses in the extending back to 0 B.C. and beyond. And too, the recent past, such as in 2009 and 2010 with the Swine Flu. And yes, precautions on a individual basis, as is mentioned in the above post are very important, But really, the full scale shutdown of our world, is so ridiculous, as to be almost funny. Note I said, almost funny, because for those who get the bug it is far from funny. But having said that, I believe the so called cure is much worst than the virus. Fueled as it is by paranoia and hysteria all being exacerbated by our irresponsible media, may have extremely serious long-term, perhaps even devastating effects. And the question that also comes to mind is, what will we do next time there is a another similar virus?
Not to mention the flu season of 2017-2018. 61,000 Americans died.
No lockdown.
No news coverage either, too busy with Russia Russia Russia!
that’s a dog bites man story, the wuhan virus is a man bites dog story
There are also discussions about the origin of the wide spread.
On the one hand, there were the contacts to lots of Chinese people living in northern Italy with economic and culturel contacts to Wuhan all the time.
On the other hand, there was a Championsleage football game Bergamo vs. Valencia with about 44.000 fans.
About 2 weeks after the match, the epidemy explosed .
One of the sources
Ok, it’s not proven, but a possibility.
Hundreds of thousands of Chinese live in, mostly, N Italy. They have taken over luxury goods manufacturing there. Plus Italy was the first European country to sign on to China’s BRI. Plus the hug-a-Chinese campaign a few days after the first known cases in Italy. Air traffic between Bergamo and Wuhan flies daily. So lots of opportunities for quick, massive infection.
Where did you hear about the hug a Chinese campaign?
https://www.youtube.com/watch?v=mNMdg4morQs
This video
Thank you Mario…that was interesting to say the least
I know. The video was well made and quite moving. Seems successful. I find it quite disturbing.
I think by the time the epidemic broke out in the town of Codogno, keeping distances from the Chinese had became a moot point already.
That part of Italy is quite polluted, yes; it also has a high density of population, industries, transport and travel. Ideal conditions for a virus to spread quickly.
Looks like your conclusion is : “served ’em right, they were all sick anyway”.
We’ll see in the coming weeks how the American population fares, after all, the US America do not have such a great reputation, health-wise.
I read and re-read the article and did not see that conclusion.
That’s a nasty characterization of a simple probe of facts.
The French health system was on the verge of collapse before the Wuhan virus.
https://www.wsj.com/articles/frances-emergency-room-emergency-11585005857
The US has the most advanced medicine in the world.
Apples and Oranges.
The French system may be under pressure but it is vastly superior to third world health care systems that just let the poor die.
The US could have a 1st world healthcare system. But it doesn’t.
North Korea has world class rocketry. That doesn’t mean it’s a successful first world country. Those with no access to the levers of power there are helpless too.
François, you are being dishonest. Willis always requests that one quote the exact words being discussed and you pull this BS, “served ’em right, they were all sick anyway.”
François March 24, 2020 at 10:42 am
No, François, that is YOUR conclusion, not mine. Don’t try to put words in my mouth. This is why I ask people in every one of my posts to QUOTE THE EXACT WORDS YOU ARE DISCUSSING—because I’m sick and tired of people claiming I said something that I neither said nor implied.
w.
Its just information Francois, if you choose to put that spin on it thats you characterisation not anyone elses.
Just read an article by https://www.foxnews.com/media/newt-gingrich-italy-south-korea-coronavirus Newt Gingrich about the situation in norther Italy. That area has 100,000 Chinese living there and there are direct flights from Milan to Wuhan. They may have had undetected cases spread throughout the area before they became aware.
Your comment about it being spread through the health system reminded me of the deaths in Washington state in one nursing home which didn’t realize that it wasn’t just the flu going around until it was too late. I wonder what the state of Italian hospital sanitary protocols are. Even in this country it was found that doctors and nurses in hospitals weren’t following protocols for hand washing between patients.
