COVID-19: Updated data implies that UK modelling hugely overestimates the expected death rates from infection

Reposted from Judith Curry’s Climate Etc.

Posted on March 25, 2020 by niclewis |

By Nic Lewis

Introduction

There has been much media coverage about the danger to life posed by the COVID-19 coronavirus pandemic. While it is clearly a serious threat, one should consider whether the best evidence supports the current degree of panic and hence government policy. Much of the concern in the UK resulted from a non-peer reviewed study published by the COVID-19 Response Team from Imperial College (Ferguson et al 2020[1]). In this article, I examine whether data from the Diamond Princess cruise ship – arguably the most useful data set available – support the fatality rate assumptions underlying the Imperial study. I find that it does not do so. The likely fatality rates for age groups from 60 upwards, which account for the vast bulk of projected deaths, appear to be much lower than those in the Ferguson et al. study.

Metrics for COVID-19’s fatality rate and their estimation

The fatality rate from infection (IFR), by age group, is a key parameter in determining how serious a threat the COVID-19 pandemic represents. Unfortunately, the IFR is difficult to determine. It is more practical to estimate the fatality rate for cases where the COVID-19 virus can be shown, by a standard test, to be present, whether or not there are any symptoms. This is referred to as the true case fatality rate (tCFR). The tCFR will overestimate the IFR, since a proportion of people who actually have been infected may show no viral presence when tested, either because they have already fought off and cleared an infection without any noticeable symptoms, or perhaps because they have pre-existing immunity. Nevertheless, where testing has been applied to a sample of people without regard to whether they show symptoms, the tCFR may provide a reasonable, albeit somewhat biased high, estimate of the IFR.

However, determining tCFR is not simple either, since in most cases infected people with no or mild symptoms will not be tested for COVID-19. Attempts have nevertheless been made to estimate tCFR by adjusting estimates of the CFR based on symptomatic cases only (sCFR), by adjusting for the non-random nature of testing, and also for the outcome of positive test result cases not being known for some time.

The Imperial studies

The Ferguson et al. study used estimates of the IFR[2] from another paper from the same team, Verity et al. (2020)[3], which had been published a few days earlier on 13 March. Very helpfully, Verity et al., unlike Ferguson et al., published the computer code and data that they used.

The Verity et al. CFR estimates were derived primarily from Chinese data, which reflected non-random testing. The authors obtained age-stratified IFR estimates (in reality, tCFR estimates) by adjusting their CFR estimates using infection prevalence data for expatriates evacuated from Wuhan, all of whom were tested for COVID-19 infection. This approach involves very large uncertainties.

An alternative approach to estimating the tCFR, as a proxy for the IFR, is to use data from a large sample of people, all of whom were tested for the presence of the virus without regard to whether they showed any symptoms, with all who tested positive subsequently being isolated and the case outcome recorded. I use that approach. While the sample of expatriates evacuated from Wuhan is too small for this purpose,[4] occupants of the Diamond Princess cruise ship do provide a suitable such sample.[5]  Moreover, the Diamond Princess sample has the advantage that it consists mainly of people from high income countries, and those requiring hospitalisation were treated in such countries.

The Diamond Princess sample may well represent the best available evidence regarding tCFR for older age groups, who are most at risk. Verity et al (2020) did analyse data from the Diamond Princess, but did not use sCFR or tCFR estimates from them for their main CFR and IFR estimates.[6]

The Diamond Princess death toll

When Verity et al. was prepared, the final death toll was not known. The data available only ran to 5 March 2020, at which point 7 passengers had died. The authors therefore used a fitted probability distribution for the delay from testing positive to dying to estimate that those deaths would represent 56% of the eventual death toll. They accordingly therefore estimated the tCFR using a scaled figure of 12.5 deaths.

Here, I adopt the same death rate model and use the same data set, but brought up to date. By 21 March the number of deaths had barely changed, increasing from 7 to 8. Of those 8 deaths, 3 are reported to have been in their 70s and 4 in their 80s. I allocate the remaining, unknown age, person pro rata between those two age groups. As at 21 March the Verity et al. model estimates that 96% of the eventual deaths should have occurred, so we can scale up to 100%, giving an estimated ultimate death toll of 8.34, allocated as to 3.58 to the 70-79 age group and 4.77 to the 80+ age group.

Accordingly, the Verity et al central estimate for the Diamond Princess death toll, of 12.5 eventual deaths, is 50% too high. This necessarily means that the estimates of tCFR and sCFR they derived from it are too high by the same proportion.

Numbers testing positive

The Diamond Princess dataset was published by the Japan National Institute of Infectious Diseases (NIID). I use the second version published on 21 February[7], which gives detailed data for 619 confirmed cases, updating it for subsequent test results.[8] Verity used the original 19 February version of NIID, which gave data for 531 confirmed cases, although they did update it for subsequent test results.

The entire set of passengers and crew, totalling 3711 individuals, was tested for COVID-19. Some 706 (19.0%) ultimately had positive test results, of whom (based on the NIID data for 619 of them) 51% were asymptomatic. The infection rate varied between 10.0% for ages under 30 years to 24.5% for ages 60+ years. The age-distribution was only known for cases included in the NIID data. Verity et al. assumed that the age distribution for the overall total of 706 confirmed cases was the same as for the 531 NIID reported cases that they used. I do the same, but using the later NIID data, with 619 reported cases. On that basis, 201.9, 266.9 and 61.6 people in respectively the 60–69, 70–79 and 80+ key age groups had positive test results.

tCFR estimate

Recall that tCFR is the eventual death toll divided by the total numbers testing positive.

My overall tCFR central estimates from the Diamond Princess 70+ age groups, where all the deaths are taken to have occurred, are 2.54% overall (8.34/328.5),[9] with a breakdown of 1.34% for ages 70-79 (3.58/266.9) and 8.04% (4.77/61.6) for ages 80+. For the 60–69 age group, there are sufficient test-positive occupants to make a crude median estimate of the tCFR, by calculating what it would need to be for there to be a 50% probability that no 60-69 year-old has died, as appears to have been the case. The thus-implied tCFR is 0.34%. There were too few Diamond Princess occupants in age groups below 60 with positive test results to provide any useful information about the COVID-19 tCFR for those groups.

