# The Italian Connection

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/

(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.
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

## 645 thoughts on “The Italian Connection”

1. RonS says:

This entire episode looks like the “climate crisis” in full blown BS mode…Deaths per 10 million? Really?

• Willis Eschenbach says:

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.

• RStabb says:

Willis,

I’m well aware of that.

Thanks,

• Jonathan Bellview says:

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?

• astonerii says:

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.

• Doc Chuck says:

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.

• Nicholas McGinley says:

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

• Phil Rae says:

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!

• Robertvd says:

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?

• Nils Nilsen says:

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.

• Steven Mosher says:

SO, you have to decide.

do you feel lucky?

Dirty harry wants to knows

• DiogenesNJ says:

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.

• Steven Mosher says:

Also

UNLESS the R0 is 1.

tough decisions, uncertain data

• Nils Nilsen says:

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.

• Nicholas McGinley says:

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.

• Steven Mosher says:

“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

• Nicholas McGinley says:

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.
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.

• tetris says:

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.

• Robin Tolbert says:

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.

• TLM says:

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.

• TLM says:

“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.

• Red94ViperRT10 says:

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.)

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!

• Mario Lento says:

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

• Red94ViperRT10 says:

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.)

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

• Duane says:

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.

• Willis Eschenbach says:

Duane March 24, 2020 at 1:38 pm

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.

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:

What all the experts are saying is …

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:

Rethinking the Coronavirus Shutdown
No society can safeguard public health for long at the cost of its economic health.

and from the Telegraph:

Economic shutdown could kill more than coronavirus, experts warn
‘We do not have the luxury of choosing between the economy and saving lives’

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.

• mario lento says:

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!

• Nicholas McGinley says:

Don’t sell yourself short Mario.
When you said, “No” to Robert, that was as perfectly eloquent as it gets.

• mario lento says:

Well, thank you again. However, after the wack a mole “No”, Willis gave him a lecture full of reason that was satisfying indeed!

• Mike Jonas says:

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

• Steven Mosher says:

“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

• Kv s says:

We have a fairly large flu surveillance system. If the actions undertaken are worthy would the flu incidence rate be a reasonable proxy?

• Steven Mosher says:

It would if the flu were not naturally declining.

BTW if you look at flu cases you can see an UPTICK
misdiagnosed covid 19

• Mark H says:

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.

• Steven Mosher says:

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?

• RW says:

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.

• Charlie says:

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.

• Red94ViperRT10 says:

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.

• Nicholas McGinley says:

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.

• Been There says:

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.

• Tommy V says:

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.

• mario lento says:

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.

• Robert B says:

Anyone else suspect that it would be a good idea if Clinton was president?

• mario lento says:

No

• Nicholas McGinley says:

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.

• mario lento says:

Nicholas.
Anything that dilutes the absolute power of No was not needed!

You just put a big grin on my face!
Thank you!

• Nicholas McGinley says:

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.

• StandupPhilosopher says:

Is she was, the media wouldn’t be attacking her and her response and we wouldn’t have nightly bodycounts.

• Nicholas McGinley says:

Is the whole world acting as they are because of who is president of the US?
Seems very unlikely.

• mario lento says:

If she was we would not have an economy to destroy… she would have succeeded in that already. HRC is poison to the core.

• RW says:

StandupPhilospher is correct.

• Silas A says:

I have thought of that a number of times and Marlo’s answer is wholly accurate.

• mario lento says:

Thank you! took me like 1ms…

• Robert B says:

That The idea Trump had would be a good one if it was Hilary’s.

• D. J. Hawkins says:

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.

• Nicholas McGinley says:

That guy Duane has been rubbing me the wrong way for a very long time.
A thoroughly detestable sort of person, IMO.

• jeremy irony says:

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?

• Derg says:

Duane what color is the sky in your world?

• Glen V says:

It is whatever color the experts say it is.

• RW says:

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.

• Nicholas McGinley says:

“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.

• Agamemnon says:

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.

• Robert of Texas says:

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.

• mario lento says:

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.

• Steven Mosher says:

car accidents are not contagious
They don’t overwhelm hospitals.
its not about the death rate.

• mario lento says:

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!

• ironargonaut says:

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.

• mario lento says:

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.

• Charles says:

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.

• Mike Jonas says:

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?”

• ironargonaut says:

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.

• Darrin says:

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.

• Craig Strange says:

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

• Michael S. Kelly says:

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.

• Tom Kennedy says:

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.

• beng135 says:

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.

• Clyde Spencer says:

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.

• It doesn't add up... says:

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.

• RW says:

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.

• beng135 says:

Duane, it’s important right now to keep one’s self-control. Maybe time to self-lockdown.

• SunnyDay says:

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.

• Steven Mosher says:

“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

• SunnyDay says:

Thanks very informative. would like to see these plotted as well to give a more predictive picture.

• Jonathan says:

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 its 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.

• A C Osborn says:

When are you going to realise that COVID19 is NOT the flu.
The “flu is made up of 4 flu viruses, not just 1.

2. Alba says:

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.

• Mr. says:

I recall getting that pop-up too.

• Alba says:

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?

• Mr. says:

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.

• ozspeaksup says:

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

• ironargonaut says:

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.

• Bill Parsons says:

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!

3. Scissor says:

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.

4. John Tillman says:

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.

• Willis Eschenbach says:

Here you go, John …

w.

• Greg Goodman says:

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.

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.

• Willis Eschenbach says:

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.

• Phil. says:

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.

• Scissor says:

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.

• M Courtney says:

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.

• Tonyb says:

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

• Scissor says:

M Courtney, the thought of fabricated data crossed my mind. Whether artificial or not, I will continue to track this relationship.

• angech says:

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

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.

• Greg says:

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.

• Steven Mosher says:

“R=0.998 implies fabricated raw data.”

SMH.

and of course if it were .986, that would be “evidence” the data is good!

please go look at holocaust data and find something to deny

• Greg says:

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.

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! ).

• John Tillman says:

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.

• Scissor says:

It might be flattening. It probably will within the next week if it hasn’t begun to do so.

• MIKE MCHENRY says:

The high density public housing in NYC is a ticking time bomb

• Ron Long says:

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!

• John Tillman says:

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.

• Ron Long says:

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.

• John Tillman says:

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.

• John Tillman says:

Also possibly fewer smokers, but don’t know.

• MarkW says:

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.

• Stevek says:

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.

• Nicholas McGinley says:

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.

• Steven Mosher says:

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.

• Streetcred says:

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.

• Steven Mosher says:

Huh, moral high ground?

you’re weird.

• Jeffery P says:

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.

• Bindidon says:

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.

5. Pillage Idiot says:

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.

• Andy Pattullo says:

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).

• Rob says:

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.

• Crispin in Waterloo says:

Pillage

The important thing is that R0 is something that is within our orbit of control.

• kwinterkorn says:

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.

• Steven Mosher says:

“Coming, though, are antivirals (eg chloroquine) which will also likely reduce R0 by decreasing the time the infected carry the virus.”

not likely

• Willis Eschenbach says:

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.

• Steven Mosher says:

““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.
3. Gets symptoms.
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

• Clyde Spencer says:

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.

• Nicholas McGinley says:

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.

• Steven Mosher says:

“I have not seen a single discussion from the infectious disease specialists that R0 is a malleable property of the disease”

• SocietalNorm says:

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?

6. Retired_Engineer_Jim says:

Thanks Willis, thanks Steve. Stay healthy.

Willis, the data are sobering.

• Greg says:

Reminds me , I need a drink !

• Clyde Spencer says:

Greg
Try Bacardi Overproof rum, if you can find it. You can sterilize your mouth and throat if you drink it straight.

• Greg says:

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 !

• Vuk says:

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.

• M Courtney says:

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.

• Greg says:

“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.”

You are omitting another important possibility from your analysis: that the data is totally inhomogenous , contaminated by confounding factors and is meaningless. You see what I mean about not looking. As soon as you do , you fool yourself that the dots and lines may contain some fundamentally informative information, when they probably do not.

As hospitals get more and more stressed by case load and basic equipment and test kits run out or are in short supply, it must be obvious that the inherent “all else being equal” assumptions that you need to make to draw conclusions are baseless.

It does not seem to me that there is any structure or even an attempt to collect homogeneous data in the UK. All countries are struggling with testing and data collection but UK does not even have a system in place.

They will just declare the number of deaths they need to justify policy.

• Rhoda R says:

Nor do I trust the Chinese data either.

• Greg says:

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 !

• jorgekafkazar says:

“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.

7. rhoda klapp says:

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.

• Willis Eschenbach says:

Sorry, Rhoda, don’t have any data on that …

w.

• Billy says:

I have heard that 65% of people over 45 are insulin resistant which is pre diabetic.
Apparently this is from US stats.

• Polski says:

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

• icisil says:

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.

Daily defined dosage per 1000 inhabitants (DID) varies considerably between countries: Italy (Campania) 2016 (Malo S 2019): 220, Spain (Aragon) 2016 (Malo S 2019): 160; Lithuania 2012 (Lisauskienė I 2017): 190; Sweden 2012 (Lisauskienė I 2017): 145; Norway 2012 (Lisauskienė I 2017): 120; Australia 2006 (Huang LY 2013): 120, Taiwan 2006 (Huang LY 2013): 42.

• icisil says:

Another drug to consider is ibuprofen that the elderly use frequently for arthritis. The Lancet paper mentioned that it increases ACE2 expression.

• John M says:

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)

• Streetcred says:
8. Stan Sexton says:

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.

• Willis Eschenbach says:

w.

• Greg says:

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.

• icisil says:

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.

9. John in NZ says:

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.

10. 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?

• Klem says:

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!

• Ronk says:

that’s a dog bites man story, the wuhan virus is a man bites dog story

11. 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.

• icisil says:

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.

• Derg says:

Where did you hear about the hug a Chinese campaign?

• mario lento says:
• Derg says:

Thank you Mario…that was interesting to say the least

• mario lento says:

I know. The video was well made and quite moving. Seems successful. I find it quite disturbing.

• Fabio Capezzuoli says:

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.

12. François says:

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.

• PaulH says:

I read and re-read the article and did not see that conclusion.

• peyelut says:

That’s a nasty characterization of a simple probe of facts.

• M Courtney says:

The French health system was on the verge of collapse before the Wuhan virus.

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.

• Scissor says:

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.”

• Willis Eschenbach says:

François March 24, 2020 at 10:42 am

Looks like your conclusion is : “served ’em right, they were all sick anyway”.

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.

• yarpos says:

Its just information Francois, if you choose to put that spin on it thats you characterisation not anyone elses.

13. Bear says:

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.

• John Tillman says:

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.

• MarkW says:

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.

• John Tillman says:

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.

• Scissor says:

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.

14. Len Werner says:

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.)

• mario lento says:

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.

• Len Werner says:

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.

• mario lento says:

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.

• Steven Mosher says:

Yup

A good rule to follow is Tufte’s rule.

• Willis Eschenbach says:

I assume you mean this one, as Tufte put out a number of rules:

Tufte claims that good graphical representations maximize data-ink and erase as much non-data-ink as possible. He put forward the data-ink ratio which is calculated by 1 minus the proportion of the graph that can be erased without loss of data-information.

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.

• Willis Eschenbach says:

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.

• Len Werner says:

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”.

• mario lento says:

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.

• Willis Eschenbach says:

Len Werner March 24, 2020 at 5:31 pm

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.

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.

• Len Werner says:

“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.

• Len Werner says:

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.
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]
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.”

• Willis Eschenbach says:

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.

15. mario lento says:

Willis: You are a national treasure. Such a well written and thoughtful post. Much thanks!

• Willis Eschenbach says:

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.

• yarpos says:

and thank you for that

• Glen V says:

This.

16. Alex says:

“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

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.

• Steven Mosher says:

“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

• shortus cynicus says:

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.

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.

17. astonerii says:

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
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%

• Alex says:

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.

• astonerii says:

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.

• It doesn't add up... says:

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.

• It doesn't add up... says:

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.

18. John Bell says:

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.

• Len Werner says:

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)

• Len Werner says:

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.

• Paul Penrose says:

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.

• Dee says:

1) from what I have read, flying to keep bare minimum schedules
2) small package cargo. People at home order stuff.

• Red94ViperRT10 says:

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.

19. John says:

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.

20. 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!

21. john cooknell says:

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.

• Steven Mosher says:

yup

• Greg says:

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.

The teenage climate activist said she appeared to have been infected along with her dad, actor Svante Thunberg.

• Red94ViperRT10 says:

…and write a press release with daddy…”

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?

• Bear says:

More likely she will just blame the Wuhan virus as due to CAGW and evil humans.

• yarpos says:

Quite a few celebrities are stressed by the lack of attention they are getting these days

• Greg says:

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.

• Greg Cavanagh says:

I enjoy irony; but I think you went Wayyy past irony with this statement.

22. Jan E Christoffersen says:

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?

• Rhys Jaggar says:

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.

• Steven Mosher says:

Yes,

Willis doesnt understand the FIERCE lock down in China
the right denominator is 60 Million

• peyelut says:

Because you are NOT an Idiot.

23. yirgach says:

YACTS (Yet Another Covid Tracking Site)

This is for the US only, very good detailed state by state data (even history). Pretty much open source, downloadable raw data and API.

24. Chris Speke says:

Willis, I have come to the the conclusion that uk should let it rip! In the winter of 2014/15 we lost 35000 mostly over 65 ‘s to winter flu. The system was stretched but it did not drive uk to shut down. This relative pusseycat of a virus needs a clamp putting around it but as you intimate, the economy of shutdown is for the birds!

• Steve Richards says:

But the 35000 lost due to winter flu had a good crack at survival. GPs open normally, hospital beds available if you deteriorated, intensive care plus ventilator if needed.

Even then we had to ‘prepare’ the NHS for the winter flu season to ensure enough beds.

Now you propose, harshly I suggest, that if, say, 100,000 people needed to be hospitalized due to COVID19 then they should just die at home?

What kind of world do you want to live in and would you want your rules applied to you, your friends and loved ones?

ALL of the current disruption is to reduce the overload on health services around the world to give people a chance of survival if they become seriously ill.

• Chris Speke says:

Today, Prof David Spiegalhalter, a renowned statistician announced that he had found a significant fit between deaths due to coved 19 and expected mortality within the next 12 months which pretty much sums up the view that if your not so chipper over the age of 70 , do not get infected with coved 19 like viruses. In summary, most of the deaths from winter flu-like viruses are just deaths brought forward. If the UK health service refuses to prepare for such peaks this is no justification for shafting the whole economy. The alternative is sentimental claptrap.

25. richard says:

“According to Professor Ricciardi, scientific advisor to Italy’s minister of health, another reason is that anyone who dies in Italy and who has the coronavirus will be listed as having died of the coronavirus. So, 80-year-olds who die of cancer or heart disease, but who tested positive for the coronavirus, are listed as having died from the coronavirus. Professor Ricciardi says, in the Daily Telegraph, that when the National Institute of Health re-evaluated the death certificates only 12% showed a direct causality from coronavirus whereas 88% of those who died had at least one, two or three underlying illnesses. A study published in JAMA (Coronavirus Disease 2019 (Covid19) in Italy’) on 17th March 2020 showed that 87% of deaths in Italy occurred in patients over 70 years of age. All this inevitably pushes up the number of deaths in the country. It is surely dangerous to extrapolate from one country’s experience. It is, perhaps, surprising that more publicity hasn’t been given to these findings which seem to me extremely important. (If you remove just half of the Italian deaths from the global total the figure looks very different.) Yesterday, I said that I thought the Italian figures were wrong because they were putting down too many deaths as coronavirus”

• Greg says:

figures for Germany jumped by a factor of five a few days ago. Both cases and deaths. This absolutely not possible clinically. Someone has a big fat jackboot on the scales.

https://climategrog.files.wordpress.com/2020/03/2019-ncov-growth-germany.png

There must be some major change in how they are counting or diagnosing cases there. Unlike China which had a similar jump but were quite clear and up front about the changes at the same time as they published data, I don’t see any notice about changes in Germany. Like France this happened just before Merkel issued new national rules she wants the regional “Land” state authorities to adopt.

• John Finn says:

figures for Germany jumped by a factor of five a few days ago. Both cases and deaths.

• More you test, more cases you find and count.

• Greg says:

80 5940 30
79 1042 0
78 1144 0
77 1174 1
76 1043 4
75 733 3

day 80 is 20th March in ECDC data file. Probably figures from previous days fatalities.

The same day Baveria, Germany’s most populous state announced “lockdown”.

• MarkW says:

Or they got a fresh supply of tests.

26. LeenaS says:

The “diseases” mentioned in Fig 3 (apart from the corona itself) are pretty common in aged U.S. population, and not only in Italy, aren’t they? How many male citizens past 50 years of age have medication against hypertension and/or diabetes and/or heart disease?

• Willis Eschenbach says:

Half of them, though, don’t have three, count’em three, other serious health problems.

w.

• LeenaS says:

True.

But most of the men past forty seem to have at least one, and quite a few have two.
Plus the combo of diabetes + statins + blood pressure medication is not that uncommon in normal and otherwise healthy folks in U.S.?

27. Nick Schroeder says:

Latest WHO statistics, 3/24/20:
The top twenty countries (out of 177) have 90.6% of the cases and 97.4% of the deaths.
The US has 11.8% of the CORVID-19 cases and 3.4% of the CORVID-19 deaths (593)).
CORVID-19 is NOT a global issue.

The lying, rabble-rousing, fact free, shit-stirring, fake news MSM propaganda machine obviously want the public to believe that a positive test for the Covid-19 virus is a sho’nuff painful, expensive hospital stay which one probably won’t survive.

And if all 46,500 cases showed up for treatment it would be disaster.

But 98% of those US positive cases are asymptomatic, i.e. they don’t produce a data point, no doctor, no hospital, no death.

So, 2% of 46,500 = 930. That’s not going to tax the medical system.

Much like the climate change scam models assuming RCP 8.5 for all their hysterical predictions or accelerating sea level rise that did not exist.

• RStabb says:

Nick,

It’s like the fake ‘climate crisis’ on steroids.

• John Finn says:

But 98% of those US positive cases are asymptomatic,

Have you any evidence for this? Most countries are reporting that about 50% may be asymptomatic.

28. Jan E Christoffersen says:

Why am I suspicious of the flat mortality curve in China, a country with 1.4 billion inhabitants. Are the Chinese authorities calculating mortality differently than, say, the Italians?

• John Tillman says:

Most likely the ChiCom regime is just lying, but infection and death rates might well have flattened out.

Hubei has almost as many people as the UK, in 89% the area.

• Steven Mosher says:

“Why am I suspicious of the flat mortality curve in China, a country with 1.4 billion inhabitants. Are the Chinese authorities calculating mortality differently than, say, the Italians?”

Why are you suspicious? Dunno. But your suspicion is not evidence.

If you watch daily numbers from China at the most granular level ( city district) You’d have a
better understanding.

Folks in Beijing are dying as predicted. Every case is tracked, publically. All new cases are via
Import.

29. holly elizabeth Birtwistle says:

THANK YOU WILLIS, for your continued data-based articles and common sense commentary. I agree with you 100%.
People need to stop listening to the talking heads (most of the ‘authorities’ and the sensationalist media.)
I’m sure President Trump agrees with you, he will lead America, and the World, out of this crisis. He’s saying one more week, and then America is getting back to work, before this shutdown creates more deaths than Influenza and Covid-19 combined.

30. JP Miller says:

There is a strong possibility that a class of the most widely-prescribed hypertension medication in Italy (ACE inhibitors) may well increase the likelihood of worsening the symptoms because the medication may facilitate transport of the virus into the cell. I couldn’t find use data by country for ACE inhibitors, but that information would be interesting.

• Greg says:

Yes, there does seem to be quite specific biochemical evidence of ACEi being a major aggravating factor.

• Here is the original Swiss doctor’s letter in Lancet. They do note that angiotensin conversion blocking or inhibiting medications are used in treating the two main comorbidities, hypertension and diabetes. And the role of ACE-2 in coronavirus getting into cells has been known since the original SARS.

• Nicholas McGinley says:

I had read elsewhere that obesity was one of the main comorbidities.

But putting that aside, in the US, and I would hazard a guess in many if not all industrialized countries, hypertension is the number of health condition effecting the populace.
Diabetes is number 3.
Hyperlipidemia is #2.

I am not gonna spend all afternoon double checking, but a quick look seems to indicate that about 22% of people in the US have hypertension. It is 12.5% of all adverse health conditions present in the populace.

Diabetes afflicts 7% of everyone in the US.
It is 5.4% of adverse health conditions in the US.
I think the prevalence of these conditions means that a lot of people dying with those conditions is not very usual for any cause or manner of death.

• Nicholas McGinley says:

Typo…dang making a lot of them today, time to give it a rest.
“…hypertension is the number one health condition…”

• ozspeaksup says:

and that in part is the pharmas push to sell more by dropping the recommended BP reading that was considere safe
ie moved a huuuge amt of people to enforced BP meds or loose their healthcover.

and the average over 50yr old is oft stated to be on at least 2 meds and often up to 5 as their norm.
and many I know are..if theyre good lil sheeples
I chose surgery for the A-Fib and while it stopped the flutter Im finding Im still having the odd fast heart and BP rises
a lot of those dying may well have had other issues
but
the corona was what pushed their systems into failure, and yes maybe the normal(nasty) flu we sent you from down sth would also do it…for some -not as many I suspect
Spains now the hotspot with massive death tolls per day.
and Africas just taking off, some there on Aids meds or antimalarials might survive better
be interesting to see the end results there.

• icisil says:

I’m slowly trying to piece it together, but it’s not easy to find. Taiwan and Japan both prefer calcium channel blockers over ACEi and ARB, especially for the elderly. In both cases morbidities and deaths are low. Italy’s use of ACEi/ARB appears to be high (see my comment above); and their morbidities and deaths are high. I’ll post more as I find them.

• icisil says:

Because ACE inhibitors frequently cause a dry cough in E Asians, Japan set their maximum doses for ACEi lower than those in the US and Europe.

31. Stevek says:

Willis,

Regarding END THE LOCKDOWN!!, I agree if the economy collapses that will cause many deaths. Economic collapse leads to the tax base drying up. Municipalities will cut police forces, firefighters, local health services. There will be more homelessness. Financial difficulties lead to depression, divorce, kids not being able to pay for college.

Trump must balanced these factors against what the doctors are suggesting to end the spread.

• KV says:

Despair has been one of the main vectors for the opiate “crisis.” As another writer noted, the lockdown is worse than the virus itself and will surely lead to more deaths.

32. Maybe obstreperous Mr. Mosher can explain what test the Koreans are doing. The naso-pharyngeal swab is invasive and until recently it took around a week to get a result. Is the test simply a thermometer for a fever? No one is much doing this in the USA, but we should be.

• Willis Eschenbach says:

That’s the “obstropulous Mr. Mosher”. He knows much more than I, but I have heard that the Koreans are using a combination of fast tests and slower more accurate tests.

w.

• Nicholas McGinley says:

I had to look up that word, as my ear has always heard it as obstreperous.
I found that the way you are spelling it is a word, but it is a corruption of the word from old Latin:
“obstreperous
noisy, boisterous, or unruly, esp. in resisting or opposing
Origin of obstreperous

Classical Latin obstreperus from obstrepere, to roar at from ob- (see ob-) + strepere, to roar from Indo-European base an unverified form (s)trep-, to make a loud noise from source Old English thræft, strife

However,

“obstropulous
(comparative more obstropulous, superlative most obstropulous)

(obsolete slang) obstreperous
Origin
Corruption of obstreperous.”

• Greg says:

Thanks Nicholas. I was familiar with the word obstreperous but had not bothered looking up this new word.

“to roar from Indo-European base an unverified form (s)trep-, to make a loud noise from source Old English thræft, strife”

Probably the origin of “stroppy” .

• Red94ViperRT10 says:

I tried to look it up. I couldn’t find it. Thanks for enlightening me!

• Peter says:

I also live in Korea and follow the news on this topic closely.