New York also has hundreds of thousands of Chinese immigrants. How many is unknown, since lots are illegal. Cuomo in 2014 made NY an air travel tourist hub as well, in partnership with the ChiCom regime. Then in 2015 he decided not to rebuild pandemic emergency ventilator stocks, in order to fund death panels and the state lottery. No wonder the Lamestream Media love him!
In northern Italy, Chinese immigrants work in, among other industries, the leather luxury good trade, so that products can legally be labelled, “Made in Italy”, despite the acute shortage of young Italians to replace retired workers.
In the meantime, today Cuomo gave an press conference where he tried to blame everything on Trump, demanding to know why the ventilators they need haven’t been delivered yet. (As if those things can be built by the thousands overnight.)
I would say that if Cuomo is so disdainful of the 400 ventilators that are being sent, send them to some other state that is more appreciative.
He could have bought 16,000 ventilators with the money he squanered on death panels and gave to the lottery to suck more money for the state from suckers.
And I say that as a math-challenged lottery sucker myself.
New York spent hundreds of millions on solar panels and wind turbines so things like ventilators could use “green” electricity when the sun shines or when the wind blows.
They just didn’t purchase any ventilators.
Willis, as you demonstrated so well in your post the other day of the importance of presenting ice-loss data with the Y-axis scaled to show the loss in light of the entire ice mass present to see whether or not it was significant, why is it acceptable to present human-loss data in scales that reflect those of which you were critical in the presentation of ice-loss, with scary rapidly-rising (vs. scary rapidly plummeting) curves?
If Covid19 deaths are plotted on a scale of the entire human population–they will look like your excellent ice-loss curves, albeit still climbing slightly.
(This is not a criticism, just a suggestion that might put this ‘crisis’ in a more realistic light.)
I think the point is to be able to use the sample sizes at a resolution that allows us to see what’s going on. Showing how it scales to an entire population will lose resolution needed to show what’s going on.
Those presenting ice-loss data will present the same defense. Note in the comments following Willis’ ice-loss data post how many were critical of those ‘lying scientists’ who present the data out of context of the total mass present. There are some parallels here.
I do not disagree. We are talking now about signal to noise.
When interested in showing the effect on the total population, then showing that the data is noise helps put it into that particular perspective.
Looking at the data in it’s isolated, zoomed in, resolution to see what it’s telling you is a different matter.
Yup
A good rule to follow is Tufte’s rule.
I assume you mean this one, as Tufte put out a number of rules:
While this is sometimes a good rule, at other times it greatly distorts the situation and impedes understanding. At times, to understand a situation it is necessary to look at “zero-based” graphs.
Suppose we have three datasets. One has a standard deviation of 10, one has a standard deviation of 1, and one has a standard deviation of 0.1. And all of them have the same unknown mean about which the anomalies are taken.
If we look at their anomalies, the graphs will look very similar, filling up the entirety of the space. Tufte would be happy. Only the scale gives any clue as to the variation.
But if we zero-base the three graphs, the differences between them are immediately apparent. And so is the effect of the given variation on the underlying data. In some cases the variation on a zero-based graph will be significant, and in some cases it will be invisible.
And despite Tufte,sometimes that is very important information … as in the case of Antarctic ice.
In friendship,
w.
Graphically representing real world data is done to make it easier to see important changes (alternatively, for the statistical liars, to make unimportant changes look much bigger).
Ice mass gain or loss, year to year, is pretty much a linear graphic. An important change there is if it goes non-linear. You see that inflection point (assuming there is one) much better when the data is plotted on a linear scale.
Disease spread, on the other hand, is exponential. An important change there is when it goes linear (which is guaranteed, one way or another). You see THAT inflection point, when it happens, much better when you plot on a logarithmic scale.
Len, the “entire human population” is shown in Figure 1. It’s the blue line labeled “World”. And it is climbing more than “slightly” …
w.