Adjustments for false negatives and underlying death rates

It appears that in about 30% of symptomatic cases the standard RT-PCR test for COVID-19 infection gives a negative result when the patient is in fact infected.[10] There is no evidence of any COVID-19 related deaths among Diamond Princess occupants who tested negative, which would be consistent with a lower viral load being associated with a lower probability both of a positive RT-PCR test result and of eventual death. The false-negative rate may be slightly lower for Diamond Princess occupants, a few of whom may have been retested or tested by a more reliable method where they had typical COVID-19 symptoms but an initially negative RT-PCR test result. However, it seems likely that the proportion of asymptomatic infected cases that are not detected by a RT-PCR test will be somewhat higher than the 30% estimated for symptomatic cases. We accordingly adjust all the tCFR ratios estimated from Diamond Princess case data down by 30% on account of false-negative test results.

The observed deaths of Diamond Princess occupants occurred over a 45 day period, during which a non-negligible percentage of old people would be expected to die from non-COVID-19 related causes. I have accordingly deducted from the adjusted tCFR ratios an allowance for non-COVID-19 deaths for 70+ age groups, based on UK age-stratified 2018 death rates,[11] to arrive at estimates of deaths caused by COVID-19. There are arguments for the non-COVID death rates being either higher or lower than those for the UK population of the same age, but using those death statistics appears to be a reasonable first approximation.

Comparing the Ferguson et al. UK and Diamond Princess based fatality rate estimates

The results of the foregoing analysis are set out in Table 1. The key finding is that the estimated tCFRs for Diamond Princess 60+ age groups, which must if anything overestimate their IFRs, are far lower than the corresponding IFR estimates used by Ferguson et al. in the study adopted by the UK government.[12] Those age groups account for the vast bulk of projected deaths. For people aged 60–69, the Ferguson et al IFR estimate is 19.4 times as high as the best tCFR estimate based on Diamond Princess data, for the 70–79 age group it is 8.3 times as high, and for the 80+ age group it is 2.1 times as high.

Table 1: True Case Fatality Rates estimated from the latest Diamond Princess data compared with Infection Fatality Rates per Ferguson et al. 2019, used by the UK government

Note: An all-causes tCFR of 0.34% (and hence 0.69 notional ultimate fatalities) is assumed for age-group 60-69 despite there being no actual fatalities in that age group (see text). Expected non-COVID-19 fatalities are based on UK 2018 death rates by age group applied to the DP positive test cases, scaled by the 45 day period over which COVID-19 deaths were recorded and divided by the same 0.96 factor used to scale up the 8 actual deaths. DP= Diamond Princess.

Discussion

Based on the Diamond Princess data, the COVID-19 fatality rates by age-group assumed by Ferguson et al. appear to be far too pessimistic for all 60+ age groups, where the vast bulk of fatalities are projected to occur. It is quite possible that they are also too pessimistic for younger age groups as well, but unfortunately the Diamond Princess data are uninformative about death rates below age 60.

It is notable that for all the 60+ age groups the projected excess death rates, based on Diamond Princess case data, caused by COVID-19 is substantially lower than the underlying non-COVID-19 annual death rate. Even assuming, very pessimistically, that there is no overlap between the two, and that the same proportion of each age group becomes infected, projected COVID-19 related deaths from an epidemic in which the vast bulk of the population became infected with COVID-19 are only 9% of expected annual non-COVID deaths for the 60–69 age group.[13] For the 70–79 age group, the proportion is 20%, and for the 80+ age group it is 26%. Relative to the expected non-COVID deaths over two years, the approximate period during which very onerous restrictions are projected to be in force in the UK, these COVID-19 excess death proportions would each be reduced by almost half. In practice, a high proportion of people killed by COVID-19 will have serious underlying health conditions, and would be much more likely than average to die from non-COVID-19 causes.

Nicholas Lewis                                                                                           25 March 2020

Originally posted here

309 thoughts on “COVID-19: Updated data implies that UK modelling hugely overestimates the expected death rates from infection

  1. “Flatten the curve” is intended to keep the medical system from becoming overwhelmed. The message from on high is that when the medical system becomes overwhelmed, the fatality rate shoots through the roof.

    • CommieBob when people show symptoms and run to the Dr or ER is that part of the overwhelming?

      What is it exactly that is causing the overwhelming?

      Thanks

      • In the general case, any medical bottleneck that kept patients from access to anything that would have improved their outcome is an “overwhelming” of the medical system.

        In this case, ventilators – and probably trained ICU staff – appears to be a fatal bottleneck for some number of patients. Keeping the number of patients below a capacity limit that may prove fatal actually depends on the time frame of infections, not total infections.

        • One bottleneck was the governor of Nevada passing emergency legislation prohibiting anyone in his state from using malaria medications to treat Covid-19 or prevent the person from contracting the disease!

          And yet it reportedly was China that found hydroxychloraquine was effective because people taking that for their lupus never came down with Covid-19! The researchers tried it specifically on coronavirus patients and found nearly 100% efficacy!

          The governor of Nevada is a Democrat that obviously hates Trump more than the people in his state!

          • To be fair, the reason he banned it was to keep supplies from dwindling. It can still be used in the hospitals, but there were multiple occurrences of physicians writing prescriptions for themselves and their families (even without a positive test) and burning through the state’s supply of those drugs.

          • A small scale Chinese study of hydroxychloroquine has shown no benefit (Journal of Zhejieng University). A small scale French study has shown the opposite. Bahrein (see below) is touting its effectiveness. For those on this site who criticise double blind controlled clinical trials as form filling, this is the very reason for them. In a disease which kills somewhere between 0.1% and 10% of its victims, and the rest recover, the only way to demonstrate efficacy for any drug is by very large scale trials of the kind which represent the gold standard for assessing results. Given the numbers now in Western Europe and the US, recruiting patients in their thousands for such trials should not present a great challenge, although administering them might.

            I believe remdesivir is under trial in Nebraska and other trials of hydroxychloroquine are ongoing. What is happening here in the UK is not clear, but I have heard that there are drug trials.

            When one looks at the current situation in Italy, it is clear that the medical and humanitarian situation is serious.

            Incidentally, I am among those who have advocated isolating those most at risk while otherwise maintaining society in a normal state, but there are two problems with it. First, here in the UK, it would be impossible for any Prime Minister to go against the advice of the Chief Medical Officer and Chief Scientist. The media would become immensely hostile, every death would be laid at his door, and his Cabinet would revolt. Secondly, identification and strict quarantine of those over 70, those with COPD, those with ischaemic heart disease, those with severe asthma, diabetics, the obese, etc., etc., would be logistically incredibly difficult, even with NHS systems.

            Those are my thoughts as a retired surgeon, for what they are worth. I refrain from responding to any of the nonsense about Vitamin injections, colloidal silver and so on. Best of luck to all. Some of us will need it.