The Koreans are using many different tests. They often use a combination of a nasal swap, mouth swap and a some spit. In some systems, test results are available within hours.

Korea is also requiring passengers arriving from abroad to install an app and to report health condition twice a day.

• Steven Mosher says:

https://www.nature.com/articles/d41586-020-00827-6

The tests in China and Korea take hours.
Korea will hopefully reduce this to 20 minutes

They were both prepared for this.

The issue is the test equipment platform. The US had selected a low volume platform.
They are switching now.

• Kip Hansen says:

Definition of ’obstropulous’
obstropulous in British English
(əbˈstrɒpjʊləs)
humorous, dialect another name for obstreperous

33. Andy Pattullo says:

Willis, great discussion about some important factors that impact mortality – age and comorbidity. There is another very important factor which likely explains a large amount of the variability in mortality rates across countries and another factor that may have some impact. The first is the testing itself. Mortality rate is the ratio of deaths to those infected, but we don’t know number infected for any setting except perhaps the closed experiment of the Diamond Princess cruise ship where 700 or so were infected and 8 died – mortality just over 1% among an older population. For all of the countries reporting the denominator of number infected is replaced by number of infections detected by testing. If countries tested far and wide they may well identified most if not all infections (no test is perfect) and then the mortality rate may be accurate. If, as in Italy you are caught with you pants down and only start reacting and testing when sick people show up in health facilities then you are missing possibly the majority of infections out in the community with minimal or no symptoms. This shrinks the denominator and provides an inflated mortality rate. If, like in Germany and those parts of China remote from Wuhan, you are forewarned and start testing early among well persons who might be at risk, you will capture a wider profile of infections and generate a much smaller death rate. The early testing and detection strategy also has its own artifact. By testing early and finding asymptomatic or minimally symptomatic cases you may give an artificially low death rate as some of those tested will ultimately become ill and some will die later (this is lead-time bias).

The second artifact in the data is case classification. If deaths are not classified the same in different jurisdictions then the same real death rate from the virus may appear different in different countries. It has been claimed that in Italy some of the deaths attributed in CoVID may actually have had other immediate causes but CoVID was blamed due to a positive test. An extreme example for illustration is if someone committed suicide but happened to test positive fo CoVID at autopsy it would give a very wrong impression to call that a CoVID death.

34. William Astley says:

“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 …”

I totally agree, Willis.

We are between a rock and a hard place. This is going to be a difficult problem to solve. (Restart world economy and stop the spread of the virus and/or reduce its death rate)

Every develop country is looking at instant 30% unemployment, many companies facing extinction, and all countries/states needing to borrow money because of collapsing revenues, due to the economic effects of extreme isolation.

We are facing an economic existential problem, not an economic recession.

People have a high standard of living because they are employed by companies and live in countries that are not bankrupt.

People do not get economic limits, the connection between a country’s current GDP, how much they have already borrowed, and the maximum amount a country can borrow.

35. Greg says:

Mosh:

go to work
stay away from crowds

… but go to work! The current western : shut everything down , is going to be far worse than the virus. At least your commander in chief seems to get it. Europe is screwed if they carry on.

36. Greg says:

“I was reading about loss of the senses of smell and taste being symptoms of coronavirus infection.”

Didn’t these medical experts notice that they lose sense of smell when they get a common cold too? Much of think of as “taste” is in fact smell anyway.

37. John Bell says:

Why now? The Chinese have been eating bats (or however this started) for 1000 years, why did this not happen before now? I suppose an animal virus mutated and got in to a person possibly by fluid contact.
I know I got viral bronchitis 4 years ago from kissing a woman who had been to Istanbul a month earlier and she had it but had no more symptoms. I was messed up for a week.

• Willis Eschenbach says:

I know what you mean, John. These days, when I kiss a woman it messes me up for a week too …

w.

• Doc Chuck says:

John, Your testimony naturally brings to mind the apropos candid lyrics from Burt Bacharach/Hal David’s song from their 1968 musical ‘Promises, Promises’ as titled by their last line here: What do you get when you kiss a girl? / You get enough germs to catch pneumonia. / After you do, she’ll never phone ya! / I’ll never fall in love again.

• John Tillman says:

The novel mutation supposedly required the bat virus to hybridize with a pangolin virus. Entirely possible that that had never happened before, or did a long time ago, when there were fewer people and no jet travel, such that the new virus died out locally.

• Toto says:

How a bat virus goes to pangolins and picks up a wicked spike/cleaver feature.
https://www.foxnews.com/science/the-coronavirus-did-not-escape-from-a-lab-heres-how-we-know
See the article for links to scientific papers. For those who do not follow links, here is the gist.

“A group of researchers compared the genome of this novel coronavirus with the seven other coronaviruses known to infect humans: SARS, MERS and SARS-CoV-2, which can cause severe disease; along with HKU1, NL63, OC43 and 229E, which typically cause just mild symptoms”

“[they] looked at the genetic template for the spike proteins that protrude from the surface of the virus. The coronavirus uses these spikes to grab the outer walls of its host’s cells and then enter those cells. They specifically looked at the gene sequences responsible for two key features of these spike proteins: the grabber, called the receptor-binding domain, that hooks onto host cells; and the so-called cleavage site that allows the virus to open and enter those cells.”

“That analysis showed that the “hook” part of the spike had evolved to target a receptor on the outside of human cells called ACE2, which is involved in blood pressure regulation. ”

“SARS-CoV-2 is very closely related to the virus that causes severe acute respiratory syndrome (SARS), which fanned across the globe nearly 20 years ago. Scientists have studied how SARS-CoV differs from SARS-CoV-2 — with several key letter changes in the genetic code.”

“The overall molecular structure of this virus is distinct from the known coronaviruses and instead most closely resembles viruses found in bats and pangolins that had been little studied and never known to cause humans any harm.”

“One scenario follows the origin stories for a few other recent coronaviruses that have wreaked havoc in human populations. In that scenario, we contracted the virus directly from an animal — civets in the case of SARS and camels in the case of Middle East respiratory syndrome (MERS). In the case of SARS-CoV-2, the researchers suggest that animal was a bat, which transmitted the virus to another intermediate animal (possibly a pangolin, some scientists have said) that brought the virus to humans. In that possible scenario, the genetic features that make the new coronavirus so effective at infecting human cells (its pathogenic powers) would have been in place before hopping to humans.”

“In the other scenario, those pathogenic features would have evolved only after the virus jumped from its animal host to humans. Some coronaviruses that originated in pangolins have a “hook structure” (that receptor binding domain) similar to that of SARS-CoV-2. In that way, a pangolin either directly or indirectly passed its virus onto a human host. Then, once inside a human host, the virus could have evolved to have its other stealth feature — the cleavage site that lets it easily break into human cells. Once it developed that capacity, the researchers said, the coronavirus would be even more capable of spreading between people.”

Scenario two has less probability of future outbreaks among humans, it says.

• Greg says:

1.

Then, once inside a human host, the virus could have evolved to have its other stealth feature — the cleavage site that lets it easily break into human cells.

So “inside” the human host, which is not a host yet because it has not developed a cleavage mechanism, and where without being able to reproduce even a single time, it mutates the necessary cleavage mechanism. Clever.

2.

In that possible scenario, the genetic features that make the new coronavirus so effective at infecting human cells (its pathogenic powers) would have been in place before hopping to humans.”

So with no evolutionary advantage in the string of animal hosts, it developed a “so effective” means of infecting a human host.

That reads like the NIST report on the collapse of WTC7. About as convincing.

Thanks for the link and reading the papers. Now I know it’s BS and the only way these “features” were acquired was with a little outside help.

Maybe it was the Creator, just messing with us again or it was the Franco-Chinese P4 biotech lab recently built in Wuhan a few hundred meters from the market ( where they would have ready access to wide range mammal genes to play with , since Chinese eat everything which moves).

• Red94ViperRT10 says:

The coronavirus did not escape from a lab: Here’s how we know

I bristle every time I see that phrase, and by the time I finish reading their “proof” I am damn near apoplectic! When you read the actual text, they don’t prove anything. The models indicated this configuration wouldn’t do what researchers thought it would do, so they wouldn’t pick this arrangement? That’s no proof! How do we know the Chinese researchers are using the same models as the researchers cited in this article use? What they’re really showing is, it’s not likely these researchers who constructed this model would have selected this configuration to build.

In any event, all this “proof” demonstrates is it may be unlikely the virus was genetically engineered (and they haven’t proved that), but that in no way even indicates this virus did not escape from a lab. Infectious disease researchers should spend more time researching diseases that occur “in the wild” than they do on genetically engineering Super-Bugs that could be used as bio-warfare weapons. Most likely scenario: this was another virus researchers were studying, who knows where they found it, or if it arose as a mutation of something else the researchers were studying, that did escape through carelessness, or even an unforeseen transmission through a route/vector that was left unguarded. I read one article that revealed workers in the lab would either steal research animals or “liberate” living specimens once an experiment ended that should have been destroyed, and sell them to make money, most likely in the wet market, or they could have had pre-arranged customers. And there is always the possibility that it was a willfully released disease that was under study in the laboratory.

Bottom line is, we may never know where this thing originated because the Chinese will not allow us to even enter their lab to investigate. Nor will they do the close examination themselves. More reason to hold the Chinese virus against them.

• Nicholas McGinley says:

1000 years ago there was not 10,000 commercial airliners in the air at any given moment, and some 100,000 such flights, each with between one and several hundred people each, traveling between every two cities on the planet every day.

38. Matthew Sykes says:

Hospitals are a notorious place to pick up nasty bugs. I seem to recall that all super-bugs are picked up at hospitals.

If you want to accept a large number of deaths, then end the lock down. Obviously slowing the infection rate allows the limited number of IC units to save the largest number of people.

Allowing firms that make IC units to do so is critical, and must continue.

All other non related social activity must cease.

That is of course logical.

• Nicholas McGinley says:

How about people selling food and medicine and stuff like that?
There may be a few others who are involved in things that not everyone in the country can really go a few weeks without.
In fact there are millions of people who need to get to work if the people in the hospitals are stores are going to keep working.
Gas stations.
Mechanics.
Home stores and other places that sell stuff for when someones well breaks, or their heater goes off line?
Is everyone with a busted appliance supposed to wait a month to get it fixed?
It really does not work when you start thinking about it carefully.
And if everyone stays home…will the bad guys?
Is everyone going to go back to offices that have been robbed blind in a few weeks or months or whenever it is?
Do we wait until no one has the virus to end the lock down?
This is a disaster, and there is no good way out of the fustercluck.

• Ed H says:

I don’t know what state you are examining. I know in the states I am most familiar with pretty much everything on your list are considered essential services and are allowed to continue to operate. Restaurants are restricted to take out, but we continue to frequent our favorites to help keep them going. Utilities and those who maintain them and repair them continue to operate, as do the stores that supply construction supplies. Gas stations are still open, etc. If there are places in the US that have locked down those items as non-essential, then that is too much.

• It doesn't add up... says:

Once ICU is at capacity they can’t save any more people, except through improved treatment that reduces stay times.

39. Rob says:

Norway’s outbreak is interesting from this nosocomial point of view – it has been reported by NRK (the state broadcaster) that a doctor returning from a skiing trip in northern Italy examined a couple of hundred patients before having any symptoms – many of whom then developed the illness.

And weren’t something like 35 deaths in Washington state all from the same long term care home?

40. MrGrimNasty says:

Spain, similar to Italy?

“MADRID: There are nearly 4,000 health workers infected with the coronavirus in Spain, more than one in ten of total confirmed cases, officials said on Monday (Mar 23) as the virus toll rose in Europe’s second-worst affected country.”

• Willis Eschenbach says:

Sadly, quite possible, as Spain’s death toll rivals Italy’s …

w.

41. Rob says:

The critical point here:

“We need to seriously quarantine the sufferers away from other sick people.”

Absolutely correct. We used to have isolation hospitals in years gone by (when we weren’t so squeamish) especially for respiratory diseases. In my lifetime, there were TB isolation hospitals in the UK and we have to consider what facilities are actually needed to treat Covid-19 cases and whether they really need to be treated alongside the rest of the hospital population. If it just a case of palliative care respiratory assistance, this can be provided in many facilities – hotels for example, or – dare I say it – redundant cruise ships!

It may be too late in some hospitals, but on a town-by-town basis this should be started right now and given much higher priority than locking down entire countries.

• Greg says:

My mother, a trained nurse, made the same point to me a few days ago. She trained in Manchester in the ’60s.

• The term “isolation ward” comes to mind …

42. J. REIBNITZ says:

Congratulations for your coronavirus-tracking post! One of the most useful in town.
May I suggest you to keep Wuhan Province in any updated chart of deaths per 10 million inhabitants, since Wuhan is probably the best benchmark for countries in the same range of population (Italy, UK, Korea, etc).
Best regards,
J. Reibnitz

43. I am also given to understand that Northers Italy has many Chinese living and working there. That the traffic between Northern Italy and China is very high. Thus some of them may have been infected. Also this has been kept under the radar because China is very sensitive and a huge investment by China in Italy would be threatened.

44. Ossqss says:

There has been much discussion on intubation, but little in the way of statistics on effectivness or recovery rates when in that condition.

45. David Blenkinsop says:

Toward the end of the head posting, Willis Eschenbach says “hundreds of thousands of people not working, jobs disappearing daily, and our economy in a shambles ..”

Here in Saskatchewan, one little province in Canada, with just under 1.2 million people in all, I’ve heard that roughly 10,000 “hospitality workers’, meaning restaurant and bar staff, have been laid off over this. Lots of those must be younger people with little chance of be able to do anything else but collect Employment Insurance (and likely some haven’t been in the workforce long enough to even qualify for that).

Maybe I’m being contrary to the conventional wisdom here, but, having made the decision to do this damage, how can authorities then complain about young people refusing to self isolate, actually carrying on a social life while laid off? They could have foreseen that idle people would socialize, undoing whatever edge they thought they had by arbitrarily tanking the economy!

Also, I note that the analysis suggesting that this virus has spread in Italy mainly via the healthcare system as such is quite intriguing. I wonder if anyone in authority is listening?

• Greg says:

“hospitality workers”, I thought that meant the sex trade.

46. KV says:

Another factor is that Italy has the lowest vaccine rate of Europe. It’d be interesting to know whether Italian elderly receive annual flu shots or have the pneumonia vaccine. Meanwhile, US media should encourage adults to get a flu shot, and wash their hands.

Ultimately, the US financial ramifications will create more despair and will cause a higher mortality rate then the COVID-19 virus. Meanwhile, 2 billion are infected with the flu which causes 300-500k global deaths every year…

47. c1ue says:

The Italy pattern isn’t dramatically different from the other epidemiological breakdowns. China didn’t have as many really old people, but still lots of old people.
However, I still note that a 0.2% to 3% mortality rate among 30-59 is still pretty damn serious. There are probably 70m to 100M Americans in those age groups; 140K to 3M is still a serious trauma to US society.
The medical impact is also likely to be high – I’m not seeing any indication that the ~20% serious respiratory problem rate is signicifantly lower for 25-59 vs. 60+.

• Willis Eschenbach says:

The mortality rate is among those with the disease, not the general population. In no country does even 1% of the population have the disease.

Taking the midrange population of 85 million in the groups you discuss, if 1% has the virus and the mortality rate is say 0.8%, that’s 6,800 people …

w.

• mario lento says:

“In no country does even 1% of the population have the disease.”

Yes indeed, nowhere close to 1%! Even the outlier, San Marino (a small country landlocked within Italy) has by far the highest at 619 cases per million, which comes out to 0.06%. Italy’s % of population infected has been counted as 1/6 of that. Spain is an order magnitude less than San Marino, and it falls off sharply from there.

Of course, we could try to extrapolate the number infected per population. But I ain’t going there 🙂

• Nicholas McGinley says:

We are not in an equilibrium situation.
A few months ago, the sum total of the living creatures on the planet with this virus may have been exactly one pangolin in a cage in food market in a city half a world away from most of us, in a city most of us never heard of.
But now, this virus may be one of the most numerous life forms on the planet, and my guess is the biomass of it is still increasing rapidly.

It is the trend…not the number.

• mario lento says:

I agree Nicholas, and in the vein, I wrote in…
“…Of course, we could try to extrapolate the number infected per population. But I ain’t going there “🙂

I do understand that there will be many more counted, and that the numbers will rise…

• Steven Mosher says:

“The mortality rate is among those with the disease, not the general population. In no country does even 1% of the population have the disease.”

and given R0, no country will ever have 1%, ……. for more than a day or so.

daily compounding interest is a wonderful thing.

wasn’t long about folks here pointing at 68 cases and saying Mosher you are nuts

Funny thing about discussing exponentials. One day you are right , and the next day
BAM.

Here’ hoping your hospital doesn’t exceed the tipping point

• John Finn says:

I’m not sure they are listening, Steve. Perhaps try again in a week or two. Thanks for posting the videos by the way. There are some good S-I-R tutorials knocking about on Youtube.

• Steven Mosher says:

They cannot hear. Its a threat to their identity.
I know it changed my life overnight as I commute from China to Korea monthly.

Folks will find multiple ways of denying/questioning/ data
Until it hits their life

• It doesn't add up... says:

I haven’t tried to run the numbers on the Oxford University model, but if their estimate/conjecture that 50% of the UK has already had the disease is correct it would imply a higher rate of peak infections.

• icisil says:

The young can have illnesses that have the same symptoms as CV and are just as deadly, but are hard to diagnose:

* Vaping illness (EVALI) that appeared just a few months before CV; most doctors have no experience with this disease.
* Tuberculosis among immigrants who brought latent TB with them from their home countries that have endemic TB

So if a youngster shows up at a hospital with either of these, and tests positive for CV, what do you think the diagnosis will be?

• John M says:

0.2% to 3% of the deaths, not of the whole population.

48. Michael Jankowski says:

“…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…”

Have to use the disclaimer that this disease crosses nationalities, races, genders, ages, etc.

But Italy has over 320,000 Chinese citizens. And this does not include Chinese people who gained Italian citizenship or were born to such parents. I’ve heard this is the largest in Europe. It is easy to see why it may have gotten established there from travelers.

49. Mike Dubrasich says:

Pardon my ignorance, but what exactly does testing accomplish?

If a person tests negative, does that mean they won’t get sick tomorrow? Can they go to work and mingle?

If a person tests positive, do we quarantine them? Where? With all the other positives or alone? For how long? Does a + get to leave quarantine in 2 weeks?

People who get the virus and survive are then immune. They can’t get it again and can’t pass it along. Do the Immunes have be locked down with everybody else? Wouldn’t it be better to have the Immunes get back to work? A herd of Immunes would be beneficial in many ways, including disrupting transmission.

But you can’t tell who is immune unless you test for antibodies, which is not happening. The Immunes are hidden. The herd is invisible. What good is that?

If you are real sick and choking, go to a hospital. If you have a minor cough, or no symptoms at all, what do you do? What good is a test, unless it’s an antibody test and you can get stamped Immune?

Does social distancing really work? Does it have an endpoint, a date certain exit strategy? Must we all be locked down forever? Who is going to feed the chickens?

• Ira M. Siegel says:

Mike Dubrasich March 24, 2020 at 12:36 pm
Pardon my ignorance, but what exactly does testing accomplish?

I think the testing concerns are really just one or both of the following: (i) a real interest in understanding the spread of the disease–in which case universal testing would be required, and (ii) a chance to spread the faux news of a supposed failure of the Trump administration.

For practical testing to be in any way helpful in the short term (and I’m not sure it would), we would have to do infection-tracing in the way South Korea is doing it. However, the people screaming that we in the USA have been having a failure in testing are of the same ilk who said we should not be doing infection-tracing during the HIV/AIDS outbreak in the early 1980s.

• re: “Pardon my ignorance, but what exactly does testing accomplish? ”

If symptoms appear, it gives adequate time to “treat”* (be treated) using one of several different regimens (including Hydroxychloroquine) found to offer “good odds” for a recovery …

.
.
* I’m assuming.

• Nicholas McGinley says:

All good points.
Testing negative for the virus only means you do not have any on the lining of your nose.
You may have got and cleared it, you may not have got it, or you may have just been exposed and not have any viral replication yet, or you might be exposed and become contagious ten minutes later on your way to the front door of the place you got tested in.
A negative test would have to be repeated like, daily or so, to be sure no one contagious was walking around and only having these tests to determine that.

• Tim Gorman says:

You bring up a *very* good point that I have yet to see mentioned on this thread.

So S Korea tested *everyone*? So what? Like you point out, those that didn’t show corona virus infection could show it tomorrow! So what good did the widespread testing actually accomplish? It gives you ONE SINGLE DATAPOINT concerning infection rate. You can’t trend from one data point! That one datapoint doesn’t tell you anything about the future.

And the data that S Korea is getting now is the same type of data the US is generating – infections vs deaths based on an ad hoc testing regime. At least I have not read anywhere that S Korea is continually testing the entire population over and over again.

I suspect that SK is has probably instituted the same protocols the US has such as social distancing, isolation, etc. They just started sooner than we did.

• Nicholas McGinley says:

About the only type of testing I can imagine being really helpful in navigating something like this with anything like aplomb, would be for everyone to have a little watch on that continuously monitors the blood and tests it in real time.
By the way I just thought of that and I got dibs on the patent.

• Even without symptomes you can infect others, as they told us here in GER today.

• Greg says:

That is not a news item. That is normal during the incubation period. COVID-19 has a relatively long incubation period for a flu virus ( 2-12 days, median 5d ) . Part of the reason it spreads so quickly.

• Steven Mosher says:

“Pardon my ignorance, but what exactly does testing accomplish?

1. identifies the positives, asymptomatic and symptomatic. Gets them out of circulation
and into hospitals

If a person tests negative, does that mean they won’t get sick tomorrow? Can they go to work and mingle?
2. They might get sick tomorrow.
3. In Korea, yes you can go to work.
4. MINGLE? No one should mingle.

If a person tests positive, do we quarantine them? Where? With all the other positives or alone? For how long? Does a + get to leave quarantine in 2 weeks?”

1. Yes they are isolated.
2. Where? In china they set up gyms and large facilities with hundreds of beds for less serious
cases. In Korea the government took possession of 7000 offices and converted them
to life care centers. Most cases are not serious, they go to life care centers
3. With other positives
4. Until they need the hospital or test negative several times.
5. You leave when you are well and test negative

50. William Astley says:

Here are two medical, paradigm changing breakthroughs, that might end the Corvid-19 problem/crisis.

https://www.distributedbio.com/covid19

First) Corvid-19 Antibody
A US company, ‘Distributed Bio’ have developed a technique that produces Corvid-19 anti-bodies that they believe will kill the virus in the body and provide the body with 8 weeks protection against Corvid-19.

This is different than a vaccine.

A vaccine is given to healthy people so they can give their body the capacity to produce antibodies.

This new technology (other companies are working on the same new technique) directly produces the antibody.

The antibody can then be given to sick people by injection and within 20 minutes the injected antibodies will start to kill the virus in the body of the infected.

The antibody can also be given to health people (target group, health care works) and if it works it will provide them with 8 weeks of protection against the virus.

The first tests of the new antibody, to test for virus killing effectiveness, will be July of this year in the US.

If all goes well, mass production of the antibodies and use in humans could start in September, 2020, this year.

Second) Universal Vaccine
The second is the development of the so-called universal vaccine.

The Universal Vaccines concept is to develop a vaccine that attacks the portion of a virus that does and cannot change.

A universal vaccine if it worked is a game changer, as it eliminates the need to vaccinate every year and makes the vaccine much more effect every year.

This is a link to a Distributed Bio’s discussion of their universal vaccine CENTIVAX which they say also would be effective to stop Corvid-19.

https://www.distributedbio.com/centivax

CENTIVAX

https://www.distributedbio.com/covid19

51. Michael Carter says:

Word of mouth info from a cousin who’s uncle died from Spanish Flu at age 28, in NZ:

The outbreak in NZ lasted from October to February (our summer). I will research it

52. J Rojo says:

Willis,
Your comment makes even more sense for the situation here in Spain with a culture and a population structure similar to that of Italy. Infected people under 60 outnumber those above 60, and are (roughly) evenly distributed by sex, yet the dead are overwhelmingly males over 60-70. In support of nocosomial factors, almost 13% of all recorded cases are people related to the health system. Add poor testing and equipment, and we are first in the race.
As to the effect of gatherings, one can see in the link below that, unlike older groups, women 25 to 60 outnumber men. I wonder if that has to do with the goverment-supported feminist rallyes of March-8. In fact, several participant female ministers (and the primer minister’s wife) got sick.