With all due respect, Willis, please read the comment effectively before responding to it; after all, it is not too much to ask of you to extend the same courtesy to others that you request of them. Mario understood it, I think you could too if you desired.
The blue line is another plot within the narrow context of the limited Y axis, deaths per 10 million population, not with respect to the planet’s “entire human population” of 7.77 billion. The plot that I’m thinking of would be analogous to your figures 5 and 6 in the ‘Graphing the Icy Reality’ posting.
This may end up being a crisis for man’s health-care systems, but it is unlikely that it will be a crisis for man, in that context. Our 7.77 billion “entire human population” is indeed still rising slightly, by 168,000 so far today, with all Covid19 deaths included.
I do appreciate that you were writing this posting in the context of only the Covid19 endemic–but by analogy so were the authors who wrote the articles on ice loss that you correctly pointed out generated scary graphs by plotting data without consideration of the context of the “entire ice mass”.
I am a bit confused about what I understood, but I usually do not understand things as easily as Willis. That said, we are all fallible.
Len Werner March 24, 2020 at 5:31 pm
Whenever anyone starts with “With all due respect”, I know they mean “With no respect”.
It seems I misunderstood what you wrote. Or perhaps you misunderstood what I wrote.
But claiming I didn’t read the comment “effectively” is a personal attack, as is following it by claiming I’m showing a lack of courtesy. That shows no respect at all.
So …
…
… piss off.
I’m not interested in discussing things with someone who thinks a misunderstanding is a lack of courtesy and who meanly accuses me of not desiring to understand it.
Guess what? At this point, I don’t care in the slightest what you wrote. Talk to the hand.
w.
“Whenever anyone starts with “With all due respect”, I know they mean “With no respect”.
“No, François, that is YOUR conclusion, not mine. Don’t try to put words in my mouth.”
Well now–didn’t you just put words in my mouth, contrary to what you demand of others? I’m sorry you took it that way–but you have certainly revealed a major part of your personality. I wasn’t rude, and you can’t goad me into being so, but your comment here remains for all to see.
Good luck to you; you do good work, but have a problem with arrogance for which you like me probably don’t have time left in life to correct. I hold no malice.
And it wasn’t even a disagreement, Willis, just a suggestion of another way of looking at things. As I said, I intended no malice and my comment certainly fit well within any of the following definitions of the phrase, but you chose your own interpretation–as did Francois. Are you man enough to backtrack this a bit?
“with all due respect
Also found in: Dictionary, Thesaurus, Medical, Acronyms.
Related to with all due respect: by way of, at least, with all respect, Idioms
with (all due) respect
A phrase used to politely disagree with someone. With all due respect, sir, I think we could look at this situation differently. With respect, I just don’t see it that way.
See also: respect
Farlex Dictionary of Idioms. © 2015 Farlex, Inc, all rights reserved.
with all due respect
Although I think highly of you, as in With all due respect, you haven’t really answered my question, or With all due respect, that account doesn’t fit the facts. This phrase always precedes a polite disagreement with what a person has said or brings up a controversial point. [c. 1800]
See also: all, due, respect
The American Heritage® Dictionary of Idioms by Christine Ammer. Copyright © 2003, 1997 by The Christine Ammer 1992 Trust. Published by Houghton Mifflin Harcourt Publishing Company. All rights reserved.
with all due respect
Although I give you appropriate consideration and deference. This polite little phrase, dating from 1800 or even earlier, always precedes a statement that either disagrees with what has been said or broaches a controversial point. Thus the Church Times (1978) stated, “With all due respect to your correspondents, I do not think they have answered M. J. Feaver’s question.”
As I said, Len, claiming I didn’t read the comment “effectively” is a personal attack, as is following it by claiming I’m showing a lack of courtesy. Then you say that I could have understood your meaning “if I desired”. Which of course accuses me of deliberately not understanding you. Charming.
That shows no respect at all, regardless of what the dictionary might say. None. Now you’re back to whine that I shouldn’t be so meeean to you, saying “I wasn’t rude” … not rude? READ YOUR COMMENT!