          • Just so you know, there are two other punctuation marks that you can end your sentences with, besides the exclamation mark you used for 4/4 sentences. They’re called the “period” (or “full stop” for those on the other side of the pond), and the question mark. You may wish to try them out.

          • John Cherry-

            “… I am among those who have advocated isolating those most at risk while otherwise maintaining society in a normal state, but there are two problems with it…”

            I agree with the approach you advocate. You are probably right about the politics- in any country not just the UK., working against such an approach, but I don’t agree with your second point.

            As an 80 year old retiree in the U.S. , I am currently under the same “stay home” order as the rest of the population in San Antonio. However, I voluntarily stayed home for a week or so before the order. In the U.S. at least, most people over 67 are on social security, and many have other retirement income. It is easy for us to stay home. Our monthly payments are directly deposited to our bank accounts. I think there would be a very large portion of those over 70 who would voluntarily comply with a with a stay home order.

            When I think of all the service employees ( waiters, barbers, and etc.) that are without any income, I become concerned. These “stay home” order will not reduce the number of people who will ultimately get the virus, It only slows down the rate. Once the hospitals are prepared for the influx of patients, the epidemic should be allowed to proceed as quickly as possible. Like quickly ripping off a band-aid, it causes less pain overall.

          • Another one is Guinness. I bet if these people had a bottle of Guinness a day, they would not need apples or hospitals. Of course original Guinness bottle necks are/were shaped such that nothing would stick.

      • Really? Your brain not working?

        Imagine a shop with 4 checkouts. No more.

        10 people waiting in line with ice cream. No problem, everyone gets served before it melts.

        Suddenly 20 people arrive and all want ice cream. Checkout system is overwhelmed and some ice cream melts.

          • Now imagine they do arrive, only instead of checkout lines and ice cream, it is people drowning and not enough lifeguards.

          • Now imagine they do arrive, only instead of checkout lines and ice cream, it is people drowning and not enough lifeguards.

            And now imagine that suddenly everyone has life jackets tossed to them from the shore.

            That’s the problem with imagining, anyone can imagine anything they wish.

          • I am pretty sure I am not imagining that we are in the middle of a situation none of us could have imagined we would be in even one month ago.

          • I am pretty sure I am not imagining that we are in the middle of a situation none of us could have imagined we would be in even one month ago.

            Ok well if you’re not imagining it then by definition that doesn’t really go as an argument against my Argument to Imagination does it?

            Regardless, I disagree. I think many people could have imagined just this scenario, and I imagine some did.

            That’s the thing about imagination, one may imagine anything one wishes.

            🙂

    • CommieBob when people show symptoms and run to the Dr or ER is that part of the overwhelming?

      What is it exactly that is causing the overwhelming?

      Also if we quarantined the high risk people only would that be a better alternative than the leaky quarantine we have now where I recently saw 10+ people In line at 5 grocery store registers?

      Thanks

    • Yes, and the stampede that has been created by the rollout of this virus is responsible for the healthcare system becoming overwhelmed. The same thing would have happened if the media had rolled out the H1N1 pandemic of 2009 the way they have COVID19. But they didn’t. They didn’t dare make their golden child Obama look bad, so they buried it.

      • Interesting, I hadn’t considered that perspective before. I think you are probably right because, as I see it, the media and the left are driving the scare and Trump is the evil red man!

        • Dr. Lewis is a statistical wizard. However, I suspect the relative health of 70-plus passangers aboard the Diamond Princess is not representative the relative health of a typical national population of 70-plus citizens.

          We can be fairly certain of this, as the weak, sick, and non-ambulatory are loath to embark on a sea voyage where enjoyment is derived through mobility.

          While his correction to Ferguson at al. Is logical, both Ferguson and, Lewis are trying to extrapolate mortality rates using unrepresentative samples.

          • You are correct. diamond Princess was all we had at the time. But there is now a much better, larger, and more representative sample—South Korea. See my comment below.

        • “…. and Trump is the evil red man!”
          Trump certainly mislead the public early on when he lied about the seriousness of the situation. He also dilly-dallied losing valuable time. In my book he is evil, but I’d say more orange though.

          • Patrick MJD
            Are you really asking me to provide you with direct quotes that highlight Trumps minimising the threat of Covid-19 early on in the game, when he hoped it would like a miracle disappear, and well before he said … “I’ve always known this is a, this is a real, this is a pandemic … I’ve felt that it was a pandemic long before it was called a pandemic.”
            But if that is what you want?

          • The line between calming peoples’ fears in order to avoid panic buying etc. and denying there’s a problem, is a narrow one, that different people will measure in different ways.

          • “Look at what he did, not what he said.”
            But what he said “probably” caused people to be blasé which is the worse possible thing at this stage of a pandemic. In case you don’t read the news, here is a timeline of his careless, opinionated, irresponsible, false, statements:

            Feb. 7 (tweet): ”… as the weather starts to warm & the virus hopefully becomes weaker, and then gone.”
             
            Feb. 10: “I think the virus is going to be — it’s going to be fine.”
             
            Feb. 14: “We have a very small number of people in the country, right now, with it. It’s like around 12. Many of them are getting better. Some are fully recovered already. So we’re in very good shape.”
             
            Feb. 19: “I think it’s going to work out fine. I think when we get into April, in the warmer weather, that has a very negative effect on that and that type of a virus. So let’s see what happens, but I think it’s going to work out fine.”
             
            Feb. 24 (tweet): “The Coronavirus is very much under control in the USA. … Stock Market starting to look very good to me!”
             
            Feb. 25: “You may ask about the coronavirus, which is very well under control in our country. We have very few people with it, and the people that have it are … getting better. They’re all getting better. … As far as what we’re doing with the new virus, I think that we’re doing a great job.”
             
            Feb. 26: “Because of all we’ve done, the risk to the American people remains very low. … When you have 15 people, and the 15 within a couple of days is going to be down to close to zero. That’s a pretty good job we’ve done.”
             
            Feb. 28: “I think it’s really going well. … We’re prepared for the worst, but we think we’re going to be very fortunate.”
             
            Feb. 28: “It’s going to disappear. One day, it’s like a miracle, it will disappear.”
             
            Feb. 28: “This is their new hoax.”
             
            March 4: “Some people will have this at a very light level and won’t even go to a doctor or hospital, and they’ll get better. There are many people like that.”
             
            March 9 (tweet): “So last year 37,000 Americans died from the common Flu. It averages between 27,000 and 70,000 per year. Nothing is shut down, life & the economy go on. At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that!”
             
            March 10: “And it hit the world. And we’re prepared, and we’re doing a great job with it. And it will go away. Just stay calm. It will go away.”
             