53. Ben Vorlich says:

Willis,
I don’t know if you’re aware that by Median age Italy has the 6th oldest population in the world. I think Greece is 5th, Germany 4th, Japan 2nd and Monaco 1st. Monaco is a bit of an odd one, but the other nations venerate their old and grandparents.

• Willis Eschenbach says:

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.

w.

• mario lento says:

And to fortify Willis’ consciousness of age and it’s relation to this post:

“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.”

54. c1ue says:

Willis,
One question I have: is it possible that the results for this preliminary study could be skewed because the really sick people die faster?
nCOV/COVID-19 doesn’t seem to be like SARS-1, which was killing younger people via cytokine storms.
Rather, it seems like nCOV goes from virusemia, to viral and bacterial pneumonia, to non-cardiopathic edema, to sepsis. Given this progression, it doesn’t seem unlikely that someone already sick would die pretty quickly, but that someone otherwise healthy would either recover or take a lot longer to expire.

55. I have just visited another excellent website, The Cosmic Tusk. Here you will find several very important posts from Dr. Chandra Wickramasinghe, an expert on viruses. The Dr. has theorized over the past many years, about viruses as originating from space. Specifically, the viruses are seen as entering the EARTH’S atmosphere and then taking in certain regions and then spreading elsewhere, and often becoming a widespread disease such as the current Coronavirus. I think the Dr.’s ideas deserve serious consideration, as he explains the origin of the Corona virus as beginning in China, from a fireball that struck China not that far from the city of Wuhan, where this virus got its start.

• re: “The Dr. has theorized over the past many years, about viruses as originating from space.”

Hmmmm … from where in “outer space” does the good doctor theorize these originate? This also presumes ‘life’ is out there, yet, we found (at least) no sign of it on the moon (in the samples brought back I’m presuming.)

• Hi Jim: I will just add, that conditions within comets is much different than our believed to be on our sterile moon. There are very complex molecules within comets that are capable of supporting viruses. This of course also implies that the virus can withstand extremely hot conditions. And this of course, the good doctor has taken into consideration

• MarkW says:

The existence of organic chemicals does not mean, or even imply that comets are capable of generating viruses.

He has taken this into consideration? How? It is well known that heat kills viruses.

• John Tillman says:

Virus aren’t supported simply by complex molecules. They can’t reproduce without cellular machinery. They don’t have metabolism, so can’t make use of organic chemistry less complicated than biochemistry.

The constiuent building blocks of life do exist in space, but as yet no evidence supports actual cellular life. It’s not outside the realm of possibility, but there is zero, zilch, nada evidence in support of viruses from space as yet. It’s pure, idle conjecture and, as noted, highly improbable.

Just like the Cosmic Tusk’s evidence-free Younger Dryas impact speculation, easily shown false.

• John Tillman says:

Highly unlikely, to say the least.

The genome of the virus from space just happens to be highly similar to those of a local bat genus?

And the 2015 and 2019 fireballs were far from Wuhan, both in NE China.

• MarkW says:

It is well known that UV light can kill most viruses.
Space in the region of earth is loaded with UV light, and there are no shadows to hide in.
If these viruses were coming from space then they would have been killed millions, if not billions of years ago.
Beyond that, how do they get through entry into the atmosphere without burning up. Yes, they don’t have much mass so they would slow down quickly. However, they don’t have much mass which means it doesn’t take much energy to heat them up.

• Ellen says:

Most viruses on/in comets would be safe from UV. Say your comet is something like a mile across (seems to be the right order of magnitude for the comets we have studied). The UV hits the surface of the comet. But there’s a lot of comet that isn’t surface.

• John Tillman says:

Nor is Dr. Wickramasinghe an expert on viruses. He’s a mathematician and astronomer.

• Agreed, John Tillman, but Dr. Wickramasinghe has been working in the field of astrobiology for decades and he along with the now deceased Dr. Fred Hoyle, another renowned expert on astrobiology, I believe must also be well acquainted with the nature of viruses. Within comets as Ellen points out, there are places in a comet that are not heated as much by their travels, even as they enter the Earth’s atmosphere. I am not totally convinced of the Hoyle/ Wickramasinghe theory, either, but I think it does warrant some further scrutiny.

56. Stevek says:

In other news New Orleans is reporting rats are coming out on to the streets due to restaurants shutting down. The rats are hungry and looking for food. This is no joke, google it for articles.

• icisil says:

That would be great fun to sit up on a balcony with a pellet gun.

57. leowaj says:

Willis, great read, as always. Just thought I’d share that I have a family member who has worked in a hospital for nearly 20 years now that services about 60,000 people in a rural area in the US. That hospital has already implemented extreme preventative measures. And they haven’t even had a COVID-19 case in the area. (And hopefully they won’t at all.) Among many of the practices they’ve implemented, they’ve closed all entrances except for the emergency entrance, where potential COVID-19 patients must enter. Foot traffic in the emergency entrance is guided to specific places that are isolated from the rest of the hospital. If you walk in with a fever, you are immediately escorted to an isolated area. Even vehicle traffic is clamped down, with checkpoints, and entire sections of the parking lot closed off to keep the number of human beings in the hospital as low as possible.

Assuming all hospitals around the US are doing this, I think were prepared for it. Not saying it’s the end-all-be-all solution, but as you pointed out, containment is hard when spreading outside the hospital, and much harder when it spreads within the walls of the hospital.

Thoughts and prayers for our Italian friends out there.

58. William Astley says:

This is a link to a CNBC video that interviews the CEO of the company that have used new technique to virus.

See my above comment for details of the new medical science. As noted in my link and this interview, human tests are scheduled to start in July of this year and if the test works, mass production and use in humans could start in September of this year.

https://www.cnbc.com/video/2020/03/23/distributed-bio-ceo-on-developing-therapeutic-antibody-treatment-against-coronavirus.html

• Nicholas McGinley says:

The FDA might have something to say about that.
Certainly nothing like that timeline has ever happened in the US for a new drug application.
There are a lot of ifs going on here.
This stuff has not been given to a single human being.
There are a lot of people who have lost a lot of money listening to drug company hotshots with glowing tales of their life saving new med that is just a formality to get through testing.

59. Stephen Richards says:

Someone feel free to give me my prognosis.

I have Hypertension, Diabetes, MGUS. Chance of survival ? 2% ?

• Latitude says:

you will 100% live and be fine Stephen….a Dr in NY was just on the news….said he has given Hydroxychloroquine to every patient that has come in….they have all recovered

60. F4F111Col says:

Willis, your nosocomial theory seems to find at least anecdotal support from reports of multiple deaths of Italian medical personnel in recent days.

61. Snape says:

Snape on March 24, 2020 at 2:49 pm
Starting March 9, I’ve noted the dates when a doubling of total fatalities from COVID-19 occurred (global).

3/09/20: 4,000
3/17/20: 8,000
3/23/20: 16,000

https://www.worldometers.info/coronavirus/

• Snape says:

Whoops, I didn’t mean to include the top line.

62. Nicholas McGinley says:

Everyone with high blood pressure is not exactly on their death bed.
Just saying.
Same with diabetes.
Many people live long and otherwise perfectly healthy lives with these conditions well controlled the whole time.
Over 100 million Americans have hypertension.
That sounds like most people over some middle age.
Another thing that ought to be mentioned is that a lot of people that are not very old and getting very sick and living.
In Italy they have had to decide who they will give a ventilator and a bed too.
Anyone with viral pneumonia and lack of proper care is gonna die.
The young people who live through viral pneumonia will not be back in the pink in a week or two…many of them will never be the same.
Most people who are youngish and get decent care can live through just about anything, but it aint no picnic, and it does not mean they are not severely damaged.

I lived through a car accident in 1982 that just about killed me, but I was very stubborn, the the surgeon who just happened to be at the Lake Hospital clinic in Yellowstone Park that morning was very very good.
But I was definitely never the same.
The binary case, lived/died…rarely tells the story where such matters are concerned.

Just sayin’.
I am not saying it is wrong to put lipstick on a pig…just that this is lipstick on a pig.
This disease is not a bunch of people who were waiting to die, finally kicking the bucket.

63. gringojay says:

Commentators have mentioned ACE inhibitor drugs in relation to proclivity for Wuhan virus fatality. I’d like to contextualize a few details, with the caveat I am not in a position to confirm these drugs are actually a co-factor in the disease outcome.

ACE inhibitors are commonly prescribed for hypertension. While diabetics get it for it’s antioxidant properties (drug limits precursor reactive carbonyl & also stymies oxidative sequels required to form advanced glycation end products. COPD lung patients on oxygen get it because reduces the drug reduces fatal outcome rate.

The medical test for the ratio of albumin to creatine is used to determine if a patient has albuminuria. So called micro-albuminuria (excess albumin) conditions are a diagnostic indicator often used for diabetics being prescribed an ACE inhibitor.

Excess albumin is clinically often associated with some degree of tissue damage in both the kidneys and the lungs; and ACE inhibitors are a drug for limiting lung damage. In cases of chronic micro-albuminuria there is an increased risk in lung patients with COPD of experiencing low oxygen content in the blood. Furthermore, smokers also have excessive albumin & chronic smokers have a propensity to kidney glomerulus damage (sclerosis).

What needs to be understood is that drug regimens that worked for patients from their 40s to (say) 70s are not necessarily appropriate for geriatric years. And also sodium restricted diets are another common age appropriate consideration.

Let me try to connect things in light of how excessive albumin relates to kidney glomeruli damage causing reduced filtration rate. ACE inhibitors reduce renal pressure & thus filtration in kidney glomeruli; while restricted salt plus ACE inhibitors reduces glomerular filtration even more. NSAID drugs (ex: ibuprofen) are anti-inflammatory drugs deemed COX inhibitors & this class of drugs significantly reduces sodium levels – to the potential extent of causing renal vaso-constriction.

Which brings me to the conundrum of why male mortality rate (in Italy at least) is higher than for women. The diagnostic level of albumin where micro-albuminaria kicks in is 20mg albumin/g. for adult males & it has to rise to 30mg albumin/g. for adult females.

In the geriatric cohort they can get low sodium despite regular sodium intake with food when take a diuretic. And a drug combination of ACE inhibitor plus diuretic is prescribed for congestive heart failure.

• gringojay says:

edit: should read “…renal vaso-constriction…” in last words of last sentence ending 3rd paragraph from bottom

• Willis Eschenbach says:

Fixes, I hate typos, although I did enjoy “renal caso-construction”.

w.

64. brent says:

The first alarm was about SARS. At the time, pundits predicted that SARS would become a pandemic and that more than 100 million people would die. Wrong. SARS died out because it was not really very infectious outside of hospitals.
http://www.thestar.com/comment/article/669727

• brent says:

Schabas: Get a grip – SARS is nasty but it’s not the next plague
The SARS outbreak in Toronto was a hospital-based problem. The vast majority of SARS victims have acquired their infection either directly in a hospital or by infected hospital staff, patients or visitors who infect other members of their household. This hospital-based problem has been brought under control.
snip
There have been very few cases of community-acquired SARS, and there is no evidence of a sustained community spread in Canada.
SARS transmission is by respiratory droplets; it is not airborne-spread. This means that, in practical terms, it requires prolonged close contact with a SARS patient to become infected.
The disease has been effectively controlled in Toronto since stringent respiratory precautions were introduced in hospitals over the latter half of March. The success of these precautions is the great story of the Toronto experience and our lesson to the world.
https://www.theglobeandmail.com/news/national/schabas-get-a-grip—sars-is-nasty-but-its-not-the-next-plague/article1159807/

65. Uzurbrain says:

Did they do an Autopsy? Seems strange that only 1% had no other disease. By that I mean that it is entirely, stylistically, probable that close to 1% actually had some other disease and it was not diagnosed and thus not in the health record. Seems to me that more than 1% of the population is walking around, functioning normally with one of the diseases that would aggravate the conditions when combined with COVID19.

66. Stephen w says:

Thanks WE, a real eye opener.

But of course the sample is not a cross section of normal healthy society. It’s a cross section of people who are now dead, so obviously not healthy. But it doesn’t prove whether or not their origins are hospital.

67. Nicholas McGinley says:

“This little beastie lives on surfaces for up to 3 days. ”

Reports today from the people investigating the cruise ship tell of them finding live virus in the cabins of the people who were infected, both the symptomatic and the asymptomatic ones, over 17 days later!

I am not sure what to make of this.
It turns all previous research on the subject on it’s head.
Now, the report was short on detail, and it seemed to say that what they found was viral RNA.
I am not sure if it is a fact that finding viral RNA means live virus is present, or if it is, if it is infective.
I have read a lot on this topic over the past few months, and at least one or two reports were to the effect that some human respiratory viruses can be alive on surfaces but no longer infective. Not that this makes a lot of sense…since viruses are not exactly alive on their best day. What does it mean to be alive but not able to cause an infection in a host? What other definition of alive is there for a virus?
Like a lot of things we hear these days, every scrap of info leads to more questions than answers.

• John Tillman says:

Could be indoors. But direct sun does seem to destroy (or kill, if you consider virions to be alive) them fairly rapidly.

• Stephen W says:

If it can survive on surfaces for that long, I expect it can survive in water supply.
I’m curious what the water treatment is on cruise ships, do they chlorinate the water between reservoir and tap? Are they wiping surfaces down with tap water?

The high rate in Wuhan specifically, in comparison to the rest of China also makes me suspect the water supplies, as if there’s something common they’re all accessing, hence the spread, and possibly why it was so deadly in Wuhan in particular in comparison to the rest of China.

• Latitude says:

Nicholas, they found RNA..not a live virus

..the report wasn’t short of detail…the media was long on hyperbole…as usual

68. James Snook says:

Item on BBC news this afternoon:

But why has Italy been so badly hit by this pandemic?

Pierluigi Cocco, an Italian epidemiologist based in the Sardinian capital of Cagliari, tells the BBC that while it is too early to determine the reasons behind this, there may be many.
“One could be genetic,” he says, meaning the effects of the virus “may vary across ethnic groups as well as individuals”.
“Some can carry the virus without any symptoms, and others die quickly, with a whole range of severity in between,” he says.
He adds that Italy has one of the highest numbers of elderly citizens in the world – the elderly are generally more susceptible and more prone to develop serious consequences once infected.
There are other contributing factors, he says, such as the cultural and social attitude of Italians, who “like to meet in large groups and exchange signs of affection with each other”. Families also remain close, with generations often socialising together.
In addition, he adds, a possible reason behind the higher mortality rates in the north is air pollution.
“The levels of industrial activity in that area, coupled with urban traffic and the climatic peculiarities of the Po Valley worsen air pollution, thereby increasing the prevalence of respiratory diseases that make people more susceptible to the effects of Covid-19.”

69. Toto says:

https://www.foxnews.com/media/newt-gingrich-italy-south-korea-coronavirus

Former House Speaker Newt Gingrich, who is currently in Italy with his wife, told the “Fox News Rundown” podcast Tuesday that flight connections between Wuhan and Milan may be the source of the early coronavirus outbreak in the European country, which currently has the highest death rate of any nation affected by the pandemic.

“None of us, at least I didn’t know that there were 100,000 Chinese [people] living in northern Italy and that many of them come from Wuhan and that there was a flight between Milan and Wuhan,” Gingrich explained.

“We think that’s how the virus got Italy early,” he added. “Initially, the government didn’t realize how dangerous it was going to be … it dealt with it initially as sort of a small town, local regional problem, and then boom, it exploded.”

70. Paul R Johnson says:

Willis,
There seems to be an uptick in U.S. deaths coinciding with increased testing. Are earlier deaths presumed to be COVID-19 (or not) being re-attributed post-mortem? If so, are these deaths counted on the date of death or the date of the test results? It would change the shape of the curves.

71. Vuk says:

John Bell March 24, 2020 at 11:46 am
“Why now? The Chinese have been eating bats (or however this started) for 1000 years, why did this not happen before now?”
Lancet: Notably, 2019-nCoV was closely related (with 88% identity) to two bat-derived severe acute respiratory syndrome (SARS)-like coronaviruses, bat-SL-CoVZC45 and bat-SL-CoVZXC21, collected in 2018 in Zhoushan, eastern China, but were more distant from SARS-CoV (about 79%) and MERS-CoV (about 50%).
My DNA has 97.5 % identity with a DNA of a mouse and 50% with the DNA of banana.
Mistakes do happen, and this is going to be a very expensive one.

• Nicholas McGinley says:

There are four corona viruses that are constantly circulating amongst human beings and causing one out of three common colds.
So my guess is, it has happened many times, some do not become widespread, and of the ones that do… over time we get used to each one after a while.

• John Tillman says:

Wuhan virus has a tiny genome, which evolves very rapidly. The ID with bat and pangolin coronavirus genomes is based upon sequences.

Even for us cellular organisms with much more stable DNA as the storage molecule, one needs to be careful to compare like with like. In eukaryotes, the comparison can be with the mitochondrial DNA, the whole nuclear genome or only those sequences coding for proteins, ie “genes”.

For instance, human and chimp protein coding sequences are 98.5% identical, but the “junk” sequences diverge more, as would be expected because epigenetic material includes control areas, such as for how long body hair or leg bones should grow.

Corn (maize, or in Chile choclo) and its wild Mexican ancestor teosinte are 100% identical in terms of proteins. Their startling differences are entirely because of control sequences.

• yarpos says:

Who says it hasnt happened before? we are a much better informed and aware world now so we know what goes on in other countries. Sadly we are also far more connected than ever before so spread is far more dynamic.

72. One factor in the coronavirus pandemic to justify a strong response, is the traumatic nature of death by coronavirus viral pneumonia. It’s a bad way to go, essentially drowning while coughing up blood from fluid filling lungs. And isolated from all family and friends.

Findings from the Wang et al study published on JAMA and based on 138 hospitalized patients show that,
despite the talk of needing more respirators, that once Covid19 goes down the path of serious complications, time is short and chances of successful treatment are not high.

https://jamanetwork.com/journals/jama/fullarticle/2761044%20

The median time observed:
from first symptom to → Dyspnea (Shortness of breath) = 5.0 days
from first symptom to → Hospital admission = 7.0 days
from first symptom to → ARDS (Acute Respiratory Distress Syndrome) = 8.0 days (when occurring)

Fear of a bad end like that is inspiring a lot of popular support for the lockdown policy.

Note also – Covid19 has a long tail.
Among those with serious illness who “recover”, many have permanent lung damage and they can remain hospitalised, even on a respirator, for weeks or even months. That’s why in China, where the spread has long been curtailed, there are still several thousand patients in intensive care. You never get that with flu. Comparisons of Covid19 with flu-colds are inaccurate and not helpful.

• icisil says:

Evidence suggests that this is a multi-factorial illness with more than one cause. Flu for most, but more severe to deadly for various risk groups.

73. Henry Pool says:

Hey Willis, Fearless Leader says he’s going to back off on restrictions by Easter. You are a smart guy, will he listen to you and can you please change his mind?

74. charles nelson says:

I read an interesting piece which compared Italian and Japanese aged health care models.
Italy relies highly on low paid migrant workers (both legal and illegal); many of whom are poorly trained, speak little Italian and come from countries with poor hygiene standards.

75. Thanks Willis – for a well-written dose of sanity amid the panic and hyperbole. The Italian analysis answered many questions.

76. Keith Peregrine says:

My concern is the reliability of the data. China has been attacking those who have been raising concern since the beginning. From defaming Dr. Li Wenliang to shutting down people reporting on happenings in China itself while blaming the US for the origin and claiming that the epidemic had ended in China.
Italy may have overstated the number of cases and of course, with limited testing in the US, the true numbers cannot be fully known.
This leads back to the old maxim: Garbage in, garbage out.

77. Go Home says:

Willis, great data charts and I like your use of starting with the day since first death.

It would appear from your charts that NY is on track to get to ‘common flu level’ in 15 days (assuming they do not bend the curve), which is half the time that it took Italy to get to that level (31 days). Several of the other states (same assumption) will get to that common flu level way before Italy.

NY has ~12% of population over age 65 with Italy at ~22% over the age of 65.

Would that counter your suspicion that Italy high death rate is primarily due to “And in some fashion, it got into the medical system.”? Or would you make that same suspicion in NY?

It seems that quarantining the country from travel to and from these hot spots in this country should be considered, similar to what Florida just implemented. Trump is looking to relax restrictions where it seems to me to be too early to make that call. Unless you are trying to solve the Social security trust fund issue.

78. ren says:

New York state is also running a clinical trial beginning Tuesday of a treatment regimen of hydroxychloroquine and azithromycin, two drugs that doctors in Africa and elsewhere say they’ve seen anecdotal evidence it may help fight the virus. The state health department will also be running a clinical trial using the blood plasma of recovered patients to treat new infections, he said.
https://www.cnbc.com/2020/03/24/troubling-and-astronomical-coronavirus-cases-increase-urgency-for-hospital-beds-new-york-gov-cuomo-says.html

• Nicholas McGinley says:

The blood plasma will definitely work.
As for that other stuff, Over a week ago we saw a directive for emergency room doctors from at least four countries in the EU list it for the treatment of choice of all but the worst off of the corona virus patient.
Over a week ago.
They apparently have plenty.
People are dying in large numbers of this in all of those countries, and I am looking for but not seeing some diminution of the numbers in those places.

If that stuff was working, why are so many still dying?
One possibility is that it is not working.
I suspect any of the things we have to use will help at best some fraction of patients.
This is what is usually found with with antiviral therapies until a lot of work has been done, typically over many years, and combinations are identified that become either gradually or sometimes and occasionally dramatically more effective.
I can recall zero instances of a new disease of such a nature being overcome with off the shelf drugs in more than a percentage of people.

• ren says:

Chloroquine increases the effectiveness of zinc anti-viral activity, and the antibiotic protects against additional bacterial infection. Plasma from people who have antibodies can be very effective. The virus is not transmitted through blood.

• Nicholas McGinley says:

My point is that people are still dying in the places that have made hydroxychloroquine the standard of care, and in fact the number of daily deaths has increased sharply since that standard was adopted.
So if it does work, it is only working for some, and only helping somewhat.
The clinical trials testing chloroquine over the past two decades vs various viral illnesses have all failed to show any direct antiviral benefit.
Also, these are drugs taken by many millions of people over many decades, so if it is a general wide spectrum antiviral, as is implied by the assertions made for the value of these drugs, why has no one ever documented a decreased incidence of viral illness in the people who take it for malaria?
The benefit for people with lupus and RA was noted soon after usage began over 50 years ago.
I think if it cured people of viral illness, it would be impossible no one ever spotted that correlation, or noted that effect.
And now it seems very apparent that much of the hype was ginned up by a known fraudster and huckster.
We can hope for a strongly positive effect, but we should all be prepared for some disappointment once results are tabulated and analyzed.

• re: ” in the places that have made hydroxychloroquine the standard of care, and in fact the number of daily deaths has increased sharply since that standard was adopted.”

Holy Toledo.

Can you substantiate any of that? Broad, sweeping statements like that require it. If you EVEN had a phone call from a physician or nurse ‘on the ground’ that would work towards same …

• re: ” people are still dying in the places that have made hydroxychloroquine the standard of care ”

AND on the other hand, we have this ‘nutball’ Vladimir Zelenko who has now claimed to have cured: “699 coronavirus patients with 100% success using Hydroxychloroquine Sulfate, Zinc and Z-Pak”. Last week he had claimed 350, then later the number was 500, and now the number is 699.