As they used to say back on the cattle ranch I grew up on, “You can piss on my boots, partner, but you can’t convince me it’s raining” …
w.
Willis: You are a national treasure. Such a well written and thoughtful post. Much thanks!
Your kind words are appreciated. My goal is to make complex subjects understandable by my chosen readership, which I describe as “interested laypeople”. Not the specialists, just average folks that are always learning.
w.
and thank you for that
This.
“Current all-cause mortality in Europe and in Italy is still normal or even below-average.”
Tell this crap in Bergamo.
Population: 120,000 and decreasing
Corona-Dead: >1,000 and increasing
1% of total population in Bergamo is ALREADY killed by the virus.
Do not look at the total numbers in a country.
It is a very beginning of the avalanche.
Only Chinese and South Koreans are able to stop it.
Not the white people.
Dear Willis, take care.
You are at a risky age.
“Do not look at the total numbers in a country.
It is a very beginning of the avalanche.
Only Chinese and South Koreans are able to stop it.
Not the white people.”
yep. doing national averages hides the problem.
Its like averaging the USA windspeed when a Hurricane hits florida
Rounding up, if people would live 60yrs on average, then for 120tsd people you have 2000 deaths per year.
Nowdays, nearly all peole are dying in hospitals where they get a virus, so nearly any dead person has a virus.
How many months have we needed to accumulate to 1000 cases? If 5, it would be nearly normal death rate.
> Corona-Dead: >1,000 and increasing
What do you expect? Decrising cumulative numebr? If yes, I have bad news: number of dead peolple in Italy will increase into perpetuality, so long as Italy exists and/or people are living there.
text form
Italian Coronavirus COVID-19 Study
2003 deaths looked at
Average age of death 79
Under 30, NONE
30-39 5 0.2%
40-49 12 1%
50-59 56 3%
60-69 173 9%
70-79 707 35%
80-89 852 42%
90+ 198 10%
Comorbidities of 355 deaths
All had Covid-19
Hypertension 76%
Diabetes 36%
Ischemic Heart Disease 33%
Atrial fibrillation 24%
Cancer 20%
Chronic Renal Failure 18%
Chronic Obstructive Pulmonary Disease 13%
Stroke 10%
Dementia 7%
Chronic Liver disease 3%
Multiple Comorbities from above list
No comorbitities 3 1%
1 disease 89 25%
2 diseases 91 26%
3 or more diseases 172 48%
These die first.
The younger are still fighting and may fight for a month or even longer.
The outcome will be the same. They die.
Italy is burning gaze.
China, after the epidemy was over, has different data.
The median of dead is at 60 years.
The 3 or more comorbidity section kind of throws your argument out. As the number of comorbitities increases, the less likely they are the majority.
What might inform statistics still further is to look at the general prevalence of these conditions. For example (and in no way accurate) if 90% of people in the population had high blood pressure, it means that anyone who dies is likely to have high blood pressure, and so the 76% of deaths that exhibit it is less than pro rata. It also says nothing too much about the chance of dying if you do have high blood pressure and contract the disease.
I should have added that a condition with low incidence may have a very high comorbidity mortality rate. So if 1% are stroke survivors in the general population, it could be that 90% of them die if infected. Again just to illustrate the idea.
Anyone ever look at https://flightaware.com/live/airport/KDTW I am a bit of a plane spotter, my point is this – look at all those jets in the sky, those are group gatherings, it seems that COVID will spread quickly on airplanes.
There are lots flying empty to lose not their atrport slots.
‘In Germany, they are carrying home about 100.000 tourists from all over the world, not that it is an easy job orf coordination.
That shows a LOT of planes in the air. If we are a species with no more creativity than to burn that much jet fuel, to put that many hours on air-frames, merely to retain the bureaucratic requirement of maintaining an airport slot–the virus will win.