            March 11: “I think we’re going to get through it very well.”
             
            March 12: “It’s going to go away. … The United States, because of what I did and what the administration did with China, we have 32 deaths at this point … when you look at the kind of numbers that you’re seeing coming out of other countries, it’s pretty amazing when you think of it.”
             
            March 15: “This is a very contagious virus. It’s incredible. But it’s something that we have tremendous control over.”

          • Did you read the article? Fauci says if cases show up get serious, till then relax. Trump as saying take it easy/relax well after Fauci said it’s time to worry.

      • “They didn’t dare make their golden child Obama look bad, so they buried it.”
        OK so a few holes in your logic. The US is not the planet. It’s a small thing but important here. Many countries that could not give a flying fig about the US, are locked down too. Are they trying to support Obama?
        The US is showing serious signs of being overwhelmed by this virus, New York being the most obvious case. Are these stats being falsely produced by the evil Obama supporters just to make Twumpy look bad?
        Finally take a look at this curve here. I think you can write dumb stuff about the politics of this when that shows signs of slowing…..
        https://en.wikipedia.org/wiki/Timeline_of_the_2020_coronavirus_pandemic_in_the_United_States

        • US cases will overtake Italy tomorrow and China in 2 days. Completely out of control.
          #TRUMPVID-19 trending.

        • His contention was:

          The same thing would have happened if the media had rolled out the H1N1 pandemic of 2009 the way they have COVID19.

          It’s an opinion and may or may not be correct. It’s at least believable that media coverage could cause a public overreaction.

          You, on the other hand, haven’t even replied to what he actually wrote.

        • “The US is not the planet.”

          On the other hand, the troll uses the problems of NYC as proof that the entire US is being overwhelmed.
          If liberals didn’t have double standards, they would have no standards at all.

          • Mark defaults to troll calling when he has nothing to say…. which is quite a lot of the time. I see the US now up to 80,000 cases. This thing is not slowing at all.

          • I like to buy heirloom tomatoes from the supermarket. In summer I grow my own. I always get annoyed when the cashiers want to weigh the orange ones separately from the red ones. I always point out that they are the same sku! And this was before covid came along.

          • That’s nothing…have you seen the people licking public toilets on video and posting it to their twitter page?

      • Yes to this.

        Also, on the issue of overwhelming the medical system… Could we not have taken steps to prevent or deal with this short of canceling civilization? How about limited quarantining of 60+ year olds while simultaneously embarking on a crash ventilator manufacturing program? Maybe set up some regional Covid-19 specific treatment facilities? For the love of God, unemployment might have actually been driven down further, millions of kids would still be in school, and the economy would be functioning.

        I don’t think people have wrapped their heads around the consequences of the course of action we ended up stumbling down. This is an unmitigated disaster, particularly for small business.

      • Thank you for that link!!!

        More people need to understand this. In my job, we serve among many others some of the NY hospitals. I was on a conference call with them yesterday. These are normally busy hospitals, but now they are getting overwhelmed. That doesn’t happen in “normal flu” season. Too many are focused on natural mortality rate with treatment rather than number whose symptoms are severe enough to require hospitalization which is a far far far higher percentage than occurs with the flu. Even with the flu affecting a higher count each winter than COVID-19 has thus far, the impact on the hospital system is already far outpacing the flu.

        • Ed H

          … and thank you for the intelligent comment, far far far above the average dumb stuff spit here around as usual.

          J.-P. Dehottay in Germoney

    • Instead of attacking the Coal & Carbon Fuels Industry, the MAOBAMA Administration pissed away $$Billions that they handed to their Crapatilist Demorats Friends to build Bird & Bat Thrashers & Friers killing a Billion Birds Worldwide that could have been used to build a National Response Pandemic Infrastructure.
      The anemic response and the outcome of the H1N1 ( 60MM infected, 300K hospitalized, and 12K+ died) should have provided the framework to fund the appropriate Manhattan-like program required.
      Instead OBAMACARE robbed $800,000,000 from Medicare reducing Senior Healthcare, resulting in reduced payments to Doctors Hospitals unable to maintain adequate inventory and money to prepare for emergencies.
      NO MEDIA challenged the Manchurian Candidate on anything to avoid being labeled a racist.

    • commieBob
      March 25, 2020 at 6:21 pm

      There is already a widespread of overwhelmed shops and markets for toilet paper.
      Who would you blame that on?
      The virus or the human stupidity?

      cheers

        • And already moving towards next projected cycle…

          The morons exit strategy from all this mess created by the morons in this first cycle:
          Do as “we” say the banny or/and the teddy bear gets it in the next cycle… 🙂

          As the front line moron has already clearly stated:
          “We do not make the time line but the virus does.
          (“do not mind, never mind at all, that I the front line moron “bombarded” all you, like forever with this;
          “Flatten the curve” the proper professional responsible solution, driven by projections solely based on the grounds that we make the time line and not the virus or it’s pandemic infection”)

          cheers

    • But that is based on a rapid rate of infection, from very little now and with relatively lower numbers of asymptomatic infection. The models are pretty good, but are totally reliant on the assumptions. The data in the UK is suggesting a much earlier time for first infection, larger numbers of asymptomatic infection and possibly quite large numbers of people already infected. That means there may be no large surge requiring hospitalisation.

      Flatten the curve is only relevant where we are not a long way up the curve already in terms of numbers infected and the percentage of those infected needing hospitalisation being quite high.

      We will get a better sense of what is going on in the next week or so.

  2. Real life numbers are different than your numbers. People 59 and younger are NOT at a zero percentage rate of death from COVID 19.

    • From Washington state USA, health officials report 25 percent of confirmed cases in Washington state are now being found in people below the age of 40. Thirty percent of cases are people in their 40s and 50s, and 45 percent of cases are in people age 60 or above. The statewide death toll from Wuhan virus climbed to 132 midday Wednesday, as Gov. Inslee’s lock down decree takes force

      • Hi J Mac, – I noticed that report of increased cases for younger people stateside. What I don’t know is whether these are confirmations in the sense of just a tested result or if a significant proportion of these younger people are actually quite ill.

        Another unspecified aspect of that data is whether those younger people involved have any underlying medical issues. Being USA inhabitants my 1st thought was if they have diabetes, but then too whether many were smokers.

        Which in turn makes me wonder if maybe they’re not cigarette smokers, but more commonly include marijuana smokers. In Washington State (among others) marijuana is legal for any purpose, including unlimited adult recreational use (I think). Then too there is the frequent ritualization where shared smoking is passed the among mouths of participants (unlike cigarettes, which usually is individually smoked).