Last Wednesday, we published the success story from Dr. Vladimir Zelenko, a board-certified family practioner in New York, after he successfully treated 350 coronavirus patients with 100 percent success using a cocktail of Hydroxychloroquine Sulfate, Zinc and Z-Pak. Now, Dr. Vladimir Zelenko is providing updates on the success of the treatment.

https://www.fliegerfaust.com/coronavirus-update–2645583199.html
———–
Whom to believe (accept as authoritative, presenting actual facts) – you, NM, or this other nutball VZ?

Side note: I’m just a ‘trier of fact’ passing on information at the moment.

79. Robert B says:

A new report by the CDC has “The virus] was identified on a variety of surfaces in cabins of both symptomatic and asymptomatic infected passengers up to 17 days after cabins were vacated on the Diamond Princess but before disinfection procedures had been conducted.”

We are quickly at the point of being unable to stop the spread. It’s time to let healthy people get infected while we isolate the vulnerable for a month or two.

• mario lento says:

Identifying a virus does not mean it is alive or contagious, me thinks.

• Latitude says:

exactly…they found RNA…not a live virus

• mario lento says:

My skeptical meter is still working. Thank you Latitude!

• ferdberple says:

It’s time to let healthy people get infected while we isolate the vulnerable for a month or two.
+==≠========
Agree.

80. Nicholas McGinley says:

It just occurred to me to consider the fact that although over 7,000 people in Italy have now died (extrapolating slightly from the 6,820 listed in the last daily report), this report only gives data on the about 2000.
So…we know that some people die quickly from this thing, and others linger for a protracted period of time.
It stands to reason that the weakest and most frail are the ones which are expiring the most rapidly after becoming infected…so that may be what we are seeing here…the fraction of the deaths who were least able to fight for their lives.
I am also gonna remind myself and anyone else that with some 69,000+ total cases, something like 3,400 people in critical condition, and only 8,300+ recovered, it is a good bet many many more will die, and they will be the ones who were not so old, not so frail, possibly not having numerous comorbidities.
Over 5,000 new patients are being listed every day recently, and we might take this to mean that lots and lots of new cases are still newly acquired, and thus many more people will wind up in critical condition.

I really am not seeing a lot of sunny news when I drill down into the details.
Kudos to anyone who can look at the bright side, and I mean that with all sincerity.
This is really depressing to me.
A week or two ago, I was thinking that most who die from this will be people who are near or at end of life stage…but i am no longer of that mind.
The information being reported has changed from that view.

81. John Finn says:

Perhaps we should revisit this post in another 2 or 3 weeks time but, at the moment, I feel a bit like the Richard Dreyfuss character in Jaws who tries to convince the Town mayor that the beaches should be closed.

While I’m sure most WUWT readers understand exponential growth there seems to be a significant number who don’t understand that is the reality of this outbreak. The number of US deaths doesn’t sound too alarming at present but there has been 5 or 6 doublings over the past 3 weeks. There is no reason why that rate should not continue. An effective level of herd immunity is a long way off. If the mitigation measures introduced don’t work the death toll could easily reach 30k by mid-April.

I’ll be more than happy to be wrong but I can see the UK heading down the same path. When China widened their lockdown on Jan 24th they had recorded just over 1000 cases.

• Derg says:

John what if the virus hit the most vulnerable first?

If Willis is right, then doesn’t the death rate kind of run out of steam? Healthy people just recover?

• John Finn says:

It will run out of steam eventually – when a population has gained herd immunity.

It might be the old & vulnerable that are dying but it doesn’t mean it’s just the old and vulnerable who will need medical treatment. That’s the problem. Some young, fit people will need ventilators and other critical care. If the health system is overwhelmed there’s a risk they won’t get the care.

• Nicholas McGinley says:

I think it is fairly well established that only a proportion of those who will ultimately die, do so quickly, and that many more die over time, as they were stronger and healthier to begin with, and thus are able to hang on for longer.
If the data indicated that anyone who lived through the first two weeks of the pneumonia stage would all recover, we would be seeing that…but it is not what we are seeing.
We are seeing people who started out strong eventually lose the ability to fight on, and many are dying after weeks in critical condition.
Those are likely not the ones who were frail to begin with.

• Phil. says:

The USA has a doubling time of 2-3 days in cases so maybe 100,000 cases by friday, still showing consistent exponential growth. Similar stats for deaths, 775 at the moment, so over a thousand in a couple of days. Another disturbing factor is that when you look at settled cases is that in the USA deaths are double recoveries. Some better news is that Italy is flattening and may have reached the inflection point.

82. Selwyn says:

Willis, you have a freakish talent for looking in the right place for data. I am sure the social conditions and direct flights to Wuhan are part of the story but your analysis is another big chunk of understanding Italy.

I also found your quote from your obstreperous friend valuable. Towards the end he mentions people in Seoul moving to voluntary social distancing. Could you prevail on him to provide some description, images, whatever of what that looks like on the ground. I live in Australia and I have been fortunate enough to visit Seoul and my impression is that it would take major effort to achieve distancing in Seoul equivalent to here on a normal day. I am hoping to get some calibration of how far we need to go.

83. ferdberple says:

Coronavirus: There is no need to shut down the economy. Quarantine the high risk group and let the low risk group keep working.

Very quickly the low risk group will become immune and the virus will die out. The high risk group can then gradually come out of quarantine.

This will minimize deaths and minimize damage to the economy.

You cannot end a pandemic locally until a large percentage of the local population has immunity. A lockdown will not work unless applied to the whole world due to reinfection from outside.

• mario lento says:

I endorse this. Let it be done!

84. Nicholas McGinley says:

IMO, we should be prioritizing masks for everyone in the country being supplied as rapidly as possible, in sufficient quantity so everyone can always have a fresh when when needed.
I suspect it is the only way we get this under control and still have an economy.
Who is the genius at the CDC who is telling the whole country that we should not be wearing masks because they do not help?

• Nils Nilsen says:

Th crazy thing about masks is that they dont really seem to protect the user, but others. Thats how doctors use them for operations. It is an act of solidarity to wera a mask!!

• angech says:

Surgeons wear masks so you cannot identify who operated on you.
Virtually no studies exist proving masks protect surgeons though they might slightly help the patients if the surgeon is ill.

• Nicholas McGinley says:

Having sterile conditions in the operating theater is a very well understood and time tested best practice.
People have all sorts of things in their mouths and on their skin that do no harm, but very definitely will not be good to have inside the body or under the skin.

Look at the places that have got this under control.
We seem to want to ignore this single aspect of what they have done in South Korea, and in China, and now we find out, what they have done in Slovakia.

This order to not wear masks in the US, I will wager anyone interested, will turn out to be one of the worst blunders in the history of medicine, and certainly in the history of this event, once it is written.

• mario lento says:

I thought that the Masks primarily do two things:

1) They protect others from solid particles spewing from the wearers mouth
2) They may protect the wearer’s nose and mouth from having particles of someone else’s sneeze.

Is it practical for everyone to wear a mask every day in public?

• Nicholas McGinley says:

Of course I know that masks are mainly for the protection of other people.
But not completely.
After all, doctors do not wear them in the operating theater to keep from getting something a patient may have.
But besides for that, and assuming it is true that they provide zero protection for the wearer…this is why everyone has to wear one.
No one knows who carrying and shedding the virus.
In fact no one can know, except in the case of someone who has already cleared the virus and is now immune.
But no one even knows for sure at this point if someone who has recovered from feeling sick is indeed no longer shedding virus.
The point is, as long as the virus is in circulation and there are people who have still not been exposed, everyone must assume that any given person MAY have the virus and be shedding it.
Therefore, unless we are all going to stay inside until all the virus is gone from every person, we will have to take steps to keep anyone infected from shedding the virus, the the MAXIMUM DEGREE POSSIBLE.
The logic is inescapable. No one can know if they are a carrier, and no one can be sure someone else they come in contact with is not a carrier.
So the only way we can get on with have a civilization is to stop being afraid to go outside, and to do that we have to stop being concerned that every single person we encounter MAY be spewing virions by the billions per breathe.
And even if the masks are not perfect, it is just like the fact that hand washing is not perfect: We not not have to avoid every single virion. One virus particle is not sufficient to infect anyone. Neither is a hundred, or a thousand.
A typical infective dose for a typical virus is in the hundreds of thousands to tens of millions, over a short interval of time, and whatever the average number is, it is far higher for some people and much lower for others.
This is why everyone does not get every illness going around, even if you are in a house with someone with a virus, and they are for sure spewing virions by the trillions per day. We have layers of defenses inside our body, inside our tissues, and inside our cells, to anything and everything, even if brand new bugs for which we have no memory cells or antibodies whatsoever.
And every layer we add to our bodies defenses, like masks, glasses, hand washing, keeping our distance, not touching body fluids of other people, or getting right into other people’s faces, frequent bathing and washing of clothing, etc…increases the odds that if we do get some virus in our body, it will be less than the amount required for the virus to overcome our defense layers and become established within our cells as a systemic infection.

Anyone who cannot understand that, just baffles me what they are thinking.

As for them not protecting the wearer, to revisit that…if we rinse our skin and face with something like povidone iodine, which has proven hours long residual action, and we impregnate the mask with something similar or even a layer of fabric soaked in iodine and then dried, we can very likely create a virus proof barrier that is quite effective.
And quite effective is gonna be good enough to keep us from having a great depression scale disaster on our hands.

85. Nils Nilsen says:

Thank you Willis for being the Gallileo who questions what all the others say.
The number that we ar normal people can use to guide us concerning risk is not the number of deaths pr positive test. We don’t know the percentage tested, we don’t know how reliable the tests are, and we don’t know how many have had Covid 19 and are immune.
But luckily, like you indicate with your graphs, we can know risk of death by nationality. China is a bit over 2 pr million. Right now, Italy has 6820 deaths in 60 million, 113 pr million.
Annual flu deaths in Italy are around 340 pr million. It the numbers doble for Covid 19, we will still be way below normal flu deaths. And most of the people dying from Covid 19 would be the ones most likely to die from the flu, so if we hadn’t started testing for Corona, we might not have noticed anything at all, especially in China, but even in Italy.
A lot of people die every day from all causes, 1700 pr day in Italy, so many die with Corona, not from Corona. Maybe all the Corona deaths would have died anyway. We really don’t know.

We could know, though. Antibody testing (now available as fingerpick) of 100 random persons would establish the percent who have or have had Corona. 100 normal swab tests of the same group could establish current virus in the system. Maybe authorities are afraid of doing this. It could make them look really stupid if we see that over half of the population has antibodies, and possibly show that it has been around much longer than we think.

The major disease groups in the study would almost all be using ACE inhibitors and could be dying because of that. It is estimated that up to 700 000 patients in the US die every year because of medical errors or side effects of medication, so that wouldn’t be the fist time doctors do more harm than good.

Anyway, the big doctor organisations sign up for Catastrophic Climate Change, so they may not be the ones to trust blindly when it comes to numbers or reasoning ability. And now the cardiac organisations say patients should not change their ACE medication…

• Nicholas McGinley says:

“And most of the people dying from Covid 19 would be the ones most likely to die from the flu, so if we hadn’t started testing for Corona, we might not have noticed anything at all, especially in China, but even in Italy.
A lot of people die every day from all causes, 1700 pr day in Italy, so many die with Corona, not from Corona. Maybe all the Corona deaths would have died anyway. We really don’t know.”

And this jackass crap is why we are in the predicament we are in, and will not soon be out of it.
Nils, you must be in the Twilight Zone or some alternate reality if you seriously think if we had not tested anyone we would never have noticed this pandemic was sweeping the world.
As if ignoring it and going on with business as usual would not have meant that what we are seeing now would be many times worse.
You need to keep up with current events if you think only people who would have died anyone are being killed and getting viral pneumonia.
That is nothing like even close to true.

The stats on the first few thousands deaths in Italy are more like if 50,000 people had their heads held under water for five minutes, and someone looked at the ones who were drowned after two minutes and concluded having your head under water was only dangerous for people who are old and sick.

• Nicholas McGinley says:

Typo:
“…would have died anyway…”

86. eo says:

Hi Willis,

I dont know if somebody have made an analysis on the cost of COVID-19? I have read in one country the stock market valuation have fallen by almost US$150 billion for 2000 reported cases and some 120 deaths. This cost excludes other cost to the whole economy. If this is true, the cost just on the stock market valuation is$75 million per case and over a billion per death. Again just like in climate change debate, the politicians could always claim that the number of cases could have gone to 100 million (far exceeding this country population) so the cost to the economy by taking draconian action is just $1500 per case and the death could have exceeded 10 million or something like 15,000 per death. Hopoefuly, the COVID is not a dry run to throw away$100 trillion to save 10 billion human lives who are at the tipping point of extinction because of climate change.

87. Robert of Texas says:

“The flu kills about 36,000 people a year in the United States, according to the CDC”

88. Robert of Texas says:

P.S. I do not believe the numbers coming out of China. Not the economic numbers, the prison death numbers, the “detained” numbers, nor the COVID-19 numbers.

Either they already had some kind of herd immunity, or those numbers are just flat out wrong.

89. AndyL says:

Looking at death rate is obviously important, but it is not the only metric – and possibly not even the most important metric when deciding policy on things like the lock-down.

If 15% of cases need intensive care and ventilators to survive, hospitals will become over-run and people will die in corridors and waiting rooms. That is what is happening in Lombardy today.

Therefore the plan is to minimise the number of cases, to protect our health facilities.

90. Paul in uk says:

I don’t understand why this Anosmia (loss of sense of taste or smell) thing is not being picked up on a lot more. Even if it could be due to something else, so can the other 2 main symptoms. If this is a symptom shown by many of those not showing any other symptoms then isn’t that incredibly important and urgent to be screaming from the roof tops since several days ago and may be very significant in helping us significantly reduce infection rates? It was in several UK newspapers several days ago, but no changes to the advice of symptoms to look for to self isolate, from governments, not even hardly any comment or discussion on it that I can find. Even if it turns out to be irrelevant, until we know that for sure isn’t it a case we would have little to lose adding it to the list of symptoms now and potentially a huge amount to gain?

I don’t understand when they say it is a new symptom; does that mean people didn’t have it before or is it a case we just didn’t pick up on it until now and if we asked all those from the early days of this virus that didn’t show symptoms but tested positive many would say “now you come to mention it, yes”? How soon does it appear? I got the impression, but could be wrong that it appears about the time you could start to be infectious, unlike the other symptoms, hence incredibly important and we shouldn’t delay waiting for peer reviewed papers?

• angech says:

Beat up.
True anosmia is extremely rare and is not a common symptom. In corona virus.
Some loss of smell is to be expected in a small number of respiratory infections if the developer sinusitis.
The story is a total beat up.
If you do develop anosmia it is a sign that you might be developing Alzheimer’s.
Be a shame to recover from the virus and find the true (still very,extremely rare) cause.

• mario lento says:

My case was very unique. Only lungs, very little sinus and no throat. Lung phlegm was not a lot, but tremendous gurgling in lungs… Never had I started a lung virus, without first having throat and sinus pain. So, fever with aches, lungs and little phlegm compared to flu or common colds.

5 days of this with extreme nutritional support, D3, Zn, quercetin, C, 3x/day and veggy and fuit juice powders and lots of water taken in small qty throughout awake time. Would not have been able to survive without rescue inhaler, albuterol.

I have posted this for others because I think that is what got me through it at 55 yrs of age with a history of lung and sinus issues. I believe there is lots of confirmation that these things work for immune response nad virus weakening support.

I take all of these supplements in moderate doses every day, so I was pre loaded.

• Greg says:

If you do develop anosmia it is a sign that you might be developing Alzheimer’s.

NO! That is what you may read in newspaper but it is NOT what is actually reported medically.

The Alzheimer test is for the capability to IDENTIFY smells. That does not mean you have lost your sense of smell, it means you have NOT lost you sense of smell but lost your memory of what that smell is associated with ! ie it is a memory test.

Since the association is quite subtle, this is often a more demanding test than asking if you can remember what day to the week it is.

91. Philo says:

The problem is sorting out cause from effect with messy, often inappropriate data.
The post on South Korea shows a typical pandemic survey protocol- basically tracing the path to infection and the spread from an infection. You can’t reliably break a chain of infection if you don’t know how the chain is tangled and interlocked.

92. Alan Millar says:

Good analysis Willis.

You might want to reflect that right across Northern Europe, including Italy, there are no excess deaths, indeed they are lower this year than the average.

https://www.euromomo.eu/slices/map_2017_2020.html

https://www.euromomo.eu/outputs/zscore_country65.html?fbclid=IwAR0j5zB5rWYoxEnEyM4V3FOHSXgUgohHIOm5mmRuP9A7maGvj9p1u-lJAjw

Not all these coronavirus deaths are real excess deaths a proportion would have died anyway as they are old and/or have significant health issues.

Germany is comparatively low for a number of reasons, one of which they are not checking for the virus postmortem and deaths are getting recorded for the underlying health issues. Italy, Spain etc are checking all deaths postmortem and if the virus is present that is going down as the cause.

The measures these European countries have taken has reduced the transmission of all other respiratory diseases as well, protecting the old and vulnerable.

Take the UK.

Here is the Government site which records statistics around deaths each week in the UK.

https://www.ons.gov.uk/peoplepopulat…nglandandwales

It compares that weeks deaths with the average over the last five years for that week. Of course you would imagine that this year, with the population growing over those five years and with it ageing slightly, that we would be getting a few more deaths than the past average. However, up to the 19th of March the UK has had, cumulatively over 4500 LESS deaths than the average.

Deaths due to respiratory causes have dropped sharply since the third week in January, when the UK started getting serious with hand washing and separation etc more than a third lower than 10/01 for instance. The individual protective measures, such as the washing of hands and social distancing will be impacting on the other respiratory illnesses people catch.

Deaths continue to occur by and large in the elderly and with very few under 45.

Also of course, you have to figure that the UK population increased about 3.4% over those five years and continued to age slightly. I would have thought we should be seeing an EXTRA 3-400 deaths a week compared to this average if we were standing still so to speak.
If you look at the 11 weeks of winter prior to the start of the fall off in deaths in late January, we did indeed see an extra 4000 deaths in that period compared to the 5 year average for those 11 weeks.

93. John Tillman says:

It’s now after midnight GMT. I don’t know if this site has made its last update or not, but at present, the US had fewer new cases yesterday (still today in the US) than the day before, 9876 vs. 10,168. For new deaths attributed to the Wuhan virus, it’s 145 vs. 140, so slight increase. But WA State had no new cases or deaths, vs. 930 and seven.

Of the 9867 new cases and 145 new deaths, 5621 and 70 were in New York and New Jersey.

• John Tillman says:

Final was 11,074 new cases, so an increase, but up less than 10%. New deaths 225, up from 140.

https://www.worldometers.info/coronavirus/country/us/

In final tally, WA had 248 new cases, vs. 225 the day before.

Might be flattening out.

NY Metro Area still the epicenter.

• Robertvd says:

Exactly, STOP public transport.

94. John Tillman says:

Public opnion polls on Trump’s handling of Wuhan virus since March 17:

Gallup 3/13 – 3/22 1020 A 60 38 +22
ABC News/Ipsos 3/18 – 3/19 512 A 55 43 +12
Emerson 3/18 – 3/19 1100 RV 49 41 +8
Axios-Harris 3/17 – 3/18 2019 A 56 44 +12

Averages: Approve 55%, Disapprove 41.5%, for Spread of +13.5 points.

95. angech says:

The Italian and most Western hospital responses has been very disjointed and poor.
Full glove and gowning and isolation for all suspected cases from unprotected hospital staff is essential.
Have taken my wife to an Italian hospital for a CT following a fall, excellent treatment. Have Italian friends who have described hospital Inpatient care there.
Not good.
Under resourced.
Q. Where is the best hospital in Italy?
A Geneva.
But that is in Switzerland?

96. John Tillman says:

Trump’s overall approval job rating has also improved:

Gallup 3/13 – 3/22 1020 A 49 45 +4
The Hill/HarrisX 3/22 – 3/23 1002 RV 50 50 Tie
Monmouth 3/18 – 3/22 754 RV 48 48 Tie
Rasmussen Reports 3/19 – 3/23 1500 LV 46 52 -6
Emerson 3/18 – 3/19 1100 RV 46 45 +1

Average almost positive, and would be but for the Rasmussen outlier, which is of Likely Voters, so its system of picking those might have skewed results over RVs (Emerson and Monmouth) and All Adults (Gallup).

97. Willis,

This is absolutely priceless information. Packed into a nutshell. I was really puzzling death rates in Italy vs Germany. The death rate in Italy is far higher than in Germany.

Smoking? Nope. Italian smoking rate = 24%, German smoking rate = 30%. The only realistic thing I could think of was social customs (you won’t find any website on “How to do the German cheek kiss” ;-)):

But this shows that, at least in this sample, the people in Italy who died simply had very little time left anyway.

Your graphs are tremendously informative, too. Thanks for all your great work on COVID-19 (and climate change, too)!

98. Steven Mosher says:

Nice work Willis.

But.

Looking at death rates on a national level can be misleading.
A few days back Willis looked at Korea and predicted a Case peak at 8100.
I explained why this was wrong, and now we are 9000+ ( headed to 10K probably)
he predicted a death total of 100.
I explained why this was wrong and why we would go to at least 150. We are at 120, now.

The reason is that infection is Local and not spatially uniform. What I could see that he could
not is surging cases in two regions of Korea. In spatial terms the case incidence has a high
spatial frequency. Clusters. so area averaging is much more complicated.

This is the same reason why rainfall is hard to ‘average’ over wide areas. Downpours. Downpours
lead to floods, damns overflowing and all that nasty stuff. very local. very local and broad area
averages can deceive you

How does this relate to death rates?
Well death rates are also local, You can think of it this way. The death rate for a given location
is probably going to be a function of.
1. The demographics.
2. The prevalence of co morbidities in that population
3. The quality of the medical care in that exact location
4. The AVAILABILITY of the medical care in that exact location

Do you get a flood that overruns your hospital? very hard to predict, and uncertainty is not your
friend

So your death rate on the diamond princess may be X due to adequate high quality medical care
and low prevalence of co comorbidities, while your death rate in Italy may be different, due to
demographics and high co comorbidities, and swamped hospitals.

Averaging over large areas will of course obscure these important differences.

The bottom line is your risk is personal, not simply because death is personal, but because
where you live, the exact city, will change your risk profile. When the risk is highly personal
of course people’s reaction to risk will differ wildly. If you are young with no co-morbidities
of course you will party at spring break. If you are an old diabetic living in a place with little health care
of course your risk is different.

This difference in risk profiles will result in people looking at data differently.

weeks ago when the USA stood at zero deaths and 68 cases someone on WUWT asked me what the us death rate was. my response? “somebody doesn’t understand statistics” I’ll stand by that answer weeks later.

Of course you can calculate an average death rate, but it’s pretty much meaningless. The national USA death rate tells you nothing about your personal risk. And it tells you nothing about the risk you pose to others.

any way, look at your hands. Assume they are lethal weapons and wash them, if not for your own good,
do it for others.

Not a germ phone, ask CTM

• Willis Eschenbach says:

Thanks, Mosh. About my only disagreement is when you say:

Of course you can calculate an average death rate, but it’s pretty much meaningless. The national USA death rate tells you nothing about your personal risk. And it tells you nothing about the risk you pose to others.

Of course it says nothing about your personal risk—that depends on how often you wash your hands, touch your face, or have sex with bats.

What the average death rate IS useful for is seeing whether your medical system is likely to get overrun, and how soon. For example:

That tells us how soon it is possible that our medical system will be stressed. From that, on given trends, we can see that Washington, despite having more deaths per capita than New York has, won’t be in trouble until well after the crunch hits New York and Louisiana. It also shows that California is much further from the crunch than I had feared.

That’s valuable data to have.

My best regards to you, stay well,

w.

• Peter says:

In Korea, about 85% of all cases are in one region: in and around the city Daegu. Not surprisingly, this is where most of the 126 people have died. The number of cases is indeed still growing. However, in the past few days most new cases are imported cases and close family members of these imported cases.
I am sure that the number of new cases and the number of people who die with the virus will increase in Korea.