What ever, found it in the newspaper / news portal (German)
There is a regular poster on this site that supports the observation–‘flightlevel”?–who I understand is an airline pilot. He also has reported ‘business as usual’ in his experience.
And I just checked Flightaware again-and when zoomed out to include the entire US, the map still shows a thick fog of aircraft in the air. Canada with one tenth the population has far fewer than one tenth of the aircraft in the air that there are in the US. Something indeed very odd is going on here.
I thank you for drawing attention to this; I will watch it to see how it evolves. It does appear that some countries in the world are in economic shut-down, and others are not–which means that a major economic re-adjustment might be taking place.
At any point in the day there is the population equivalent of a large city in the air. It’s not quite as large a city as before the Wuhan virus, however it’s still a lot of people.
The numbers of flights airborne globally have been in sharp decline, and are probably down close to 50%.
Article here with more data on individual locations.
https://www.dailymail.co.uk/news/article-8150631/Deserted-skies-Flight-tracker-reveals-scale-global-coronavirus-lockdown.html
1) from what I have read, flying to keep bare minimum schedules
2) small package cargo. People at home order stuff.
I saw a headline just yesterday that Southwest Airlines is reducing their 4,000 daily flights by 1,500/day, starting Friday. I think I saw the article on Monday, SWA put out the announcement on Sunday, revising a previous announcement made on Friday that they were reducing by 1,000 flights/day. So they’re parking aircraft. I didn’t check on any of the other airlines ‘cuz that’s not what I was investigating at the time.
Willis,
You may find this analysis from a Scottish GP interesting,
https://drmalcolmkendrick.org/2020/03/22/covid-19-update/
It also analyses the Italian situation but from a medical viewpoint, particularly for those with hypertension and on specific medication. It is a few days older than the analysis above, so the numbers may not exactly match.
The Swiss doctor’s report you link to now itself links to an Italian government report, in English (dated 20 March). Don’t know if it’s the same one; but at least I don’t have to resuscitate my very bad Italian!
Willis makes a good point, but speaking as someone who had to make important decisions based on very little evidence I can see why we are where we are!
I have been in situations where you have to make a call, you cannot go back, you must go forward but none of the options are clear cut or palatable.
somebody has to call it, politicians are in the frame, and none of them are Winston Churchill, they are bluffers at best, crooks at worst, so we end up in a mess.
yup
Greta Thunberg says she may have coronavirus and is isolating with her father after displaying symptoms
I hope that she does recover quickly and takes time to reflect on misery to be imposed on humanity she has been advocating so recently.
https://www.dailymail.co.uk/news/breaking_news/article-8147765/Greta-Thunberg-says-coronavirus-isolating-father.html
Attention seeking more likely. She’s been off the front page for a while. Best way to get some more coverage is to “self declare” and write a press release with daddy. Plus a bit of virtue signalling about how responsible she is and setting an example for the rest of the world, as usual.
You mean Daddy wrote the press release, don’t you? I believe Greta Thunberg has had zero input in any of the press releases, posts, tweets or any other verbal burps attributed to her. Prove me wrong?
More likely she will just blame the Wuhan virus as due to CAGW and evil humans.
Quite a few celebrities are stressed by the lack of attention they are getting these days
Yes, definitely an “at risk” group we are ignoring. We should all go and click their like buttons on Instagram. It is so unfair to abandon them now when they need us most.
They who have given us so much and asked so little in return.
I enjoy irony; but I think you went Wayyy past irony with this statement.
Why do I feel suspicious about the flat mortality curve in China, a country with 1.4 billion inhabitants, many who are old. Are Chinese authorities calculating mortality differently than Italy, say?
The vast majority of cases were in Hubei province, which has a population of just under 60 million, so somewhat similar to the UK or France.
China literally shut down all contact with the rest of China, so they managed to in effect limit the disease area to only 50 million of their 1.5 billion.
If you use 60 million as the ‘population’ in the ‘Chinese outbreak’ things look much more consistent with the rest of the world.