        [WUWT has posts about the virus using a receptor which the body makes more of in cigarette smokers. It may be, in part, likewise for many of the inhaled marijuana products requiring heat when partaken.]

        • Vaping illness (EVALI) has the same symptoms as CV, appeared for the first time a few months before CV and is associated more with cannabis use than other things. Vaping cannabis is probably very common in WA. Most doctors have no experience with EVALI. So if a patient with EVALI shows up at a hospital and tests positive for CV, guess what he will be diagnosed with?

          • What about aerobic fitness? Look at countries ( NW Europe)where people ski, run, cycle and walk extensively in fresh air and keep high levels of aerobic fitness into their 80s. Type 2 diabetes will be associated with people who are over weight and do not take vigorous out door aerobic exercise. How dangerous will vaping and smoking cannabis be found to be ?

          • Very dangerous. Lung damage from vitamin E acetate (one culprit) can kill the most healthy. Nobody knows what chemicals are in all of the various vape products.

          • Very dangerous. Lung damage from vitamin E acetate (one culprit) can k!ll the most healthy. Nobody knows what chemicals are in all of the various vape products.

          • From personal experience, The only time in my life when I was not healthy was in my 20s when I smoked pot.
            I had bronchitis about twice a years and ended up with pneumonia twice.
            Since I stopped I rarely even get the flu or a cold.

        • Hi gingojay,
          We can speculate about possible variables contributing or detracting from the Wuhan virus virulence and morbidity… but it is just speculation, without rigorous data to support. In the coming months and years we will have data generated from rigorous double blind studies that may address some of our speculations and lead to more refined studies but, until then, we have to use what little real data we have to make the best decisions we can…. and live (or die) from the consequences. That’s life. It isn’t ‘fair’. It isn’t ‘unfair’ either. That’s just the way it is and, in part, it is what drives the human species to learn, survive, adapt, and thrive better than just about any other animal on the planet.

          Learn. Survive. Adapt. Thrive. Stay happy out there and remember:
          Like the veterinarian said about the cat’s hair balls “This too shall pass!”

  3. “In the US in 1976, when epidemiologists warned of ***another 1918 Spanish flu pandemic after a few young Army recruits died of swine flu at Fort Dix in New Jersey. Eight months later, the federal government launched a mandatory swine flu vaccination program. About a quarter of the country was vaccinated before the program was abruptly shut down. No pandemic had materialized. The virus infected a few people, then vanished. But directly as a result of receiving the vaccine, dozens of Americans died and several hundred acquired Guillain-Barre syndrome.

    Liberal Fauci on AIDS back in 1983, when he was with the National Institute of Allergy and Infectious Diseases, but not yet its director: “As the months go by, we see more and more groups. AIDS is creeping out of well-defined epidemiological confines.” (It didn’t.)

    Both the No French Kissing rule and Quarantine Everybody rule are perfectly rational positions for an epidemiologist to take. That’s why we need to listen to people other than epidemiologists. Today, the epidemiologists are prepared to nuke the entire American economy to kill a virus. What about the jobs, the suicides, the heart attacks, the lost careers, the destruction of America’s wealth? A country is more than an economy, but it’s also more than a virus.”

    • I have had the same discussion with friends here in Adelaide which is essentially locked down with many small businesses built up over a lifetime being destroyed.. The stress will result in deaths and misery which have to be attributed to the cure, not the disease

      • the financials are being sorted for most, the focus on economy and money is pretty stupid , when if people die due to rampant spread the damage would be far harder to contend with later.
        this way we may have some hard times(for the already not badly off) the poor always live like this. they now have to find “reality” temporarily.
        the supposed claims of decades to recover are laughable
        as soon as people are able to safely return to work things will resume, and life goes on.
        banks deferring 6mths of loans sounds good?
        read the fine print
        they need to be hauled in as the interest is still added, thats NOT ON.
        the ancient Jewish Jubilee idea of a clearing of minor debts for ALL mightnt be a bad idea about now.
        people who can or must work to do so. those that cannot to be supported
        everything just goes into stasis no interest added rents etc forgone until it improves.
        and for complacent Aussies remember this is the Beginning of winter. we also have the return of our last yrs flu due as well
        and the govts supply of flu vax for those who use it is still unavailable till april 2nd ditto the pnumovax which SHOULD be available yr round but is NOT.
        injecting phenol doesnt appeal to me but many dont read the inserts and are happy to take it.
        nth hemispheres summer might turn up soon and that WILL help a lot for recoveries and maybe lowering transmission, sunlight and heat are good things for the ill.

    • Let me tell you a secret. Epidemiologists are idiots. Due to an educational defect (and other things I’m sure) they are only able to focus on one thing – pathogens; all other etiologies and co-factors are ignored and discarded. That’s why all of their dire predictions never come to pass.

  4. Here’s some data:
    Plot up the US total deaths. Here’s a couple data links for you:

    https://www.worldometers.info/coronavirus/country/us/
    or
    https://covidtracking.com/data/

    Feel free to cross check against other sources.
    Fit an exponential function to the total deaths for the last 10 days & calculate the doubling rate [ ln(2)/ln(exponent of fit) … for those who don’t know how to do that]
    You will see the total deaths are doubling roughly every 2.6 days.
    And check out the R^2 … tell me the last time you saw a natural data set with that high of R^2
    Go ahead & see where that puts us in 10 days … which is pretty much already baked into the numbers given incubations times, external life times of viruses etc.
    Flatten it how you want past 7 days but I suggest you use WA State & Italy as possible analogs , as they took pretty much the same steps we are taking now.
    Make a projection out to 30 days using these reasonable analogs
    Then come back & tell us all how this isn’t a huge problem … or maybe tell us why you don’t put that much value on human life.

    No tests needed for death – dead is dead. Mortality rate is irrelevant – only important metric at the end of day is how many people die , not what % dies.

    And oh – and go ahead & shred me. Fulling expecting it for disagreeing. That’s how things role here lately. But support it with some data, analysis & models. In the mean time, I am under “shelter at home” orders for the next 3 weeks.

    • And also, go ahead & project the current rate (with a R^2 = 0.996) out 17 days from now … we will have 100,000 dead at that point. Do you think we should just let that happen because it’s a small % of those infected??

      I don’t care what the mortality rate is , I care about reducing total mortality, regardless of %. Please take this seriously, if not for yourself then for the sake of others.

      • 100,000 dead?

        China has been ground zero for way more than 17 days and reports fewer than 3500 dead. Whether you believe the Chinese or not is up to you. But 100,000 in the U.S.? Come on.

        • Please do the math & show me how we stay under, instead of an emotional reaction, then get back with me .