According to the media, the number of critical cases and severe cases has roughly been 90 for about a 10 days. This is a relatively low number of cases compared to Italy and other countries. I would be interested to hear people’s opinion on this difference.

• Toto says:

Good video.

“Looking at death rates on a national level can be misleading.”
Looking at cases rates on a national level can be misleading too.

As an example, there are about 69,000 cases in Italy. The population of Italy is about 60.5 million.

There are about 30,700 cases in Lombardy. The population is about 10 million.

We could zoom in further, to Bergamo, population 1.1 million. About 2500 cases (old number).

And it goes the other way too.

Molise has 73 cases, about 300,000 people.
0.02%

https://www.statista.com/statistics/1099375/coronavirus-cases-by-region-in-italy/

People look at those low numbers and think that it doesn’t matter what they do. Wrong.
It is a gamble. Sometimes you win (you don’t meet that carrier), sometimes you lose (when you do meet him). Don’t shake hands and wash your hands. You never know. If the virus spreads, we all lose.

Daily new cases in South Korea. Well done! Way to go!
https://www.statista.com/statistics/1102777/south-korea-covid-19-daily-new-cases/

How physical distancing compliance affects the virus. 70% is not good enough.
https://www.abc.net.au/cm/lb/12086230/data/model-shows-physical-distancing-is-vital-to-coronavirus-response-data.png

99. holly elizabeth Birtwistle says:

Thanks Willis, agree 100%, and appreciate so much your articles.

100. holly elizabeth Birtwistle says:

Thank you Willis, appreciate all you are doing:))

101. Steven Mosher says:

“From Guro-gu call center in Seoul, 2 additional cases (2 contacts under self-quarantine) were confirmed. The current total is 158 confirmed cases since 8 March. (11th floor = 94; 10th floor = 2; 9th floor = 1; contacts = 61)”

1 guy in a company of 207, call center
Note the spread outside the company.

102. Marc Gipsman says:

Outstanding work Willis. Do your numbers take into consideration that the elderly in Italy are not offered ventilator support because the health system is so overwhelmed? Ventilators are only offered to younger patients with fewer comorbidities. The old are basically left to fend for themselves, with resultant higher mortality. This would seem to to skew Italy’s statistics. Perhaps the elderly death rate would be better if ventilators were more available.

103. farmerbraun says:

Thanks Willis and Mosh.
So global average death rate is about as meaningful as global average temperature.
Funny that.

• Steven Mosher says:

wrong. temperature is more predictable. Low spatial frequency.

testable.

• Greg says:

wrong deaths are fungible .

104. Steven Mosher says:

Arrg

Korea cases continue to be recorded. As in China the vast majority are IMPORTS
Nationals returning to korea
Same in China

I’ll have to look at the exact numbers but it gives you an idea of the attack rate.

put 1000 people from the US on planes to Korea
How many show up with the critter?

Also note you are not getting on the plane with a fever, so these imports are asymptomatic.

105. John F. Hultquist says:

Steven Mosher March 24, 2020 at 7:12 pm
. . . writes about geography

In the Seattle area (Kirkland) the virus was there and being spread by all manner of folks before they knew anything.
The officials have taken this unique situation and applied it as a template to the entire State. Across the State, all that can be has been closed.
Testing has still not ramped up. It is being directed toward medics and other responders. That’s fine, but doesn’t do much good for everyone else, and those not in the local Seattle area.

• Willis Eschenbach says:

Thanks, Loydo. Depends on what they’re calling “compliance”. I doubt that in the US we’re achieving 50% of whatever it is … subways, service stations, airplanes, grocery stores …

w.

• Josh Postema says:

Where are the error margins on those predicted curves?

106. In terms of wanton extrapolation from limited data I had to pinch myself.
Just like Climate Change!

A lot of people are in denial here.
Well COVID-19 denial has a Darwinian corollary.

Be the first one in the block to have your mom leave home in a box!

107. LdB says:

Willis there is a BIG PROBLEM with your analysis.
Do a search on the rules of who gets a ventilator in Italy given there are not enough.
It become obvious why the figures get heavily distorted … because if you have an underlying condition or are over 60 you don’t get ventillation.

• mario lento says:

LdB:
Your lazy note does not do anything to refute anything in Willis’ analysis. Geeze have some manners.

• Willis Eschenbach says:

LdB, that’s happening now. The study was done when there were only about a third of the deaths we have now.

w.

• LdB says:

Sorry Willis I don’t read Italian you probably need to spell that out more. You could tell me that your report link said literally anything it is all pretty meaningless to me.

• Robertvd says:

Maybe we should make things touched by many people out of copper and bronze and silver again especially in hospitals.

108. Pft says:

Report shows up to 88% of Italy’s alleged Covid19 deaths could be misattributed

“The way in which we code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus […] On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity – many had two or three,”

– Professor Walter Ricciardi, scientific adviser to Italy’s minister of health
Report in English:

https://www.epicentro.iss.it/coronavirus/bollettino/Report-COVID-2019_20_marzo_eng.pdf

• Greg says:

Yes but that is pretty typical. We rarely put flu on the death cert. as cause of death either, which is why it has to be determined statistically as “excess deaths” at the end of the flu season.

Certainly there are differences from country to country, what is more worrying is inconsistency within the same country from day to day , week to week.

It’s pretty hard to asses the progress when they clearly keep moving the goal posts. Or like in Britain they have not even worked out where the goal posts are supposed to go.

• Nicholas McGinley says:

For weeks Germany reported a tiny number in critical condition, and a far larger number of deaths every day.
Now suddenly Germany has over 1500 people in critical condition.
This is obviously because the reporting has changed, not the number of people in critical condition.
Deaths per day continue to increase there, as in most countries.

109. Pft says:

Another thing, as a result of austerity measures Italy has far fewer ICU beds per capita than US. Up to 5 times less. As mention by earlier commenters, many older and already sick people are not being treated.

One thing people dont understand, nationalized health systems are about providing preventive health care, they are pretty bad at sick care . The US system does an awful job with health care, but if you are really sick and can afford it or willing to go bankrupt to live a few months/years longer, there is no better place to be sick.

Also, given the high death rates among mediterranean peoples (Iran, Italy , France, Spain) one wonders if there is a genetic/epigenetic factor at play

• re: “The US system does an awful job with health care ..”

STILL waiting for actual examples of this, because, this has NOT been my experience with a past case of pneumonia, a bicycle accident (picked up by medics unconscious off the road), a MC accident (minor pelvis fracture) and years later blindness due to cataracts (remedied by surgery!) …

• Nicholas McGinley says:

Mine either.
Our health care system is fantastic.
Some people seem to conflate health insurance or various systems of payment with “care”.

110. Archie says:

W,

“In American hospitals alone, the Centers for Disease Control (CDC) estimates that HAIs account for an estimated 1.7 million infections and 99,000 associated deaths each year.”

Thanks

111. Steven Mosher says:

have fun

• Greg says:

The differential equations shown are simply under damped. If you increase the damping they end up looking a lot like the SIR model shown.

I doubt any of those simple models have any mechanism to account for changing inputs like social adaptation, confinement etc. The are just a creative process fighting a decay process.

• re: “simple models … mechanism to account for changing inputs … social adaptation, confinement etc. ”

Does anybody remember the “object lesson” imparted by the failure of LTCM (Long Term Capital Management)? Probably not … all the King’s horses and all the King’s PhD ‘quants’ could not keep Humpty Dumpty profitable in the market …

• Steven Mosher says:

“I doubt any of those simple models have any mechanism to account for changing inputs like social adaptation, confinement etc. The are just a creative process fighting a decay process.”

Ya Think?

that’s why its a simple model!

Imagine that in this science field there are 100 people half as smart as you.
what do you think they would do?

• Nicholas McGinley says:

Is half as smart the same as twice as stupid?
Seriously not sure what that even means.

112. Steven Mosher says:

“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. ”

A good portion of our cases in Korea are traced to medical facilities.

113. Ron says:

Young people are less likely to die that’s right. But it is hard to get numbers how many are hospitalized, need ventilators for their treatment and for how long. All these factors determine the overload of the system and even if the percentages are low in the group 40y> a high infection rate could easily tip the balance.

The main co-morbidities obesity, diabetes and high blood pressure are not that rare in the American population. I wouldn’t be so relaxed.

114. Peter says:

Just one little comment. In Italy they are sending people above 70 home to die. You don’t have chance for ICU bed if you are above 70. This corresponds nicely with your graph.

• Giuliano says:

In Italy no sick person is sent home to die (even now with the curse of COVID-19). Even older patients. Even these days.

• Peter says:

Sorry, you are right. Not sending home. Just giving sedatives and keeping rest on nature. This is not from my head, but from italian doctor. They are using war codex to triage patients.
Hold up guys.

115. otropogo says:

Thanks Willis for acquainting us with this exhaustive documentation on the suicidal folly the USA, Canada, France, and Italy have embarked on. Thanks also to the “Swiss doctor” who compiled this evidence. I believe I’ve followed more links from this one report than I normally do in a year of browsing.

My only suggestion for improvement to the presentation would be to flag the language requirements of the various links (mostly German, with Italian a distant second)

I was particularly impressed by the video of Professor Sucharit Bhakdi

which, although spoken in German, had very clear English captions.

What bothers me most about this situation, other than the likely collapse of the global economy due to the interruption of international trade and travel, is that I cannot imagine that the supposedly all-knowing intelligence services of Nato failed to draw the same conclusions and warn their governments against the draconian measures underway.

• Nicholas McGinley says:

This kills a lot of old people.
Who has the power and the money in our civilization?
Do you think this was done to protect some people in nursing homes?

• otropogo says:

The other aspect of this socio-economic buffalo jump that intrigues me is – who is going to lend four essentially bankrupt countries (the four above -mentioned ones) trillions of dollars, and why? And beyond that, what will be the global effect of the USA defaulting on its debts? Will this be the end of the US Dollar as the world currency? And who will own and control the industrial and transport infrastructures of the USA, Canada, France and Italy afterward?

I believe we are witnessing the first global human engineering project. One can only speculate as to its intended goal, and whether it is progressing as designed or has gone off the rails. But it appears to me that it has already irreversably weakened the power of Nato vis a vis Russia, China, and the rest of the world.

Hopefully Nato will accept this defeat gracefully and not plunge the world into a global nuclear conflict to reassert itself.

116. AndyL says:

There’s another reason why people with co-morbidities are dying at higher rate in Italy.

The hospitals are so over-run that doctors are having to prioritise who to treat. People with lower chances of survival (age, other illnesses) are being denied treatment because there are not enough ventilators to go round.

In UK treatments for other conditions are being held back because of demands on hospitals. For instance a lot of chemotherapy treatments have been postponed or cancelled.

117. richard says:

Interestingly there are 80 countries with corona and without a death.

Surprising which countries as well. Maybe they have a younger , survival of the fittest population.

• Nicholas McGinley says:

People generally do not start dying for about a month after the virus enters an area.
A month ago the list of places with known virus was very short.
IOW…give it a while and look again.

118. richard says:

Meaning in those countries other communicable diseases lay waste.

So far 2,998,924vCommunicable disease deaths this year.

When Corona is over in a few months who will be thinking of the above.

• richard says:

you prove my point!

millions dying elsewhere.

• A C Osborn says:

Stephen, I never thought that I would find myself agreeing with you (referring to Climate Change), but on COVID19 I agree.
Ther are many aspects of COV that make it useless to compare it to Flu, for anyone who thinks this “is just flu” take a look at Worldometer data and pay attention to cases Vs active cases Vs serious/critical cases.
Flu is usually a few days in bed and a week after getting it you are fine, for some it might lead to pnuemonia.
COVID19 is not like that, it is for about 70%-80% of the cases, but for the rest it attacks the lungs and other organs directly as well as leading to viral or bacterial pnuemonia and scepsis, patients spend weeks on ventilators.
This is the cause of the Health System overload, once that point is reached all other critical health deaths also increase, but do not get counted as COVID19, they die because they can’t get critical care.
As to Mr Eschenbachs ideas, I applaud them, especially Quarantine away from current Hospitals.
The western world seems to have forgotten the principle of “Isolation Hospitals”.

Except for his idea of ending the lockdown immediately that is, every country needs a period of time where what he is suggesting has time to be put in place, for the COVID hospitals to be built/erected, for the ambulances to be converted to transfer ICU cases, for equipment & medicine to be made and/or distrubuted, for extra nurses and doctors to be trained in ICU and isolation techniques.
The last because you cannot strip the current hospital ICUs of staff, because all the non COVID cases still need them.
To remove social distancing until you have it in place will mean thousands of extra COVID ICU cases and complete saturation of the current hospitals, which by the way will need complete decontamination once the COVID cases have been removed.
The fact that the Princess Diamond surfaces still have living COVID viruses 17-21 days after the last patient left is scary.

As to applying SK or Singapore type controls it is too late for any country that already has 1000s of cases, it needed to be used when China started exporting the virus to the rest of the world.
For those countries just started on the curve with only a few cases it makes sense to to copy SK or Singapore if they can.

119. Barry Sheridan says:

Thanks again Willis for your clarity. I noted on the Order-Order blog yesterday that the head of the Italian Civil Protection Agency, Angelo Borrelli, stated the likely number of infections was around ten times the quoted figure, this reduces the actual death toll to around 1%. Still not good, but less alarming than the near 10% being mentioned elsewhere.

• Mariano Marini says:

This is correct. The tests are made ONLY to whom shows the symptoms, so we don’t know how many has a virus but symptoms!

• Greg says:

To those whom show the symptoms and go and seek medical care. I would imagine most people are now avoiding doing that at all costs until they can no longer breathe on their own.

• Karl says:

It is COMPLETELY overblown.

Using the data from the following figure: 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.

We find that only 1 PERCENT of Italians that die WITH COVID-19 (approximately 10% of those confirmed to be infected), were otherwise healthy. (yes it is a small sample,but it is data W chose to present)

So (based on the data presented) the risk of death for an OTHERWISE HEALTHY ITALIAN infected with COVID-19 is .1%

ONE-TENTH of ONE PERCENT

HOWEVER,

Figure 2 shows ZERO deaths under age 30, and 17 between the ages of 30 and 50, with a total number of deaths being approximately 1900 (not the same data set as the 355 from Figure 4)

The bins are rounded, erroneously raising the death rate metric (30-50yrs) to 1.2% from the correct .89%.

Now fun with extrapolations (well, if the media can fear monger by extrapolating data from one place to another I can use it to be reasonable).

If we extrapolate that only 1% of all fatalities are otherwise healthy based on figure 2, we get a HEALTH-ADJUSTED risk of fatal COVID-19 infection for HEALTHY persons between 30 and 50, of

.0089%.
(1% of .89% from Figures 4 and 2)

AND ZERO for people under 30 per Figure 2.

120. Bert Robel says:

Willis there is a very, very interesting interview in an article ( title: “In der Todeszone”) published yesterday in a German newspaper, the „Süddeutsche Zeitung“. It is with a priest from the little town of Nembro (11,000 inhabitants) about 10 kilometers northeast of Bergamo, until now the most hardly hidden bigger city in Italy. The statement of the priest extremely supports your conclusion „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.“

The priest states in the interview (translated from German by Google translator):

“The thing has been around since the beginning of the year – or even since Christmas”
Don Matteo emphasizes that he is not a doctor – and that is why he does not want to go too far. The Vicar of Nembro therefore confines himself to describing the facts that have caused so much devastation in his community.
“We believe,” he says, “that this thing has been going on since the beginning of the year or even since Christmas without being identified. First, the nursing home in Nembro had an increasing number of abnormal deaths: in January, twenty people died of pneumonia “There have been only seven deaths there in the past year. So the number of funerals grew week after week and everyone was talking about this severe pneumonia. Before the carnival, half of the city was in bed with a fever. I remember that we were.” , while we were discussing whether we should hold the celebrations and the parade with the children, had to close the ‘homework room’ because most of the volunteers who looked after the children were sick, but there was no corona virus in Italy at the time. Who knows how many of us were sick and then got well. ”

The article could be findet under:

The article is a translation from the blog:
https://www.mariocalabresi.com/

121. richard says:

Let’s keep calm-
Israeli virologist urges world leaders to calm public, slams ‘unnecessary panic’
‘People think this virus is going to attack them all, and then they’re all going to die,’ says Prof. Jihad Bishara. ‘Not at all. In fact, most of those infected won’t even know it’

A leading Israeli virologist on Sunday urged world leaders to calm their citizens about the coronavirus pandemic, saying people were being whipped into unnecessary panic.

Prof. Jihad Bishara, the director of the Infectious Disease Unit at Petah Tikva’s Beilinson Hospital, said that some of the steps being taken in Israel and abroad were very important, but the virus is not airborne, most people who are infected will recover without even knowing they were sick, the at-risk groups are now known, and the global panic is unnecessary and exaggerated.
“I’ve been in this business for 30 years,” Bishara said in a Channel 12 interview. “I’ve been through MERS, SARS, Ebola, the first Gulf war and the second, and I don’t recall anything like this. There’s unnecessary, exaggerated panic. We have to calm people down.

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“People are thinking that there’s a kind of virus, it’s in the air, it’s going to attack every one of us, and whoever is attacked is going to die,” he said.

“That’s not the way it is at all. It’s not in the air. Not everyone [who is infected] dies; most of them will get better and won’t even know they were sick, or will have a bit of mucus.”

But in Israel and around the world, “everybody is whipping everybody else up into panic — the leaders, via the media, and the wider public — who then in turn start to stress out the leaders. We’ve entered some kind of vicious cycle.”

He urged the public to internalize that “we’re talking about a virus that is not airborne. Infection is via droplet transmission… Only if you are close to someone who has the virus, and you get the saliva when he sneezes or coughs, can you get ill. And if you don’t then maintain personal hygiene,” primarily by washing hands.

He said the virus did not appear to be “too intelligent” — unlike flu, “which is very intelligent, it changes, adapts, and it infects people via their airway passages.”

Bishara said some of the harsh steps taken in Israel — which has essentially closed its borders, limited gatherings to no more than 10 people, closed all educational facilities, and shut down malls, restaurants and places of entertainment and culture — were motivated by the leaders’ acknowledged awareness that the Israeli health system will buckle under any further strain.

Home quarantine has been ordered for “everyone who has passed by someone who may have been infected by someone else,” he protested, “because they know that our health system cannot withstand coming under any more strain, because we are perennially stretched to the limit.”

Referring to Italy’s national lockdown, he said that “quarantine is an effective precaution, but there has to be temperate use. You can shut down a whole country, but there are other means.”

Prime Minister Benjamin Netanyahu (left) with Health Minister Yaakov Litzman (right) and Health Ministry General Manager Moshe Bar Siman-Tov at a press conference about the coronavirus, at the Prime Minister’s Office in Jerusalem on March 11, 2020. Netanyahu is explaining how the coronavirus can spread from a sneeze. (Flash90)
At this stage, he said, “we know how the virus behaves, how it spreads, and which groups are in danger. We know now that his virus is primarily dangerous to old people, and to people with a history of chronic disease, and those who are immunocompromised.”

Appealing to Israeli leaders “who are appearing every night at 8 p.m. to announce all kinds of steps, some of them very important,” he said, they should “first and foremost calm people down.”