        • Dear Jeff,

          I ran your model (deaths doubling every 2.6 days) based on today’s death total of 247 from the site you linked to. It turns out that after 52 days everybody in the US will be dead. After 62 days everybody on Planet Earth will be dead.

          This is depressing news. I’m not sure how to respond your scientific model — except that it’s time to party hearty people! Everybody get nekid!

          • Mike,
            Perhaps you didn’t read my other comments … extrapolate 10 days, then flatten how you like but be consistent with other datasets and recognized epidemicological models , see where the numbers take you then gate back with me.

            In the mean time, smart ass answers do no good for anyone.

            As I said up front, go ahead & rip me a new one with out looking at any data or do any analysis. That’s how things roll now on WUWT . Used to be a good science website. Now, if if you dare disagree with the orthodoxy… crucify !

          • Dear Jeff,

            I DID use YOUR data. I DID YOUR analysis — exponential doubling every 2.6 days. I did not rip you a new one; I followed your model.

            The fact is, according to the orthodoxy of epidemiological statistics (with which you apparently disagree), disease epidemics do not follow exponential curves — they follow logistic curves. Sigmoid growth curves. Such as Gompertz functions or Weibull distributions.

            And all that has been discussed at length on WUWT, the Best Science Blog in the Blogosphere.

            See: https://wattsupwiththat.com/2020/03/13/the-math-of-epidemics/

            If you prefer an expert epidemiological statistical analysis using the available data, please see:

            https://wmbriggs.com/post/29886/

            Try to keep up. And chill out. Alarmism is frowned upon by many of us WUWT aficionados.

          • The exponential increase does end naturally but that’s because the number of susceptible people in the population is reducing. Also a good proportion of the infected population will have recovered.

            That could take a while in a large, dense city with a ‘business as usual’ scenario.

        • All you can say is lets talk in 14 and 30days and see who was right, there is no point arguing it. Your country is locked into certain actions and they either get it right or wrong.
          Currently South Korea is the winner, currently it will become the focus of studies of how to deal with a pandemic.

          • Icsil: face masks for all is response
            all countries where virus spread slowly have tradition to wear face masks, South Korea, Taiwan, Japan
            In my country (Slovakia) face masks were partially ordered (shops, gatherings, public transport) form day 7, fully ordered from day 21
            Look on our graph for 5.5 million people:
            https://domov.sme.sk/c/22368395/koronavirus-covid-19-pandemia-epidemia.html?ref=diskusie
            Last 3 days new cases: 19, 12, 10
            Yes people are staying home, but this is everywhere. Working is still allowed, as trips to nature.
            From Japan it looks that wearing face masks alone is giving doubling per 10 days.

          • No, Singapore is the winner.
            High Population Density, massive throughput of flying passengers and the first case was 23rd january.
            Hoping not to jinx them but 683 cases and 2 deaths.

        • Jeff, the Gompertz Curve will eventually level off the exponential growth – otherwise you’ll have the entire population of the earth dead in less than 3 weeks.

          • Of course – please read my other comments – I am very aware of that … but be aware of where we are on the curve. In the early stages the curve, an exponential curve will fit with a very high R^2 – just as we are observing – just as has been observed everywhere that is ahead of us in terms of the mortality curve. Until we see the doubling rate start to flatten (ie getting above the inflection point on the curve , heading to the top), the current correlation tells us where we are heading for the next 10+ days .. as the death curve is a trailing indicator … then we can start about talking about how & when the curve starts .. per the Gompertz Curve. IF we don’t take this seriously, that inflection point will be much higher.

          • Here in Washington State where I live (ground-0 for the outbreak), the inflection point has already been passed. This will eventually happen in other states in a generally west-to-east fashion. When doing a “post-mortem” on this virus, it will be interesting to group states according to like policies and then plot an average length of time from first identified case to a least-squares fitted inflection point – no doubt taking into account other normalizing factors to make any conclusion meaningful. (Multivariate Statistics will come in handy here.)

          • If we don’t take this seriously?
            SERIOUSLY?
            What do you want to do, euthanize anybody found with symptoms and incinerate the corpse within the hour?
            How the hell can we take it MORE seriously than the complete destruction of the economy?

            Back in 2009, Obama did exactly nothing about H1N1 up to about the point we just passed yesterday. Then we heard hagiography after puff piece about how his brave leadership had saved America.

            Give us a break. It’s a horrible human tragedy for those impacted medically (in both events). Nobody is suggesting otherwise. But it’s reprehensible the amount of shameless fearmongering going on for obvious political reasons.

            It’s far less Trump minimizing the risk than millennials with Trump derangement syndrome refusing to act responsibly because Trump said it. I haven’t left my house in 10 days. Am I serious enough?

      • How do you project out 17 days? What is your model and how do you justify your assumptions? I have my own projections, but they are so fraught with unjustifiable assumptions I keep them to myself, but you sound much more confident in yours, so please share.

        • Thank you Gerald for your astute observation.

          https://wattsupwiththat.com/2020/03/23/covid-19-tests-the-non-fake-news/#comment-2945438

          Excess Winter Deaths in the USA average about 100,000 per year from all causes, including influenza. When Joe D’Aleo and I wrote our paper about Excess Winter Deaths in 2015, nobody cared.
          Now, we are supposed to be terrified by 582 deaths to date in the USA caused by the corona virus.

          In the UK in just England and Wales, Excess Winter Deaths (“EWD”) totaled 50,100 souls in Winter 2017-2018. That is THREE TIMES the average per capita EWD rate of the USA and Canada, in part due to excessively high energy costs in the UK, where fracking of shales is banned for no good reason. When we reported this startling statistic, nobody cared.
          Now, we are supposed to be terrified by 335 deaths to date in the UK caused by the corona virus.

          In 2016 I reported an extremely dangerous situation at a sour gas project close to Calgary that almost killed 300,000 people. When it was mentioned in the news media, nobody cared.
          Now, we are supposed to be terrified by 24 deaths to date in Canada caused by the corona virus.