A MESSAGE FROM THE EDITOR OF TIMES OF ISRAEL
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For as little as $6 a month, you can help support our independent journalism — and enjoy an ADS-FREE experience, as well as special benefits and status as a Times of Israel Community member! Read more JOIN THE TIMES OF ISRAEL COMMUNITY Already a member? Sign in to stop seeing this READ MORE: Israel & the Region coronavirus COVID-19 Jihad Bishara Beilinson Hospital 357,785 shares COMMENTS • Nicholas McGinley says: The basic problem is…”most people” are scientifically illiterate. And it is even worse when it comes to medical science. Comments from people here on this site reveal that to be true. Many seem willing to throw logic itself out the window when it comes to medical issues. Even people that in other contexts understand the difference between emotional and logical arguments. 122. Fabio Capezzuoli says: Good work, Willis. I and other Italians reached similar conclusions, but it’s good to see them validated by an external observer that can be regarded as immune from cultural biases and tunnel vision. However, I think that total of COVID-19 in Italy is much higher than reported, at least by a factor 5, as high as 10. No conspiracy or coverup there, just a heavy sampling bias towards symptomatic cases. This would make mortality rate less outstanding. That said, also later analyses of the deceased health situation confirm what’s written here: overwhelingly elderly, with a number of pre-existing pathologies, in particular high blood pressure. There is evidence that ACE inhibitors make not only lungs but also myocardium more susceptible to viral attack. The view that the infection spread largely in hospitals (due to lack of proper PPE and isolation procedures) is gaining ground. Personally I think that coronavirus came in two waves: one, undetected and with lower mortality, hit Italy in the autumn of 2019, when some GPs and medical rescue doctors reported an unusual number of pneumonia cases (again, among the elderly). This first wave induced at least partial immunity to a significant fraction of the population, which reduced the impact of the second and more deadly wave hitting in february. 123. Teerhuis says: Willis, 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.” Influenza- and other viruses can destroy the cells of the olfactory epithelium. The sense of of smell is lost and returns in a few days. I experienced that several times. But there is a chance that the damage is permanent. Some years ago, at the age of 65, I got a cold and lost my sense of smell on the fifth day. But before that, on the third day, every substance lost its proper smell which was replaced by a strong phantom smell, poorly described as ‘burned acrylic plastic’. On the eighth day a very slow recovery of the sense of smell started, but my sense of smell did not return completely, I estimate a recovery of about 90%. I learned from your articles that that cold-virus was probably a SARS-virus. Best to you, Dirk 124. Nicholas McGinley says: So, three sailors aboard a US Navy aircraft carrier have tested positive. The ship was last in port 15 days ago in Vietnam. Vietnam currently has 117 active cases listed for the whole country. Presumably the number was even lower two weeks ago. Obviously in every place with the virus spreading, the case numbers are the small tips of very large icebergs. It will probably be two weeks before the Navy knows how many people on that carrier were infected by those three before they became symptomatic and got tested? How many will those second generation of infected on the ship, infect themselves before they show symptoms. The progression of a virus which is contagious, highly contagious, long before people show symptoms, and for which half or more get it, spread it, and keep spreading it because they never show symptoms, ever, is predictably very fast. Obviously something that can infect a planet in a few months can never be stamped out until either everyone has had it, or a vaccine is developed and everyone is vaccinated. So…we get a vaccine, and a whole subset of people refuse to take it, being antivaxers. What does the world do with such people? After all of this, what is the appropriate thing to do? • Karl says: How “highly contagious” is it, really? Wuhan has a population of 11 Million people, and LESS THAN 80,000 were confirmed infected, over the course of MONTHS. COVID-19 is either A. Highly Contagious –AND — highly asymptomatic or B. Not very contagious, actually. • Greg says: That , despite initial restrictions simply put the whole city in quarantine for the outside. People could still circulate freely in the city. • Nicholas McGinley says: It started out with zero people. By the time the number was in the tens of thousands a few weeks into it, behaviors changed. There are specific instances where one person very efficiently infected many others in a short span of time, and then some of those people infected others in a short span of time. Is a virus that multiplies from one animal in a cage in late November, to all around the planet and almost certainly millions of people by mid March…at which point an entire industrial civilization ground to a halt in many of it’s sectors, and hundreds of millions of people stopped leaving their home for weeks on end…is that “highly contagious”? If it is not, what is? Besides for all of that, Karl offers a totally false dichotomy. There is no such either/or as the above choices A and B asserts. What does “highly asymptomatic” mean? Compared to what? Some large percentage of people who are exposed get an infection which they are able to spread but for which they get either no symptoms of relatively mild ones. But that sure is not what some other people experience. The people who die are not the only ones that are being badly harmed here. Some 20% of the people infected wind up in a hospital, many for several weeks, and many in a fraught struggle for their life. One, two, and in some cases four weeks of fighting for every breath in order to survive, is not something everyone emerges from unharmed. Five percent of the people who are infected are winding up in an ICU, and for them it is even more unlikely they will ever be the same again. Something like one in five of them are dying. And unlike what many seem to think, there are a large number of these people being hospitalized who are not old and are not otherwise sick. I am pretty sure that if every cold and flu bug going around was landing this many people in such a life or death predicament, we would not have so many people living as long as we have seen in recent decades. I am also pretty sure that someone with well controlled high blood pressure getting the flu and then dying has not previously been explained away, because that someone had a “comorbidity”. • Greg says: The co-morbidity seems to be especially high blood pressure in Italy where they heavily prescribe ACE inhibitors and ARBs. We know in full biochemical detail how that opens the door to COVID via the ACE2 receptor. • Karl says: Still waiting on a QUANTITATIVE VALUE for “highly contagious” State a QUALITATIVE value, that is supported by EVIDENCE Put up or shut up. In the meantime, re-read your Philosophy 101 textbook re: False Dichotomy • Nicholas McGinley says: Put up or shut up? Did you really say that to me? Are you giving me orders, Karl? Who the hell do you think you are? You have given zero reasons for anyone to even begin to take you seriously. 125. Terry Anderson says: I believe that Willis follows the data. He makes decisions on analysis. Willis is one person that leaves his opinion out of his work. It is why his work is so powerful. • AndyL says: Willis is very good at being open about his findings, but there really is no such thing as a person who purely follows the data. It is a matter of choice what data to investigate. 126. Steven Mosher says: watch • Phil Salmon says: Korea’s situation was simplified by the fact that the majority of the initially infected people were members of the quasi-Christian sect (forgotten its name) and thus easy to find. • Nicholas McGinley says: I think there is one chance to get ahead of an outbreak. We missed ours. Under normal circumstances, one might trace contacts of people who were going about their day, but how does one do that for people who have been panic shopping in a dense horde or strangers? Or waiting for 6+ hours to get out the door of an airport, while shoulder to shoulder with thousands of people who just arrived from overseas? People who should have been sitting at home watching TV were waiting in a mob so they could but three years of TP and hand sanitizer. • Karl says: Respectfully, Mr. Eschenbach, China let people run into and out of Wuhan for quite a long while, before they let them ONLY run around Wuhan. And there were 60-some-odd thousand cases inside Wuhan, approximately half a percent of the population. It is my contention that the COVID-19 virus is not a particularly robust, not a particularly contagious, and not a particularly symptomatic virus that quickly burns itself out. Evidence you presented shows a possible 1% INFECTION rate, yet seasonal influenza is estimated to INFECT 20% of the population EVERY YEAR. (yes I know that = up to 60 Million cases in the US alone, and guess what? INFLUENZA HOSPITALIZES more people in the US EVERY YEAR, than have been infected by COVID-19 WORLDWIDE) -per the CDC 127. dmacleo says: have not read everything yet but wanted to post this as I found it interesting https://www.telegraph.co.uk/global-health/science-and-disease/have-many-coronavirus-patients-died-italy/?fbclid=IwAR0QkEmrIJHo575gU86SUiUpntWD3wD0xoJlnzZ34Ebs8uKmh_jqlNgVnrw …Prof Ricciardi added that Italy’s death rate may also appear high because of how doctors record fatalities. “The way in which we code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus. “On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity – many had two or three,” he says. This does not mean that Covid-19 did not contribute to a patient’s death, rather it demonstrates that Italy’s fatality toll has surged as a large proportion of patients have underlying health conditions. 128. Robertvd says: If natural selection because of better medical treatment is postponed you create a huge group vulnerable for anything new. Most American’s native population was killed by new diseases not by war. 129. What I had to learn today in Germany: Our son has been averted from a fellow student he worked together in a common project for the university two weeks ago, that she has some possible symptoms of Corona, light fever, than difficulties breathing in. She phoned the given registration number asking for a test. She was told, if not having had contact to a verified positiv tested person, a test isn’t possible, b’cause of a lack of kits ! Have to say, I feel well secured here. 130. LP says: “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” Thanks Willis for the hard work! I think this is a very plausible hypothesis: that most of Italy’s infections are nosocomial which would explain their abnormal rate of death. I read somewhere about an interview with prof. Remuzzi (?) – not sure I remember correctly the name – who mentioned what he called ‘strange cases of pneumonia’ in Oct-Dec ’19 which could be covid and could explain how the virus got into the hospital chain. 131. cedarhill says: Italy is a full fledged member of the PIGS – see financial history. As is Spain. However, there really is no proof of isolating those exhibiting symptoms has ever “stopped”, “slowed”, “flattened” the spread of any respiratory flu, cold virus. Only conjecture. These class of viruses are hardy, can last for years on various surfaces, float around in the air ignoring the 6 foot stop signs. What happens is most, if not all, modern Western communities will have every member exposed. Quite possibly by the time even the first case appears at the hospital doors. There’s a complete disconnect of calling a virus “highly contagious” and “isolate, quarantine” those with proven symptoms. Take another virus labeled “highly contagious” – measles. All it takes to become infected in a classroom setting is for one kid to enter the classroom, sneeze, and all non-vaccinated kids are infected. One kid, entire class, one sneeze, one time. That’s a virus (about the size of all flu and cold viruses – range of 0.1 mircons) that’s highly contagious. One might even say the one sneeze in the classroom exposed all the kids that one time. Yet popular medicine would have you believe that quarantining, after the fact, only of those with symptoms (and half of those infected never produce symptoms, most of the others too mild to notice) somehow set up an invisible boundary of containment? Toss out the myth flag please. Same with washing hands or social distancing. For example, meta studies (2016) of clinical trials of hand washing to reduce the incident of flu like symptoms stated there was no statistical difference in washing versus not washing. Washing for bacteria (orders of magnitude bigger than viruses) works due primarily to their size. So wash to get rid of bacteria. Obtw, same with hand sanitizers. Most do not have enough alcohol and then most to not let it stay, wet, on their hands long enough (10+ seconds). Search PubMed. The only method which might work for quarantine is that proven to work with other mammals – all entries (travelers) entering a nation are isolated in quarantine for 3 to 6 months. You can research the whys. For humans, quarantine could work if (1) we could test all incoming travelers crossing national borders quickly and 100% reliably AND scan all surfaces they carry along which can harbor these viruses (and note, the workers would have to be decontaminated that handle or process the travelers/luggage. Even just shipments would need to be scanned/decontaminated. This simply will never happen in this millennium. Maybe on Star Trek? What should, and is now feasible considering the huge advances in biochemistry, sequencing, genetic and cellular engineering, would be detection and treatment. We actually have the technology to develop rapid production of anti-bodies when one of these viruses start circulating. Rapid testing is possible but only after initial detection. Capitalism is a perfect environment to reward those that can engineer this technology. Recall how many decades a few years ago they were saying it would take to sequence just one humans genome. Today, with competition and capitalism, it’s done in minutes (see 22andme for example). It’s truly astounding. Meanwhile, wash your hands, shelter in place, keep social distancing, hoard supplies – in short do the things that comfort you and feel secure in the fact that you’ve already been exposed to the Wuhan along with a host of other respiratory viruses. For the Darwinist, be secure in the knowledge that we’ve evolved fighting, and winning, these viruses for millennia – they’ve even found active corornaviruses at paleo digs from 6,000 years ago. 132. Olen says: The country has to work to survive. The human body is the same in a way, if it does not move it will die. 133. Rod says: Just a thought about something I know little of, but am curious about: It involves ACE, which is what I know little of. But I read where many current blood pressure drugs work on the ACE whatevers and that CoVid-19 also involves the ACE whatevers, and that the blood pressure meds could make a person more susceptible to death by CoVid-19 as a result. Then I see that the largest comorbidity is hypertension which made me wonder. I realize that most older people are dealing with high blood pressure, hence the chart. What I’m wondering is what percentage of the younger people, say 50 and under, also had high blood pressure and were on the meds that deal with the ACE whatevers. Just putting it out there in case there’s something to it. Sorry I know so little about whatever the ACE is/are. • Karl says: Angiotensin Converting Enzyme Inhibitors A large body of evidence indicates that ACE Inhibitors suppress the synthesis and release of TNF-alpha, and IL-1 (interleukin -1). Both cytokines are involved in the regulation of both the immune and inflammatory response to viral challenge. The link below identifies that ACEi interfere with cytokines, it also mentions the interference is not completely understood. A hyper-inflammatory response, a weak immune response, or a combination of both could potentially be the cause, but I have not found any explicit ‘smoking gun’. https://www.sciencedirect.com/science/article/abs/pii/S1043466685700713 134. Steven Mosher says: “From the call center building in Guro-gu, Seoul, no additional cases were confirmed. The current total is 158 confirmed cases since 8 March. Of the 158 confirmed cases, 97 are persons who worked in the building (11th floor = 94; 10th floor = 2; 9th floor = 1), and 61 are their contacts. The KCDC shared the interim result of their epidemiological investigation in collaboration with Seoul City, Incheon City, and Gyeonggi Province during the monitoring period of 9-22 March. The call center on the 11th floor had the highest infection rate (43.5%), compared to 7.5% and 0.5% for 10th and 9th floors, respectively. There was no confirmed case from other floors. Of the 226 persons identified as family members of the 97 confirmed cases who worked in the building, 34 (15.0%) were infected. Of the 97 confirmed cases, 8 (8.2%) were asymptomatic cases. Of the 16 persons identified as family members of the 8 asymptomatic confirmed cases, no confirmed case was found.” n Daegu, testing has been completed for every person at high-risk facilities. Of the 32,990 test results, 224 (0.7%) were positive results. So basically if you target your testing SPATIALLY and follow lines of causation, you have a chance to wake that mole. Or you can limit testing to symptomatic people and skew your death rate “In light of the recent surge in COVID-19 cases in the United States and the rise in the number of imported cases from the US, starting 0:00 of 27 March, a stronger screening process will be applied for inbound travelers from the United States. All symptomatic persons entering from the US, regardless of nationality, will be required to wait for testing in a facility within the airport. Persons who test positive will be transferred to a hospital or “Life Treatment Center”. Persons who test negative will enter self-quarantine at home for 14 days. Korean nationals and foreigners with a domestic residence who are asymptomatic at the time of entry will enter self-quarantine in their home for 14 days and get tested if symptoms begin to occur. Foreigners who are on a short-term visit without domestic residence and thus are unable to self-quarantine will be tested in at a temporary facility. If they test negative, they will be allowed entry under enhanced active monitoring.” “The Central Disaster and Safety Countermeasure Headquarters will strengthen the management of inbound travelers under self-quarantine. Persons subject to self-quarantine will be issued a self-quarantine notice at the airport. Failure to comply is punishable by imprisonment up to 1 year or a fine up to 10 million won. They are also required to install the self-quarantine mobile app (made by the Ministry of the Interior and Safety) on their phone, so that their local government can monitor their self-quarantine.” 135. Rud Istvan says: Mosher’s comment to WE got me thinking about the data and CFR. Previously, I had been using the Diamond Princess final report from Japan, knowing it was skewed high by passenger age and viral titer so was an unrealistic worst case. South Korea now provides a much better statistical figure because of the aggressive testing. WorldoMeter has most of the data. About 270,000 tested, as of yesterday 9037 positive with 20% asymptomatic 14 days after testing positive. So the CFR denominator is known: 120 deaths/ 3507 recovered = 3.4% CFR in a medical system that is NOT overwhelmed like Italy. Not good. Infection rate in the country using masks and social distancing is 9037/~270000 =3.3%. 5410 active cases. 11% of active cases go to serious (supplemental oxygen) / critical (ventilator). 3.4/11=> ~1/3 of S/C become fatal. Lets hope chloroquine works to change that number towards zero. 136. Steven Mosher says: Typical social distancing guidance “In light of the continued emergence of outbreaks in various venues such as religious facilities and workplaces, the KCDC urged everyone to participate in enhanced social distancing campaign for the next 15 days (22 March – 5 April). Citizens are advised to stay home as much as possible other than for going to work, visiting a healthcare provider, and purchasing necessities. Working citizens are asked to maintain a distance from other people during lunch breaks, refrain from using break rooms and other social venues, and pay closer attention to maintaining personal hygiene (e.g. washing hands). Employers are advised to implement various methods of minimizing person-to-person contact for employees, such as reorganizing workspaces to ensure greater distancing and implementing work-from-home and flexible hours systems. Those who show symptoms should be advised not to show up at work. Workers who develop symptoms mid-day should be sent home immediately. The government has also limited the operation of high-risk facilities including religious facilities, some indoor fitness facilities, and nightlife venues. Venues that remain in operation must strictly comply with infection prevention guidelines (e.g. disinfecting, ventilation, distancing, mask wearing) set by the authorities.” 137. Toto says: https://coronavirus.1point3acres.com/en “COVID-19 in US and Canada Real Time Updates With Credible Sources This site is made with (heart) by first generation Chinese immigrants” It has graphs and stats by state and you can click on the map to see details at the county level. 138. Tim Bidie says: I’m obviously missing something here. I have contracted pneumonia twice from seasonal influenza, 1973 and 2014, both times aged between 15-64. Given less fortunate circumstances, I could died on either occasion. Neither occasion was even remotely pleasant but neither was atypical of a British winter, nor occasioned the shut down of the entire economy In fact, in 2014/15, 701 people aged 15-64 in Britain did die of influenza, out of 25,143 of all ages. In 2015/16, over 10% of deaths in Britain from influenza were aged 15-64. In 2017/18, 1,462 people aged 15-64 in Britain died from influenza. Coronavirus is, according to the W.H.O., less contagious than seasonal influenza. Its lethality may very well be similar, possibly even a great deal less, given the lack of any clear infection numbers globally. Underlying health conditions, advanced age and obesity, appear to be the common denominators of lethality. Ingestion of harmful chemicals of one sort or another also appears to be a major contributor to fatality. All of this is also true of seasonal flu. https://swprs.org/a-swiss-doctor-on-covid-19/ So I have a crisp red £50 note that says, once the dust has settled, fatalities in Britain from Flu/Covid 19 2019/20 will prove to have been less than those from seasonal flu in 2014/15 or even 2017/18. And who will be held responsible for the economic meltdown in progress? That would be no-one…….. • Clyde Spencer says: Tim I was watching a news program on TV last night when the reporter asked an epidemiologist how the COVID-19 was different from seasonal flu. It was my judgement that the doctor’s face showed distress at the question. He came back with what I would call a “non-answer.” He said, without any qualifications or explanation, that COVID-19 was worse. If I were the reporter I would have pressed him and asked, “How is it worse? We have fewer cases than seasonal flu (>1,000,000), and fewer deaths than seasonal flu (>30,000). Are hospitals turning away patients because of a lack of resources?” From my perspective, there are a lot of unanswered questions. • Tim Bidie says: Entirely agree. Talked to some people today, at some distance. He was hospitalised with a still undiagnosed respiratory infection in November 2019. His son shows Leeds University students around accommodation. Leeds University has an exchange program with Xi’an Jiaotong University in China….hmmm……. • Phil. says: Leeds has program with Southwest Jiaotong which is in Sichuan not Hubei. • A C Osborn says: Was there social distancing and lockdowns and handwashing advice for the Flu in either of those UK epidemics? Where the hospitals completely overloaded? The WHO lied about COVID19 being transferable by humans (based on Chinese info), they lied about Mask usage and I am pretty sure that they are lying about it being less infectious than the flu, especially considering that there are 4 flu viruses to 1 CORVID19. • Karl says: Why do you think it is more infectious than the FLU? • Nicholas McGinley says: Karl, You give every indication of having absolutely no idea of what you are tanking about, and of being an opinionated blowhard who speaks in absolutes, and of babbling incoherently while demanding information from other people. Relative values for infectivity are estimates, they vary, and besides there is no general precise consensus value for many viruses. What exactly do you mean by “infectious” Are you talking about the Basic Reproduction Number? Are you talking about how “contagious” it is? What criteria are you using to disagree so rudely with people here? This virus is objectively far more “infectious” than any strains of influenza, even Spanish Flu, and certainly seasonal flu strains. It just is. Do some reading. Or cite a source. • Karl says: Prove it is far more infectious with objective data. The Diamond Princess falsifies your assertion regarding. Objective Data — Spanish Flu Infected 500M out of 1.5 Billion THIRTY PERCENT OF THE WORLD POP https://www.cdc.gov/flu/pandemic-resources/1918-pandemic-h1n1.html COVID-19 Infected 500K out of 7 Billion World 60K out of 11.8 Million (Wuhan) Not even ONE PERCENT TRY AGAIN • A C Osborn says: Yes of course with the Spanish Flu they tested 500M people didn’t they? They guessed the numbers. The people in the Diamond Princess were in Isolation in their cabins almost from the start and still were infected. Nobody knows how many people have actually had COVID19 because they haven’t been testing everybody. 139. Bindidon says: ” 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. ” Maybe it was recently. But the member we all should by no means emulate is named in between ‘Spain‘, which just bypassed China for the death toll. This was predictable since days for everybody having followed the situation described at the web site https://www.worldometers.info/coronavirus/#countries If instead of producing a logarithm-based chart of the death toll / Mio, Mr Eschenbach would have concentrated on a linear representation of the case / death toll ratio, i.e. last day’s deaths / (total deaths – last day’s deaths) he would have shown us this for March 23: USA: 0.34 Germany: 0.31 Spain: 0.30 France: 0.28 Italy: 0.11 and this for March 24: USA: 0.41 Spain: 0.29 Germany: 0.29 France: 0.28 Italy: 0.12 (The numbers and ratio for cases btw are quite similar to those for deaths.) These numbers vary day by day – but not in a way contradicting the trend. I’ll store them by now; I should have done that since mid January. * Many comments on this page are strange: nearly everybody tries to diminish what happens, if necessary by publishing amazingly wrong numbers when comparing the seasonal flu with the current viral disease. Why? While flu in the US has a mortality rate of about 1 death per every 1,000 cases (i.e. 0.1 %), SARS-CoV-2 won’t show much less than 1.5 %. That is a little bit more, isn’t it? We all shouldn’t panic. And the best way no to do still is to show things simply as they are. Rgds J.-P. Dehottay • Josh Postema says: “While flu in the US has a mortality rate of about 1 death per every 1,000 cases (i.e. 0.1 %), SARS-CoV-2 won’t show much less than 1.5 %. ” This is a common mistake. The estimated flu mortality rate is this equation: Deaths With Flu / Estimated Cases of Flu The coronavirus mortality rate is this equation: Deaths with Coronavirus / Tested Positive Cases of Coronavirus Do you see the difference? • Bindidon says: 140. TheFinalNail says: [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 … __________________ That is just tragic. The world will owe an enormous debt of gratitude to these largely under-paid and under-appreciated folks once this finally settles. • Derg says: “ these largely under-paid and under-appreciated folks once this finally settles.” I know lots Of well paid and appreciated folk. • Steven Mosher says: ya happens every flu season sarc off 141. Matthew R Marler says: Willis, thank you for your essay. And for your ongoing graphing of the worldometers data, especially the use of the log scale. And for including the informative comment by Steven Mosher. 142. Red94ViperRT10 says: I gotta say this (I have not perused all the comments, if I’m repeating someone else’s observations, I apologize for taking up pixels), in your very first chart, your Figure 1, that red line, supposedly for the course of the Wuhan virus in China, caused my B.S. alarm to ring, loudly. That red line is much too smooth, that does not look like a graph of empirical data, that looks like a graph of a model-produced trend-line. In which case, I suspect the “model” was programmed to produce exactly and only what the Chinese Communist Party wanted it to show. In other words, it’s a total fabrication. Can there be any other explanations for such a smooth line? 143. Willis Eschenbach says: Steven Mosher March 24, 2020 at 10:19 pm “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 You keep bringing this up. First, here was my actual prediction, in this post of mine: So far, there have been some 7,362 cases in South Korea. The Gompertz Curve estimates that the final total will be on the order of some 8,100 cases or so. Now, that’s not a hard number, of course. All kinds of things can happen to bend the curve either up or down. But it’s better than just making a blind guess. Not a hard number. The curve could bend up or down. And for number of deaths, I said: Finally, let’s take a look at the deaths in South Korea. It’s still early, deaths are still happening, so this will be more uncertain. Although the uncertainty in this one is greater, it looks at present like the final total of deaths in South Korea will be on the order of one hundred, give or take. Early days. More uncertain. First, I didn’t specify a number in either case. I said “on the order of”. I said “give or take”. I said it was not a hard number, and that there were lots of things that could happen to change the numbers. Given those caveats and the fact that AFAIK I was the first person to make such a public estimate, I’d say I did well. There were 60 deaths in Korea at the time, and it certainly looked like it could go through the roof. Next, you say “the curve for Korea was wrong as I pointed out at the time”. I just reread every comment you made on that post of mine and I can’t find you saying that … although it’s a long thread and I could have missed it. Nor, as far as I can find, did you make a corresponding estimate at the time of the Korean deaths. You didn’t say how many you thought there would be … I did. So for you to now pretend that I predicted hard numbers and you were all prescient is historical revisionism. You didn’t make an estimate, I did, and now you want to nitpick and misquote my estimate? Next, as I said about the Korean data back when I made the estimate, “It’s still early, deaths are still happening, so this will be more uncertain.” However, now we have a bit more data. The Gompertz curve is now saying that Korean deaths will end up on the order of 210 … and yes, the usual caveats apply—there are lots of things that could push that estimate either up or down. Next, you say that “The problem with Gompertz and Farr’s law is they are non mechanistic. For a mechanistic model you want SIR compartmental models.” In general, a more complex model is likely to give a better answer. Presumably based on such models, you say above that the Korean deaths : … we are at 120, and head to 150 Minimum based on the the daily death rate of those under care./blockquote> Doesn’t seem like your more complex models are giving much detail if that’s your prediction … but we’ll see in the fullness of time … My best to you, stay well in the land of good food and lovely folks, w. • Steven Mosher says: “Next, you say “the curve for Korea was wrong as I pointed out at the time”. I just reread every comment you made on that post of mine and I can’t find you saying that … although it’s a long thread and I could have missed it.” You want to double down after we hit 94 I questioned you again and you re interated your prediction of 100. But I guess now your predictions are not really predictions? basically it is time to say that Gompertz is not a good model. I explained to you that we had two other zones popping . maybe if Mann had fit a gompertz you’d have less tolerance for the mistake • Willis Eschenbach says: Steve, first off, please quote where I “doubled down” on my 100 number. AFAIK, I just pointed out that we hadn’t hit 100 deaths in Korea at that point. Next, you say “But I guess now your predictions are not really predictions?” I hedged them about from day one, saying that THEY WERE NOT HARD NUMBERS and that THE UNCERTAINTY WAS LARGE and that THINGS COULD CHANGE TO PUSH THEM UP OR DOWN. I put that in CAPITALS because you continue to ignore it. I did it in part because I knew how uncertain that they were, and in part because I knew some prick would come along and hassle me if they weren’t exactly right … Given those caveats, are they “predictions”? Yes, just fairly general ones. Is fitting a Gompertz curve to the data a “good model”? Well, since the curve fits the death results of every country to date, I’d say yes. Is it predictive? Well, it’s done a pretty good job, I’d say. So I’d disagree that fitting it was a “mistake”. Finally, all you do is sit on the sidelines and snipe. AFAIK, your vastly superior models haven’t given us one number as a prediction. But when I do, you want to tear it apart … look, I’m not trying to predict it to within ± 1% or something. I’m trying to get a handle on it. When the Korea death data first came out, it looked like it could be going to be going up, up, up into the multiple thousands. That was scary to me. But when I fitted the curve, it said in the hundreds, not the thousands. I thought that was valuable information, and it has been borne out. Yes, it looks more like 200 than the 100 I estimated while SAYING IT WAS EARLY DAYS AND I HAD LITTLE INFORMATION … So what? Seriously, so what? Why this incessant unsuccessful reaching up on your part to try to bite my ankles? What’s the point? Yes, the Gompertz curve is a rough tool … but it has a huge advantage, in that you don’t have to know the R0 and the time of infectivity and the other dozen things that go into your model … and we still don’t have that data. Heck, over at Judith Curry’s always excellent blog there’s a new post by Nic Lewis entitled COVID-19: Updated data implies that UK modelling hugely overestimates the expected death rates from infection … the experts can’t get your vaunted models right, and you want to rag on me for back-of-the-envelope calculations in the right order of magnitude? Get a life, bro’ … this is a very ungood look on you. Please stay well, as much as we disagree, you’re a very valuable contributor to all of the ongoing discussions. w. • Willis Eschenbach says: Yeah, those models are so much better than considering Gompertz curves as a rough-and-ready estimator, all right … they’ve already cost us TRILLIONS via this crazy lockdown. Well done! w. • Steven Mosher says: show me where I prefer him? quote my words. haha what I objected to was simple Willis. YOU DID NOT LOOK AT THE DATA! if you looked at the local data it was obvious gompertz would not work same for deaths. BUT you had a story to sell, I’m betting you still haven’t looked at the local data. as for biting ankles, you’re a big boy • Willis Eschenbach says: First you were aggravating. Then you were amusing. Now, you’re just boring. Go whine at someone else. Not interested. w. • Steven Mosher says: Over 130 now willis headed to 10000 You didn’t listen you still are not You could just say , thanks steve! next time I’ll look at the data rather than fitting a curve • Willis Eschenbach says: Go bother the guy who used one of your models and wildly overestimated Britain’s deaths, leading to all kinds of misjudgments. And if you think the Korean deaths are headed for 10,000, I’m not going to comment on that prediction at all. Finally, you foolishly say I should have said: “next time I’ll look at the data rather than fitting a curve” … um … er … just what do you think I was fitting the curve to? The air? You truly don’t seem to understand the concept of using a “back-of-the-envelope” calculation to constrain the possibilities. And seriously … don’t you have something better to do with your time than to publically fail at harassing me for making an early estimate based on early data? I’m out here doing things, and you’re standing on the sidelines and whining and bitching about a meaningless point? That’s your contribution? Your choice. Me, I’m a doer. w. • mario lento says: Just when I start liking Mosher for the good stuff he can do, I see why everyone picks on him, and downright slams him. He seems to like it. He will even go as far as to make some detailed and fake stuff up, which is all twisted, and try to pin it on someone to see if they will play his game and defend it. Willis, I feel for you here. I am sorry you have to deal with this crap and hope this does not deter you from the free stuff you do that’s worth gold to the rest of us. 144. KT66 says: I have noticed that older people are always handing their phones to other people because they can understand what is being said. With phones we are always handling them with, usually unwashed hands, and then putting them right to our faces. 145. A C Osborn says: For all those who think it is just old farts with underlying health problems that die. A UK 21 year old healthy girl died today and a 37 year old UK ambassador to Hungary also died. • Derg says: Was Coronavirus is the autopsy as cause of death? No other conditions present? • Josh Postema says: “For all those who think it is just old farts with underlying health problems that die.” No one has ever said that only old people with underlying health problems die. What the stats clearly show is that out of all the people who die, that demographic represents almost everyone. • Nicholas McGinley says: Some people are clearly saying that only old and sick people are dying. • SocietalNorm says: Even the yearly flu kills healthy young people. It’s all about the percentages. I know of 3 healthy younger people who ended up with pneumonia with this year’s influence. • SocietalNorm says: influenza 146. John Murray says: Italians over 65, and those with health problems, get an annual flu vaccination. Free. As do a lot of other European citizens. In the UK the old, sick and children get annual flu vaccination. The only people being admitted to hospital in the UK, for sars-cov-2, are those with serious respiratory problems. Elective surgery for non-life-threatening problems has all been cancelled. My local hospital is not even admitting people to emergency care for minor injuries/illness. 147. KT66 says: There is always the possibility that there is common denominator in the gene pool of some localities which make people more susceptible to succumbing. Also are there customs in some localities such as a greeting involving close personal contact? 148. Jacques Lemiere says: from the swiss doctor Regarding the situation in Italy: Most major media falsely report that Italy has up to 800 deaths per day from the coronavirus. In reality, the president of the Italian Civil Protection Service stresses that these are deaths „with the coronavirus and not from the coronavirus“ (minute 03:30 of the press conference). In other words, these persons died while also testing positive. As Professors Ioannidis and Bhakdi have shown, countries like South Korea and Japan that introduced no lockdown measures have experienced near-zero excess mortality in connection with Covid-19, while the Diamond Princess cruise ship experienced an extra­polated mortality figure in the per mille range, i.e. at or below the level of the seasonal flu. Current test-positive death figures in Italy are still less than 50% of normal daily overall mortality in Italy, which is around 1800 deaths per day. Thus it is possible, perhaps even likely, that a large part of normal daily mortality now simply counts as „Covid19“ deaths (as they test positive). This is the point stressed by the President of the Italian Civil Protection Service. However, by now it is clear that certain regions in Northern Italy, i.e. those facing the toughest lockdown measures, are experiencing markedly increased daily mortality figures. It is also known that in the Lombardy region, 90% of test-positive deaths occur not in intensive care units, but instead mostly at home. And more than 99% have serious pre-existing health conditions. • Nicholas McGinley says: “More than 99%” is an wild exaggeration. I have seen zero data suggesting anything like that number. That would suggest a healthy person has virtually no risk of dying. We know this is not true. The risk of any serious medical condition is greatly elevated for the elderly and those who have serious health problems. But exactly what counts as “serious” is open to interpretation. Hypertension can be either quite mild or it can be life threatening. It can be well controlled, or uncontrolled, it can be being treated it it can be undiagnosed and untreated. Given that…is it accurate to call it blanketly a “serious pre-existing health condition”? No one dies from mild pre-hypertension, although it is a risk factor for hypertension later in life and greatly increases risk of many other medical conditions. It can increase risk of stroke or heart attack…but people can have these without ever having elevated blood pressure too. In the Dutch study, it describes about 1/4th of those hospitalized had any other medical conditions. It does not say what this proportion is for those who dies, but many other sources have described numerous examples of deaths among people with no health conditions who were not elderly. 149. Wim Röst says: About the [possible] use of antibody-rich blood plasma for cure and prevention: Article: How blood from coronavirus survivors might save lives New York City researchers hope antibody-rich plasma can keep people out of intensive care. Source: https://www.nature.com/articles/d41586-020-00895-8 Some excerpts: “US researchers are hoping to increase the value of the treatment by selecting donor blood that is packed with antibodies and giving it to the patients who are most likely to benefit.” “A key advantage to convalescent plasma is that it’s available immediately, whereas drugs and vaccines take months or years to develop. Infusing blood in this way seems to be relatively safe, provided that it is screened for viruses and other infectious agents. Scientists who have led the charge to use plasma want to deploy it now as a stopgap measure, to keep serious infections at bay and hospitals afloat as a tsunami of cases comes crashing their way.” Antibody plasma kills the virus: “But Liang Yu, an infectious-disease specialist at Zhejiang University School of Medicine in China, told Nature that in one preliminary study, doctors treated 13 people who were critically ill with COVID-19 with convalescent plasma. Within several days, he says the virus no longer seemed to be circulating in the patients, indicating that antibodies had fought it off. But he says that their conditions continued to deteriorate, suggesting that the disease might have been too far along for this therapy to be effective. Most had been sick for more than two weeks.” “In one of three proposed US trials, Liise-anne Pirofski, an infectious-disease specialist at Albert Einstein College of Medicine, says researchers plan to infuse patients at an early stage of the disease and see how often they advance to critical care. Another trial would enrol severe cases. The third would explore plasma’s use as a preventative measure for people in close contact with those confirmed to have COVID-19, and would evaluate how often such people fall ill after an infusion compared with others who were similarly exposed but not treated. These outcomes are measurable within a month, she says. “Efficacy data could be obtained very, very quickly.” “Even if it works well enough, convalescent serum might be replaced by modern therapies later this year. Research groups and biotechnology companies are currently identifying antibodies against the coronavirus, with plans to develop these into precise pharmaceutical formulas. “The biotech cavalry will come on board with isolating antibodies, testing them, and developing into drugs and vaccines, but that takes time,” says Joyner.” • Nicholas McGinley says: Even the best treatments for viral infections are highly sensitive to the stage of the illness of the patient. In Ebola testing for the Regeneron monoclonal antibody, it cured over 94% of people who were recently infected , had low viral loading in serum assays, or had recently presented with symptoms. But in patients with high plasma viral counts, the success rate of even this very effective treatment was well below 50%. At that stage, most patients died, no matter what was done. 150. Former NIH Researcher says: You can’t use a map unless you know where you are and know if you are going in the right direction. Before we do RANDOM testing of 100 individuals with antibody testing (to determine who has had Corona and are immune) and 100 swabs to determine number of active cases in the population, and repeat this every day, we have no idea where we are and where we are going. If we decrease social distancing and the random test still shows more immune people and less active cases, we can continue, if not, it is back to lockdown ASAP. But we have to know. DO THE RANDOM TEST. Aren’t there any scientists out there? • Nicholas McGinley says: How do we do random tests? Knock on doors? Stop traffic? Pick people out of a phone directory? What rights have people to participate or refuse? Who is gonna do it? Who has funding, or authorization, or the manpower…or the test kits? Scientists are being told to stay home and social distance too. What sort of scientists are qualified to go around testing people? Medical information is protected and privileged…has HIPAA been suspended? It has not. And what sort of test? Nasal swabs are invasive and uncomfortable and expensive and must be done with careful adherence to PPE, both to protect the tester and the testee. Is the guy testing me infecting me? Does he change his gloves with every patient? How and when was he trained? What is a nasal swab test actually saying? • Steven Mosher says: very Nice Micheal 151. Eddie says: This link gives the distribution by age of patients in The Netherlands: https://www.parool.nl/nederland/cijfers-rivm-meeste-patienten-tussen-55-59-jaar-oud~b06453055/?referer=https%3A%2F%2Fwww.google.be%2F It actually shows – distribution by age of people tested positively – distribution by age of people hospitalized – distribution by age of deaths Unsurprisingly the peak shifts right. Conclusion from this – all age groups get it equally, the first graph is almost a cross section of the population (apart from kids) – mostly the old die I find this undermines your reasoning to come to the hypothesis of “I was forced to a curious conclusion, … 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” Note that you first call this a guess, then a suspicion and then you put it forward as “likely”. You are every inch right that this can be a hypothesis, but you should only start to call it likely based on good evidence. That famous swiss doctor report is again a list of incomplete quotations. 2 examples While the Italian report indeed does reveal things it should be read well, eg on the deaths -40. It says they are nearly all “with serious pre-existing pathologies (cardiovascular, renal, psychiatric pathologies, diabetes, obesity).”. Note that they call diabetes and obesity a serious pre-existing pathologie. According to CDC data 10% of Americans have diabetes and a whoppy 40% is obese. Ignoring that there is probably overlap one could say that half of the US population has at least 1 serious pre-existing pathologie and thus is at risk! The Swiss doctor says that 90% does not die in an IC unit. The report goes on to mention that patients do not make it to the IC unit in time, because of an overload on the medial system. If you are not an expert in a domain it is best to stay out of it • Nicholas McGinley says: The newest version of the Edge browser has a built in function that will translate entire web pages. The link you posted would be worthless to me without it, but I can read it in English with one mouse click. Thank you for the link! • Bindidon says: Eddie Excellent comment, thanks. Rgds J.-P. Dehottay • Nicholas McGinley says: Medical experts tell us that when it comes to people above the age of 50 and especially 60, nearly everyone has a “comorbidity”. How many people who are 60 take zero medications? How about 70? 75? 80? Other questions abound: Someone with mildly elevated blood pressure in the US is strongly advised to treat it. Below a certain limit, this condition is not strictly speaking hypertension, but is prehypertension. With medications both prehypertension and hypertension can be either well controlled or poorly controlled, or uncontrolled. But in postmortems, are these distinctions being accounted for? Is anyone taking a medication being lumped together? It is likely many people are undiagnosed (but hypertensive) when they arrive in a hospital with a COVID infection. It may well be that pneumonia raises a person blood pressure above the limit of hypertension. Are they talking about what a person was measured as having while they were well, or after arriving at a hospital or ICU? Zero data on this from the sources reporting on these things. Later stages of illness often cause a drop in blood pressure as the body goes into shock. A quick review of an internet search reveals that pneumonia is given as both raising and lowering BP. There is an awful lot of parsing required to know what conclusions can validly be made of this data. • Steven Mosher says: “If you are not an expert in a domain it is best to stay out of it” don’t expect any one here to listen. well, I’ll listen 152. geoff@large says: Hi Willis, another aspect of nosocomial deaths is from ther respirators. This US study https://sigmapubs.onlinelibrary.wiley.com/doi/full/10.1111/j.1741-6787.2006.00066.x says ” Preventable adverse patient events, including hospital‐acquired infections, are responsible for 45,000 to 100,000 deaths annually, …in the United States (Kohn et al. 2000). Ventilator‐associated pneumonia (VAP) is the leading cause of nosocomial infection in critically ill adult patients around the world, surpassing central line‐associated bloodstream infections and catheter‐associated urinary tract infections (Patel et al. 1998; Centers for Disease Control and Prevention [CDC], 2003). The incidence of VAP ranges from 4% to 42% of all mechanically ventilated intensive care unit (ICU) patients…”. Some people have said people over 60 are not getting ventilators in Italy, but I haven’t been able to verify that, and if so how consistent is the practice and when did it start. 153. Steven Mosher says: 154. Dennis Kuzara says: Willis There are a lot of underlying reasons for what is happening in Italy. It isn’t just the numbers. 1. there are 330,000+ Chinese working in 4000+ Chinese owned factories in Italy. 2. The outbreak happened shortly after the Chinese new year (January 25th – February 8th) ended. , (One guess as to where a lot of the Chinese workers in Italy went for the most important holiday.) 3. The Italians did not close their borders or stop air traffic from China because they feared being called racists. Political correctness is a hallmark of left leaning governments. 4. Italians are very touchy-feely. They kiss on both cheeks, young and old, every time they meet; it is to them what a hand shake is to us. 5. They have large families which get together often and most certainly on holidays or for sporting events. 6. Evenings are spent out and socializing; they walk everywhere and eat out often. They are rarely alone. 7. A large percentage of the population smoke, male and female, which has a negative affect on the the lungs. 7. At mass they use a common challis and many go to mass several times a week. I am sure I missed some, but in short it was the perfect storm. Their customs are based on close contact, they are heavy smokers; add to that a massive influx of COVID-19 carriers and a government that did little to shut the gates. Sometimes it is more than just statistics. • Toto says: https://www.rebellionresearch.com/blog/northern-italy-wuhan-partners-for-better-or-worse The answer lies in the connection between northern Italy and Wuhan, China. Two very seemingly distant geographies are actually extremely tied together. Italy was the first country to offer direct flights from Europe to China 50 years ago and was also the first G-7 country to embrace China’s Belt and Road Initiative. Northern Italy has a very prosperous fashion and apparel industry. Many of the most famous brands around the world from Gucci to Prada originated in the region. As China has offered cheaper manufacturing for their apparel factories, more and more Italian fashion houses have outsourced work to China, and specifically to Wuhan. Italy created direct flights from Wuhan and allowed over 100,000 citizens from China to move to Italy and work in their factories. In addition, as the Chinese became increasingly wealthy over the last two decades, more and more Chinese citizens moved to northern Italy to reside and many Chinese purchased Italian firms. Today there are now more than 300,000 Chinese nationals living in Italy, according to Fortune Magazine, and over 90% of them work in Italy’s garment industry. https://uk.reuters.com/article/uk-health-coronavirus-italy-timing/italian-scientists-investigate-possible-earlier-emergence-of-coronavirus-idUKKBN21D2IT Adriano Decarli, an epidemiologist and medical statistics professor at the University of Milan, said there had been a “significant” increase in the number of people hospitalised for pneumonia and flu in the areas of Milan and Lodi between October and December last year. […] Giuseppe Remuzzi, director of the Mario Negri Institute for Pharmacological Research, in Milan, said some family doctors in Lombardy had reported unusual cases of pneumonia late last year that now looked potentially suspicious. He said among those were several cases of bilateral pneumonia – which means both lungs are affected – in the areas of Gera D’Adda and Crema in late November and December, with high fever, cough, fatigue and difficulty breathing. “None of these cases have been documented as COVID-19 because there was no evidence yet of the existence of COVID-19,” he said. The article points out that this claim is far from proven. It does not speculate that the Wuhan virus might be a joint Milan/Wuhan venture, that a bat virus from Wuhan infected some in Milan before it mutated into its novel evil form. Wild speculation, with lots of ‘coulds’. Maybe they will exhume some early Milan victims. 155. Jacques Lemiere says: the swiss doctor is deceptive he published data of march 7th initaly the 24th sayong no signal on mortalityt and at that time it was true.. but this is deceptive 156. Bill Parsons says: A question for a statistician… I’m curious if someone can interpret this and tell me if this represents a statistical artifact of our testing procedures in the U.S? The “Infection Trajectory” chart would suggest we now have the most cases AND the fastest rate of increase of cases. To see the U.S. hover over the curves. Ours is furthest to the left. https://www.visualcapitalist.com/infection-trajectory-flattening-the-covid19-curve/ • Nicholas McGinley says: We are now doing the most testing of any country, which is why cases have exploded up far faster than the number of deaths, and the number of patients in critical condition. All of these numbers are rising, but for a long time we were hardly doing any testing, and now we are doing a lot of testing…but as far as I know, we are not testing large numbers of people not known to have been exposed, and are not testing anyone at random. So even with greatly expanded testing, we are surely only seeing the tip of the iceberg regarding the number of people actually carrying or have carried the virus. And it may be many people are dying without going to hospitals. Typically, people who die of flu at end of life stage include a large number of people who die in their bed at home after a long period of being bedridden or close to it. 157. Bill Parsons says: Correction to above post on the infection trajectory: is the graph telling us (in the States) that we have the fastest rate of increase – and may soon have the largest number of confirmed cases? • Nicholas McGinley says: I have open the link and will have a close look, but I wanted to offer some thoughts first. One is that, due to many possible and actual disparities between countries and even regions and states and cities within a country in how information is tallied, data is collected, and how terminology is defined (such as what counts as “critical” condition, when is a death due to COVID, etc), and other such vagaries, all of these graphic comparisons ought likely be taken with a larger than usual grain of salt. Superimposed on the above…in the midst of any crisis, particularly one in which people are not able to be in the sorts of places that typically compile statistics, all information is spotty and hence dubious, at best. In a way this situation is akin to an earthquake or hurricane, in which info from ground zero is more likely than not incomplete at best, at least from the aspect of detailed information. • Steven Mosher says: ” is the graph telling us (in the States) that we have the fastest rate of increase – and may soon have the largest number of confirmed cases?” Yes cases are dominated by NY, they have a doubling time of ~4-5 days, But it is slowing lockdown will start to bend the curve there, already has. Other states are behind on testing. Marti Gras ( they allowed it to go on) will start to show up in hospitals. Spring break seeds will return home .. more cases. where will the USA end up? past China but only on cases not on deaths,,,, unless hospitals get swamped. Pretty soon there will be county data for the USA, THAT will tell you a lot. its the Granularity that planners use. So Ignore all national data, unless you want to muck about and make mistakes. County data, or city data if you can get it. • Phil. says: Phil. March 17, 2020 at 7:37 pm michel March 17, 2020 at 1:04 am “Finally, a plea for proportion. US coronavirus deaths are currently at 67, we’ll likely see ten times that number, 670 or so, might be a thousand or three” Looking at the US data the number increases by a factor of ten in ~12 days so I would anticipate being over 1000 deaths by the end of the month. I posted this in another of Willis’s posts just over a week ago. Looking at the death stats it seemed clear to me that the US would clear 1,000 by the end of the month (at that time there were 67 deaths), unfortunately if anything that was an underestimate. Deaths are doubling still in 2-3 days so I expect us to be over 2,000 by the end of the month. I believe that the rate in NY is starting to flatten so if they can maintain control of the hospitals that should be good but other states which have hitherto been relatively unaffected are sating to pick up so I think the overall rate will stay exponential for a week or so. • colin smith says: Stephen, a query on the SK testing if I may… …when a case is identified do you know “how far removed” contacts are traced and tested? In the example you’ve highlit of a high-rise. In the high rise you said a floor plus one above & below, and more floors IIRC when +ves (positives) were found. Was each +ve then queried as to, say, friends, businesses visited, workplace, public places such as a restaurant? Would direct contacts only be checked (or not), attempts to find visitors to the public places? • Steven Mosher says: “In the example you’ve highlit of a high-rise. In the high rise you said a floor plus one above & below, and more floors IIRC when +ves (positives) were found. According to previous reports, at first they tested all employees on floor 10, 11, 12. Guy sat on the 11th floor of a call center. Its on the news every night. Poor company. Then they announce that 553 residents of the building would be tested. I think it was floors 13-18 ( I could go reread it ) Was each +ve then queried as to, say, friends, businesses visited, workplace, public places such as a restaurant? From the Reports, family members are all tested ( 80% of transmission in china was family) Then Contacts tested. The Travel history is collected and we have apps where you can see where various “cases” travelled. Then you can decide if you want to report for testing. They don’t track down Everyone who went through a station. If you went through station X, then you can go present and ask for a test. In that case if you have no symptoms they might charge you 132 bucks Would direct contacts only be checked (or not), attempts to find visitors to the public places? Contact tracing App http://www.koreaherald.com/view.php?ud=20200326000987 • colin smith says: Many thanks, and the link, I also found an earlier sciencemag article link. This building had both residential and business premises, I had misunderstood that the business and the residential were different examples in different places. I might say there’s an element of both active & passive intervention. Active – we’re going to test people. Between the two – you get a warning of nearby cases if you have the app/kit/user skills. Passive – location information is available, up to the individual to discover/choose. Datasharing on people’s lives seems key. And there is (recent) legislation to provide for this. I’m in the UK and of course concerned that the level of testing and tracing is woefully short. I struggle to see, despite the seriousness of the situation, that the UK would be willing to row back on data protection, privacy and personal freedom to allow this to work. Even temporarily. Despite it being demonstrably successful and an example of best practice. Much technical literacy is also needed in the population. Need smartphone as a minimum. On the plus side might engage the young more who are the heaviest users of such tools. • A C Osborn says: Yes, in the UK we have suffered badly from the first cases because the Government didn’t name the people or at least give an exact location of where they lived or exact locations of where they had been. Nobody had any idea if they had been in contact with them or their surroundings, the Government relied on the patient remembering who had had contact with. Madness. 158. McBryde says: From Willis’ article: 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. Yesterday (Weds) on UK Column they saI’d there was a doctor who said that there was a new disease causing pneumonia in Italy BEFORE this thing started in China. (I’d need to go back and find exactly whar was said, buts too hard for me in this phone.) https://www.ukcolumn.org/ukcolumn-news/uk-column-news-25th-march-2020 • Fabio Capezzuoli says: Anedoctal: My parents’ GP, who is also a rescue volunteer, said he noticed an unusually high rate of pneuomonia back in November 2019. • Steven Mosher says: Flu surveillance system in the US says 2020 was an “up” year 159. SurferDave says: “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.” Yes, one more piece of the puzzle. More and more it is clear that this originated in the USA. It is not possible for the Australian sources of infection 2 or 3 weeks ago to show huge numbers from the USA (three times those from China and we have significant Chinese population and significant travel from) unless it was there *before* the Chinese found it. My understanding is they traced back to November 2019, the fish market was not ground zero, it was just where a clear cluster occurred leading them to the diagnosis. – Ft Dettrick floods in August 2019. – Mysterious ‘vaping ling disease’ in October, probably misdiagnosed COVID-19. – CDC shuts Ft Dettrick (too late!) due to failed effluent treatment systems and staff ‘accidental’ leakages. – Why is the CDC silenced at the moment? Right now the source does not matter, this evil genii must be put back in a bottle and the bottle destroyed. • Dennis Kuzara says: More and more it is clear that this originated in the USA. (See my post for more) 1. there are 330,000+ Chinese working in 4000+ Chinese owned factories in Italy. 2. The outbreak happened shortly after the Chinese new year (January 25th – February 8th) ended. , (One guess as to where a lot of the Chinese workers in Italy went for the most important holiday.) • re: “More and more it is clear that this originated in the USA. “How a bat virus goes to pangolins and picks up a wicked spike/cleaver feature.” https://www.foxnews.com/science/the-coronavirus-did-not-escape-from-a-lab-heres-how-we-know See the article for links to scientific papers. For those who do not follow links, here is the gist: ————————- “A group of researchers compared the genome of this novel coronavirus with the seven other coronaviruses known to infect humans: SARS, MERS and SARS-CoV-2, which can cause severe disease; along with HKU1, NL63, OC43 and 229E, which typically cause just mild symptoms” “[they] looked at the genetic template for the spike proteins that protrude from the surface of the virus. The coronavirus uses these spikes to grab the outer walls of its host’s cells and then enter those cells. They specifically looked at the gene sequences responsible for two key features of these spike proteins: the grabber, called the receptor-binding domain, that hooks onto host cells; and the so-called cleavage site that allows the virus to open and enter those cells.” “That analysis showed that the “hook” part of the spike had evolved to target a receptor on the outside of human cells called ACE2, which is involved in blood pressure regulation. ” “SARS-CoV-2 is very closely related to the virus that causes severe acute respiratory syndrome (SARS), which fanned across the globe nearly 20 years ago. Scientists have studied how SARS-CoV differs from SARS-CoV-2 — with several key letter changes in the genetic code.” “The overall molecular structure of this virus is distinct from the known coronaviruses and instead most closely resembles viruses found in bats and pangolins that had been little studied and never known to cause humans any harm.” “One scenario follows the origin stories for a few other recent coronaviruses that have wreaked havoc in human populations. In that scenario, we contracted the virus directly from an animal — civets in the case of SARS and camels in the case of Middle East respiratory syndrome (MERS). In the case of SARS-CoV-2, the researchers suggest that animal was a bat, which transmitted the virus to another intermediate animal (possibly a pangolin, some scientists have said) that brought the virus to humans. In that possible scenario, the genetic features that make the new coronavirus so effective at infecting human cells (its pathogenic powers) would have been in place before hopping to humans.” “In the other scenario, those pathogenic features would have evolved only after the virus jumped from its animal host to humans. Some coronaviruses that originated in pangolins have a “hook structure” (that receptor binding domain) similar to that of SARS-CoV-2. In that way, a pangolin either directly or indirectly passed its virus onto a human host. Then, once inside a human host, the virus could have evolved to have its other stealth feature — the cleavage site that lets it easily break into human cells. Once it developed that capacity, the researchers said, the coronavirus would be even more capable of spreading between people.” Scenario two has less probability of future outbreaks among humans, it says. • re: “More and more it is clear that this originated in the USA.” “NYT visualization: How the Chinese government enabled the spread of coronavirus Allahpundit” Posted at 5:01 pm on March 22, 2020 https://hotair.com/archives/allahpundit/2020/03/22/nyt-visualization-chinese-government-enabled-spread-coronavirus/ The Times gave its feature the anodyne headline “How the Virus Got Out,” but scroll through it and the culpability of the ChiCom regime becomes bracingly clear. Seven million people, many infected, left Wuhan and started seeding outbreaks around the world during the first three weeks of January while the Chinese government was busy assuring everyone that there was no cause for alarm. Two months later, we’re staring at a global depression and potentially millions of people dead before this thing burns itself out. 160. Steven Mosher says: 161. Steven Mosher says: • Jacques Lemiere says: would be better to give at least the mortality per age.. and per condition of health.. and mortality per age in two cases..you could get intensive care or not.. if not you just don’t know what to think about the numbers.especially italian ones . people want to know” i have diabitis i am 73 “how likely am i to die if i get the virus.. and if you want to project mortality to speculate about the maximum number of death s.. you have to be more precise and make group because mortality vary a lot .. 162. Jacques Lemiere says: i read somewhere that they have to make hard choice because o the lack of respiratory devices for instance, meaning they didn”t take care of the old sick people that well.. so can that explain partly the fact that old and sick people die? 163. Karl says: I posted above but part was unfortunately missing. If one looks at graphs of the number of new daily cases in China and Italy (which has peaked 21 March), one will find a potentially remarkable similarity. I say potential, because, although the number of new cases continues to decline in Italy, it is possible a second peak may be introduced due to reporting lag. Cases peaked after approximately 21 and 28 days in China and Italy respectively. Post peak cases in China declined to almost nothing within 3 weeks. If the trend holds for Italy, new cases should decline to a handful by April 11th give or take. https://www.worldometers.info/coronavirus/country/italy/ https://www.worldometers.info/coronavirus/country/china/ • A C Osborn says: Yes of course they are peaking in Italy, they are on LOCKDOWN, what about lockdown don’t you get? If they weren’t on lockdown the numbers would still be accelerating at exponential rates. Why do you think they introduced lockdown, because they wanted to lose lots of money? You also seem to forget that when hospitals are totally overwhelmed everybody who needs intensive care operations or treatment dies, stroke, heart attack, renal failure, accident victims, cancer patients, because they either don’t get what they need or COVID19. You can double the numbers of dead from just COVID19. If the world was actually prepared with all the necessary equipment and actual, real Isolation/Quarantine Hospitals with thousands of beds in every country what you suggest would be OK. But unfortunately they don’t exist. You keep asking for how contagious COVID19 is compared to flu. Educate yourself. https://www.sciencealert.com/the-new-coronavirus-isn-t-like-the-flu-but-they-have-one-big-thing-in-common 164. Karl says: <<<>>> This is a test run to see if measures actually slow the spread of a weaponized virus. And a cost-benefit analysis. not to mention tallying up how much money killing off very old very sick people saves <<<>>> Pretty soon we will be 10 Trillion dollars in cost (lost wealth, cost of economic stimulus) versus (call me callous) on the high side 50,000 dead. 50,000 lives versus 10,000,000,000,000 dollars =$20 Million per life — lives don’t matter that much, regardless of color or uniform —