          SO LET ME GET THIS STRAIGHT: WE ARE SUPPOSED TO PANIC WHEN A FEW HUNDRED PEOPLE DIE, BUT NOT WHEN A FEW HUNDRED THOUSAND DIE, OR ALMOST DIE. OK. GOT IT.
          _____________________________________________

          COLD WEATHER KILLS 20 TIMES AS MANY PEOPLE AS HOT WEATHER SEPTEMBER 4, 2015
          by Joseph D’Aleo and Allan MacRae
          https://friendsofsciencecalgary.files.wordpress.com/2015/09/cold-weather-kills-macrae-daleo-4sept2015-final.pdf
          __________________

          ACTIONS THAT PREVENTED A POTENTIALLY CATASTROPHIC SOUR GAS DISASTER AT THE MAZEPPA PROJECT NEAR CALGARY

          In May 2016, Allan MacRae, as an uninvolved citizen, became aware of unsafe operating procedures at the Mazeppa critical sour gas project near Calgary. At some personal risk, he investigated, consulted with trusted colleagues, and following the Code of Conduct of Alberta’s Professional Engineers (APEGA), he reported his concerns to the Alberta Energy Regulator (AER), and followed up to ensure proper compliance.

          The AER quickly shut down the Mazeppa project, and canceled all 1600 operating licenses of the parent company, which was placed in receivership and bankruptcy. The Managing Director was fined and sanctioned. This was the most severe reprimand of a company in the history of the Alberta energy industry. A 2005 analysis of Mazeppa wells by the Alberta ERCB concluded that an uncontrolled sour gas release would affect an area within a 15km radius and could kill 250,000 people. By 2016 that total increased to 300,000 people.

          • Excess Winter deaths are measured from December 1 to March 31 – 4 months.

            It’s five days to March 31, when they stop measuring Excess Winter Deaths. Think about why this matters.

          • https://www.gov.uk/guidance/high-consequence-infectious-diseases-hcid?fbclid=IwAR1BUeXVJwQA9WYkv-P3In3trSHhCUFAvmP40Skl3L5J7UDSbnud9WcIiw8

            UK Status of COVID-19

            As of 19 March 2020, COVID-19 is no longer considered to be a high consequence infectious diseases (HCID) in the UK.

            The 4 nations public health HCID group made an interim recommendation in January 2020 to classify COVID-19 as an HCID. This was based on consideration of the UK HCID criteria about the virus and the disease with information available during the early stages of the outbreak. Now that more is known about COVID-19, the public health bodies in the UK have reviewed the most up to date information about COVID-19 against the UK HCID criteria. They have determined that several features have now changed; in particular, more information is available about mortality rates (low overall), and there is now greater clinical awareness and a specific and sensitive laboratory test, the availability of which continues to increase.

            The Advisory Committee on Dangerous Pathogens (ACDP) is also of the opinion that COVID-19 should no longer be classified as an HCID.

            The need to have a national, coordinated response remains, but this is being met by the government’s COVID-19 response.

            Cases of COVID-19 are no longer managed by HCID treatment centres only. All healthcare workers managing possible and confirmed cases should follow the updated national infection and prevention (IPC) guidance for COVID-19, which supersedes all previous IPC guidance for COVID-19. This guidance includes instructions about different personal protective equipment (PPE) ensembles that are appropriate for different clinical scenarios.

        • Does anyone have a dataset for last winter’s flu infections/deaths? If so, what does the chart of infection and deaths on a daily basis look like?

          Has anyone fitted a mathematical model to the numbers, and do we think that COVID-19 will follow a comparable infection/death path?

          I appreciate that a proportion of the population would have been vaccinated, but I think that is irrelevant to this question. What I’d like to see is the shape and duration of the curve

        • Yes, but they all had access to hospitals & ventilators etc. If you overwhelm the system then, no many die.

      • See? No one shredded you. Willis did a fine job pointing out the other day that the Gompertz function is a better approximation than the exponential function.

        Look, most of what the site’s been doing vis a vis covid-19 is a bit of sensible data driven theorizing and arm chair quarterbacking over a political decision that did not perform an adequate opportunity cost analysis measured in lives vs. lives.

        One possible thing though here is that you’re not understanding that the economy IS lives, even at the dead or alive level. You’ve adopted a frame that seperates economic matters as an academic, abstract concept from humanism and people. You see economy as just numbers going up or down va. a pathogen that kills people. That inherited frame is intended to dissuade you from learning about how an economy works. How capitalism works. What is an economy. It’s an extremely humanistic operation on the whole. It’s part psychology: folks by in large wish to work honestly; produce something that someone else finds valuable enough to be paid for and make their lives better and those they transact with. The more exchanges and the more folks who are free to engage in them without coercion, the better things for the vast majority get, and health, people, and lives are fundamental factors of cause and effect.

        We squabble over how much of the collective wealth we redistrubute to the less fortunate (and to whom amongst them). And, sure, the system is now grossly tainted at this point by special interests, rent seekers, powerful interests, a bloated bureaucracy, all of whom not aligned with wide public interest (and opposed to it in many cases!), but that’s another matter altogether. I digress.

        Point is, is that destroying the economy is destroying lives, costing lives, and will continue to destroy and cost lives long after this virus hysteria is finished. The question Lewis is getting towards, or why his analysis matters, is because we have not put adequate consideration to the opportunity cost of the blanket shut downs, but we’re starting to pay for it. There were and are alternative methods for protecting the vulnerable, but that went out the window with what may week have been an incomplete consideration of the available evidence, and a pathological press, many of whom openly welcome economic depression if it will reduce ‘bad orange man’s chances of re-election.

        You think the media will analyze the short, medium, and long term effects of a collapsed economy on all aspects of health?

        • Shouldn’t we have some studies in the US by now of the fallout on humans and human life over similar economic market failures? There was the 1929 depression, late 70s, nasdaq bubble, 9/11, 2006, 2001 a space odyssey, any others? Some of these recent ones my family and I still have not recovered from financially.

        • RW, your assessment of this crisis is well stated.

          “You think the media will analyze the short, medium, and long term effects of a collapsed economy on all aspects of health?”

          The mainstream media will abandon this critically important analysis. Only real journalists will take on this subject.
          The “blanket shutdowns” in rural remote areas, where there are no known cases is downright destructive to peoples’ lives. This needs to be addressed right now.
          Is this intentional?

      • JeffL, I made this comment on a thread here 12 days ago when there were only 1600 cases and was laughed at as being idiotic.

        “The US’s response to Covid 19 is a complete shambles, a debacle from the top down, far worse than Italy. It wont seem so idiotic in a months time when victims are dying in the corridors of overwhelmed ICUs as they are in Italy.”

        “Shredded” if you like, mainly because I criticized Trump’s mesmerising stupidity, which continues to this day: “Easter is a very special day for me… and you’ll have packed churches all over our country.”

        Many Americans STILL seem to actually believe they are an exception to the rules of epidemics, but they are facing a tsunami that is still weeks from breaking, no amount of spin will stop it. Within days the US will have the most cases and within two weeks the most deaths and still the tsunami will not have arrived in most of the cities. “Easter” ffs. 100,000 is a gross underestimate.