unless everyone on this board has a 20 Million Dollar life insurance policy, DON’T you dare take issue with my acerbic wit

This exercise in futility shows that — ABSENT LOCKING EVERYONE IN A BUBBLE, you cannot stop a virus that is even mildly contagious and has a moderately long incubation period

Mic Drops — horrible feedback

165. Karl says:

Furthermore,

It is shocking to see people who are so staunchly anti government involvement in Renewable Energy be so “FOR” government involvement in DESTROYING FREEDOM and Wealth.

Freedom of Travel –
Freedom of Assembly –
Freedom to Earn –

The governments of the world have ERASED Trillions of Dollars of WEALTH, and the US alone is going in the hole for 2.2 Trillion in spending and $4 Trillion in extra money supply via the fed. When all is said and done probably 15 TRILLION or more will have been spent WITH NOTHING TO SHOW FOR IT. Yet if$15 Trillion was spent on SOLAR, WIND, GEOTHERMAL, and other technologies as well as DISTRIBUTED GENERATION INFRASTRUCTURE:

We would have a resilient, modern power and electricity architecture with multiple redundancies that would support future growth and expansion that FOSSIL and NUCLEAR cannot support, while at the same time being able to operate regardless of terrorism or natural disaster.

SHAME ON YOU

• re: “Yet if $15 Trillion was spent on SOLAR, WIND, GEOTHERMAL, and other technologies as well as DISTRIBUTED GENERATION INFRASTRUCTURE: We would have a resilient, modern power and electricity architecture with multiple redundancies” ———- Doesn’t work that way with Wall Street “on paper” funny money. Distributed generation will get here, but not with the ‘tech’ you have in mind; to take your course is to solve tomorrow’s problems with yesterday’s tech solutions. We have a system that works adequately today, without spending a ton of money that would surely become stranded assets were we to to take your prescribed course. • Red94ViperRT10 says: …if$15 Trillion was spent on SOLAR, WIND, GEOTHERMAL, and other technologies as well as DISTRIBUTED GENERATION INFRASTRUCTURE:

We would have a resilient, modern power and electricity architecture with multiple redundancies that would support future growth and expansion that FOSSIL and NUCLEAR cannot support, while at the same time being able to operate regardless of terrorism or natural disaster.

Not hardly. Even if batteries, or pumped storage, or something/anything existed to cover those periods when the sun don’t shine and the wind don’t blow, well, let’s do a thought experiment.
What if you tried to take your house off the grid. You could purchase and install a gasoline or diesel generator that could meet your needs, and since it runs nearly 24/7, all you have to worry about is meeting your peak demand, that’s the size generator you buy. Now, all you clowns supporting solar keep telling me how solar \$/kW is competitive with a coal-fired plant, so here’s your chance to prove it, supposing you instead buy solar panels that have that same nameplate capacity, and according to your claim, they’re the same cost.

But wait, solar panels only work for ~1/4 of the day. No problem, you say, that mythical battery will provide backup, so you buy enough batteries to give you 3/4 of a day of energy, you make hay power while the sun shines, and stuff it into those batteries, and all is well… but wait. You only bought enough solar panels to meet your home’s peak demand, and suppose the peak demand occurs at the same time as peak solar, there’s nothing left over, you have to buy more panels, about 4 times more panels, since they only get 1/4 of a day to make power, to have enough energy made to stuff it into those batteries. But wait, stuffing power into a battery and getting it back out isn’t 100% efficient, I would venture only 80% efficient, so you have to buy another diesel generator’s worth of panels to make enough power to be wasted to the atmosphere.

But despite my fairy tale above there still is no solution to what happens when the wind don’t blow and the sun don’t shine, and yes those 2 frequently happen concurrently. The amount of batteries needed to cover those periods push the already outrageous prices to install unreliables into stratospheric range, so I’m not gonna do it.

And just for good measure, those unreliables don’t do what you pushers are saying they do anyway. Over the life of the system, just as much CO₂ enters the atmosphere as would with a fossil fuel powered system. Not that I think they need to, I believe this world needs more atmospheric CO₂, not less.

BTW, I’m not in favor of shutting down the economy, either. I believe we have already entered the cure-is-worse-than-the-disease zone.

• Nicholas McGinley says:

And all that is only for a house.
It sucks to lose power in a house, but it does not shut down an entire business or industry.
What about smelting, or any sort of manufacturing, or hospitals, or water treatment, or sewage treatment, or any of a thousand industries and critical infrastructure usages that we need to have power for, all the time, continuously?
In those instances, losing power is not inconvenient, it can be deadly and destructive.
In the case of some industries, losing power can bankrupt the company…say with a smelter that solidifies.
Of course, there is a solution that we can build starting today with none of these drawbacks…but for some strange reason, most warmistas are firmly against nuclear…and even hydro power.
Which are the only two non fossil sources of cheap reliable, and abundant power we have.
There are not enough batteries made on the planet in a year to power even one large city for even a day or two, even if the batteries could be drawn down fast enough to make it work for a short time.

166. Doc Chuck says:

It occurs to me that there is something going on here that surpasses the admittedly appealing simplicity of exponential mathematical models that can only soar to the moon.  A similarly simplified positive feedback global thermal runaway would also have a familiar ring even if neither can have happened historically, inexplicably leaving us here to further converse.  Like so much that is biological (and earthly in general), infection is a more complex interaction between an intrusive bio-agent and a host population than in all due candor we yet fully grasp, neither party of which is really static but exhibit potential for variation both in invasiveness and host susceptibility during the extended course of their encounters.

Any complete therapeutic sequestering the extremely ill along with their most invasive viral intruders serves to concentrate them out of otherwise continuing wider community action populated by mutated viral strains responsible for less severe or asymptomatic afflictions that become supernumerary there while contributing to the herd immunity that eventually suppresses that contagion.  Note too the reports that only a small minority of assumed Italian coronavirus deaths have tested positive post mortem, so that worst case data may not be what we think it is and so becomes ‘garbage in’ to our handy math model.  But certainly beyond social distancing and personal hygienic measures in the whole population, a most pertinent sequestering is the intentional isolation from exposure of the most susceptible high risk hosts who are burdened by other comorbidities, who plainly warrant similar protection during each yearly flu season.  And should we identify effective antiviral agents or vaccines or even avoid some exacerbating pharmaceutical/chemical factor, the damage can be further blunted.

However hysteria is particularly unavailing, even if desperately sought after for targeted political effect.  And of course no matter what be the proximate mortal attribution, in the end as ‘the bard’ reminds us: “live we how we can, yet die we must”.  But meanwhile unsettled elitists on either coast eyeing their ascendant exponential curves can at least rest easy in this thought regarding the ultimate survival of the human race despite such an epidemic: somewhere in the vast stretches of the central continent in what they consider merely ‘fly over country’ reside isolated prepper deplorables who are perhaps most likely of all to survive, disembark their ark, and repopulate that republic they so ‘bitterly cling to’.  So I suppose it can be said that ‘hope and change’ do still linger upon the horizon.

• re: ” A similarly simplified positive feedback global thermal runaway would also have a familiar ring”

Don’t forget your physics; thermal emission proportional to T to the fourth power (T^4).

Stefan-Boltzmann law. Stefan-Boltzmann law, statement that the total radiant heat power emitted from a surface is proportional to the fourth power of its absolute temperature.

• Bill Parsons says:

Actually we’re mostly New Jersians, New York-ites and Californicators now in Colorado. I’m not so sure how prepped they are to do anything but speed and spend. God bless ’em!

167. Willis Eschenbach says:

I’ve added the following graph as an update at the end of the head post …

w.

• Nicholas McGinley says:

That is not at all what the graph for cases in Florida looks like.
For Florida, the peak is in the center (ages 45-54), and appears normally distributed in a bell curve, with a slight preponderance in the upper age groups:
Click the Florida Counties tab in the center at bottom to see cases for the whole state by age group in a bar graph:
https://experience.arcgis.com/experience/96dd742462124fa0b38ddedb9b25e429

Here is the one I am referring to on my Twitter page:

• Willis Eschenbach says:

Those are two different variables. I’m looking at the age distribution of the deaths, while your link looks at the age distribution of the cases.

Now, suppose you mostly tested young people … what would age distribution of the cases look like? Yes, it would indeed skew young.

This is why I’ve focused on deaths rather than cases … cases is a function of testing.

w.

• Nicholas McGinley says:

OK, my bad. I was looking at the text in the little box, not the y-axis of the graph.

• Nicholas McGinley says:

You do raise an interesting point…what is the age distribution of the people tested so far?
Does it match the distribution of the cases found?
I am not sure how they are deciding who gets tested.
Clearly who is tested, and the number of tests given, as well as how they are selected (or turned down for testing, for that matter) will all have a strong influence on the number of positive test found…assuming as most of us probably are that a large pool of people who have the virus have not been tested yet.
The number of cases may be far larger, maybe 10x, than those that have been found by testing, and IMO, surely is, since few seem to have any idea how they were infected. Not sure how other people feel about that likelihood though.

Hi Willis,

I sort of overall agree .. this damned illness started a long ago unknownly, creeping and spreading silenciously through the population and eventually deeply rooted in sanitary bodies like hospitals etc..
With a long incubation time .. and often in an asymptomatic way (or slighlty symptomatic, getting lots of cases misunderstood as flu clincial pictures..)
And yes, the young and “healthy” ones aren’t generally severely affected ..with some unavoidable exceptions due to the individual immunitary ultimate responce..

And, what’s more.. the test is not always truthful with this bloody bug..

I am sure it comes negative sometimes even if the person is infected.. I don’t know why.. probably the bug RNA is not always shown on our nasopharingx lining to be detected…
I am sure there are “window periods” in which you cannot pick it out..
That’s why i’ts wise to repeat the test.. in proper times according to the clinical evolution of the persons/patients tested and the jobs and tasks they are in charge to accomplish if they are judged virus “free” and allowed to keep working and have some social involvement!

And we well know there have been (and there still are!) persons clearly symptomatics (for example like some nurses of ours and even the chief of the Civil defence yesterday..) who in spite of suggestive symtoms have come negative to the tests.. that I know, one nurse of ours even 2 times negative!

I am strogly convinced this damned probably lab. modified virus is really different and unpredictable from the other ones that mankind has experienced up to now…

So yes.. the rules are: sanitysing and sanitysing.. keep attention to hygene and your distances… for many months but possibly allowing more “wise freedom” for the Citizens soon.. although it will never be completely easy to realize in a safe way due to the inevitable stupid ones taking risks..

One last word: I hope.. and I am almost sure that at the end of this first pandemia a LOT of persons will develop/build a “herd immunity” that will surely help us to keep on surviving with much less risks of relapse … UNLESS this bloody virus is designed to significantly CHANGE its molecular markers and so managing to broadly escape our already produced immunity response!

Kind Regards

Italy

169. barn E. rubble says:

170. Fabio Capezzuoli says:

I see things have gone downhill here with conspiracy theorists and global warming maniacs acoming out of the woods.

• re: “with conspiracy theorists and global warming maniacs coming out of the woods.”

Normally the phrase is “coming out of the woodwork”, but ‘coming out of the woods’ works too. :^))

• farmerbraun says:

The ones who can’t see the trees , I guess.

171. Toto says:

“Benjamin Gompertz originally designed the function to detail his law of human mortality for the Royal Society in 1825. The law rests upon an a priori assumption that a person’s resistance to death decreases as his age increases.” His model is built on the assumption that “the rate of absolute mortality (decay) falls exponentially with current size”.
https://en.wikipedia.org/wiki/Gompertz_function

Since then the Gompertz model has been used for other things. Because it has the right shape for those things. But that does not mean it has the right shape for all things.
The Gompertz model has been developed further in several ways. review paper:
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0178691
“The Gompertz model [1] is one of the most frequently used sigmoid models fitted to growth data and other data, perhaps only second to the logistic model (also called the Verhulst model) [2]. Researchers have fitted the Gompertz model to everything from plant growth, bird growth, fish growth, and growth of other animals, to tumour growth and bacterial growth [3–12], and the literature is enormous. The Gompertz is a special case of the four parameter Richards model, and thus belongs to the Richards family of three-parameter sigmoidal growth models, along with familiar models such as the negative exponential (including the Brody), the logistic, and the von Bertalanffy (or only Bertalanffy) [13][14]. ”

Note the word ‘fitting’. Fitting a curve to data is a common thing. But sometimes it is not appropriate.
In the covid case, we are fitting the early phase — we do not yet know what the final phase looks like.

Steven Mosher: “The problem with Gompertz and Farr’s law is they are non mechanistic. For a mechanistic model you want SIR compartmental models”
These models compartmentalize the population into Susceptible, Infected, and Removed (which includes both the recovered and dead) and then uses probability theory to study how the infection moves through the population. Steven linked to an excellent video about this, a recording of a prof teaching his class online and making it available on YouTube.

The course outline
http://www.leonidzhukov.net/hse/2020/networks/
Lecture 9 Compartmental epidemic models: SI, SIS, SIR.
Epidemics on Networks Part I https://www.youtube.com/watch?v=IXkr0AsEh1w
Lecture 10 Spread of epidemics on network. SI, SIS, SIR network models.
Epidemics on Networks Part II https://www.youtube.com/watch?v=GVTDWQEXZj0

Both are mathematical. The first one you can watch and understand even without a math background.
The second one requires more math background, but it goes beyond the idealistic models of the first and gets into what our situation really is. Note the importance of airlines to the spread of the disease.
He includes graphic simulations in both which makes the concepts easy to understand.

BTW, there is also the SEIR model where some become immune. But he said then the math gets hard.

Note that the SIR models show that everybody will become infected if R0 is greater than one.
For the SIR Network models, that is more complicated. It depends on connectivity of the network.

I encourage everyone to look at those two videos.

• Toto says:

Sorry, the E in the SEIR model is for Exposed where there is a time delay between exposure and infection. Scratch the word ‘immune’ word in that sentence above.

For an SEIR Epidemic Calculator, see
http://gabgoh.github.io/COVID/index.html

You can adjust the parameters to see what happens. In particular, drag the slider for the R parameter after the intervention day

• MAYBE it’s just me, or maybe not … but it occurs to me that the word ‘model’ is a bit over-used in some of today’s present dialog.

A ‘model’ to me would imply that first principles from physics are involved, whereas WHAT is actually being described are simple mathematical formulas that have been found to closely mimic various performance ‘curves’ that are observed in nature, but, it’s not what nature does. Nature uses physics’ first principles. NOW add in human behavior, our ability functioning as a society, with researchers, scientists and engineers (able to create medical treatments et al) and all AND another ‘unknown’ (another variable or ‘millyun’) is added to the ‘protocol’ stack.

• Phil. says:

The model usually used to describe growth in these circumstances in ecology is the logistic function:
{\displaystyle {\frac {dP}{dt}}=rP\left(1-{\frac {P}{K}}\right),}
where P is the population, r describes the growth rate and K is the carrying capacity.

Starts of as an exponential in the early growth phase as we can see in the COVID-19 growth curves then it tails off as we can see in the Italy curve and ultimately flattens off as in the case of S Korea.

• re: “The model usually used to describe growth in these …”

An equation, an expression, a mathematical formula describing an idealistic ‘growth’ curve; in my world: “not a model”.

In my world a ‘model’ would be comprised of the physical geometry of a structure (3D depiction in say AutoCad), included would be the composition material of said structure ‘element’ from which the electrical constants (first principle of physics) would be extracted before being fed into the ‘modeling engine’ which uses Maxwell’s Equations to ‘solve’ for the structure’s resonance and (electrical) radiation (emission) characteristics.

You (Phil) described a mathematical formula that simply describes ‘a curve’; little bearing on the first principle physics involved (which would be complicated for a virus, but not unsolvable today).

I didn’t see any ‘factors’ or terms which take into consideration ‘human’ action (intervention, like treatments, quarantines, etc.) either (of course not!) because you described a simple ‘curve’ which took into consideration ONLY growth of the contagion in a population. Not a very useful, realistic ‘model’ eh?

172. farmerbraun says:

It’s happening here too. Jo Nova’s site is the same. Scepticism is no longer a word in the brave new world (order).

H.G.Wells The War of the Worlds radio broadcast . Anyone recall that?
Hang in there Willis. (As if you would not :-))

173. Keith says:

Very interesting article. Makes me think of the high numbers of deaths from individual old age homes, whether they be in Washington State or Madrid. In other words the institutions affected are these, as well as hospitals.

174. Willis Eschenbach says:

The CDC’s recommendations for Chloroquine use are here.

w.

Willis

I include a text file of University of Washington test results. They create an interesting graph I do not have the time to work out how to post here. I hope you can copy the data. I used their graphic as it contained the amount of samples tested each day.

http://depts.washington.edu/labmed/covid19/

The other data set I found for what appears to be considered an infection epicenter. Washington State Flu season report: Week 12 many people reporting for testing .

https://www.doh.wa.gov/Portals/1/Documents/5100/420-100-FluUpdate.pdf

Date Negative Inconclusive Positive Positive_tot Tests %Positive
02/03/20 30 0 1 1 31 3.2
03/03/20 4 0 2 3 6 33.3
04/03/20 202 4 7 10 213 3.3
05/03/20 125 3 0 10 128 0.0
06/03/20 187 2 16 26 205 7.8
07/03/20 220 4 14 40 238 5.9
08/03/20 466 15 79 119 560 14.1
09/03/20 380 5 40 159 425 9.4
10/03/20 721 4 46 205 771 6.0
11/03/20 1113 9 91 296 1213 7.5
12/03/20 1171 11 82 378 1264 6.5
13/03/20 1361 8 95 473 1464 6.5
14/03/20 1529 20 96 569 1645 5.8
15/03/20 1643 9 94 663 1746 5.4
16/03/20 1487 8 135 798 1630 8.3
17/03/20 2134 14 170 968 2318 7.3
18/03/20 2857 31 183 1151 3071 6.0
19/03/20 2072 26 138 1289 2236 6.2
20/03/20 2733 19 193 1482 2945 6.6
21/03/20 1440 14 114 1596 1568 7.3
22/03/20 942 8 94 1690 1044 9.0
23/03/20 987 7 152 1842 1146 13.3
24/03/20 1257 10 141 1983 1408 10.0
25/03/20 1755 19 192 2175 1966 9.8
26/03/20 2409 21 244 2419 2674 9.1