    • “ … or maybe tell us why you don’t put that much value on human life.”

      Why don’t you value human life?

    • Why would anyone “shred” you? Everyone is discussing a novel virus and attempting models from woefully incomplete data. Anyone who claims to know the “right” answer at this point is not a scientist.

      However, the initial R0 of 2.3 was based on the infection rate of the disease for a population of humans that had not yet changed their behaviors. The R0 is not an immutable property of the virus.

      I personally hope that the recent human behavior changes are soon reflected in the data, and we fall off of the horrible curve that you are referencing!

      • All of the numbers being put into the models are little more than guesses.
        Beyond that, things like R0 are highly dependent on social reactions. Effective quarantines reduce it.
        So any attempt to project what R0 is going to be in the future is even a bigger guess.

        • I would think that on this site we all would and should be skeptical of models. So forget the models. There is a hard reality that does not occur annually with normal flu that is already happening before we are close to any inflection point in any model. That hard reality is hospitals actually already getting overwhelmed in our own New York City and starting to occur in some other cities. In my opinion, this is another strong example of why concentrating so many people into large cities is a terrible idea for human civilization, but it is reality. We have to flatten the curve of required hospital admissions. That is what makes this far different and far more necessary to take distancing steps than any normal flu.

          No models required, just actual known current experience of what is actually happening with our health care system.

      • It was also based upon social habits in Wuhan. Unless one knows how people behave in different countries the R0 is inly relevant to a country for a particular time. Wuhan had air 50x worse than WHO guidelines, many people live and work in overcrowded conditions , are heavy smokers, people spit in the street, how often do they thoroughly wash their hands, aerobic fitness, diabetes, people buy infected meat from a densely crowded market , etc, etc

        What this disease will show is that there are many factors which increase and decrease spread and morbidity and we have to obtain far better field data.

    • No one needs to shred you. What you seem to fail to observe is the real time curve. The US has not increased infections in 4 days. 10K, 9K, 11K, 11K. That’s called a flattening of the curve. I don’t have a crystal ball, but if that continues for a few more days, then starts to decrease, it will signal the top of the curve. My own back of the envelope modeling puts the maximum US deaths at 4000. That is a far cry less than H1N1 of 2009, and it was a stinking Flu for which we already had an effective drug. The only wild card is NY, but NY is not the entire United States. But what I do know is there are lies, damn lies and statistics. R2 means nothing in a fluid unpredictable situation. Pandemics aren’t like physics. What we do has an effect. Treatments have an effect. …. and even your quarantine for 3 weeks will have an effect.

      • Case data is irrelevant because testing is so sparse compared to population, which is also why % mortality is irrelevant. We have no idea how many people have been infected so we have no idea what the % mortality is.

        So let’s focus on what we know – total mortality – no test needed. Dead is dead. Please go plot this data (no back of the envelope – do the math) – & tell me how we will be at a maximum 4 k deaths. And please go plot data sets for individual states and countries with longer histories. And then tell me how this is unpredictable and how R^2 doesn’t matter. And maybe look at Italy & their measures & how the rate changed with time with their measures & we will stay below 4k deaths.

        And maybe tell me all this after you have lost someone close to you from this virus.

        • Ok … so I am really sorry if you lost somebody, but try to have a little faith. Case data is irrelevant, true, but deaths is not. Wuhan has 11 million people, Hubei Province has 58 Million. They had 3200 deaths. Here in the States, NY is the epicenter, with a population of 19 Million and accounting for half of the problem here. While the US has 321 Million total, most of that population is spread out across the nation with much of it in rural areas. 4000 max is a pretty good estimate, regardless of cases.

          Further, the spread of this thing seems to span about 2 mo. China and WA were about 2 mo then their numbers drastically declined. Based on that, we will have an issue through about mid April. With the social distancing and the progress being made with treatments, that could very well be shortened. This is not to say we won’t still have cases, but the panic and flooding of the hospitals will decline.

          • “4000 max is a pretty good estimate, regardless of cases.”

            4-3-20: 7,392 deaths & still doubling every 2.7 days … next time do the math before spouting off. Lives are at risk & your comments encourage people to think this isn’t a problem

        • Look at the graphs for China, S. Korea, Italy, etc. on a log scale. The transitions from exponential growth becomes readily apparent. You will see that a graphical solution finds the asymptote that is equivalent to the final total cases, deaths, etc.

        • Jeff
          You said, “So let’s focus on what we know – total mortality – no test needed.” OK, we have seen recent annual deaths from seasonal flu reach 80,000 and we didn’t even blink. I’m just not convinced that this thing is as deadly as we are being told. I may well be wrong, but I don’t think that the epidemiologists have made a convincing case.

          • Trying plotting up deaths through a flu season & the rate we are accumulating covid-19 deaths & then you will understand … all the data you need is available from the CDC. It will become readily evident why this isn’t the flu. Even for a bad flu year (say 80k dead for a season), at this point ( 30-45 days into the outbreak ), you would have less than 1000 dead.
            You are right they are not making a convincing case but the data is if you look at. They are scientists but not skilled at communications.

        • Jeff L, why don’t you first explain to us how China has kept their dead below 3500 after all this time (if true) and why the U. S. rate is going to be so vastly different. Because you have done neither up to now.

          • You actually believe the data coming out of China after they repeatedly lied and infected the rest of the world.

          • A C Osborn no I don’t, and I made very clear that the data is suspect. You put words in my mouth that aren’t there. A cheap shot.

      • Your back of the envelope sounds about right, though it’s early in the flattening process. In about 3 x 2.6 days, roughly a week, we’ll have a much better handle on it.

    • regarding Worldometers – Just how valid is there data?

      I have been looking at the info related to Australia and a lot of their references are from the common or garden media (abc, news.com.au) rather than anything that is easily identifiable as ‘official’.

      The other observation I have made with the Australian graphs is the ‘new infections’ has a noticeable spike every 6 days followed by a downturn. One would assume that has happened is someone has collected a day and a half of data and bundled it, resulting in day 6 being artificially high and day 7 artificially low. However that 6 day cycle (March 4, 10, 16 and 22) confuses me somewhat.

      Another musing is the ‘recoveries’ stats. Since you have to have the virus in order to recover from it the data from a few days ago suggested that it was taking 10 days to recover from infection based on the number of total recovered (120 from memory) and the date at which Australia first reached 120 known infections.

      However who is controlling the ‘recovered’ data? I would suggest that given the ratio of mild condition to serious/critical cases (currently listed as 2536:11 here in Oz) the vast majority of cases are being ‘treated at home’ and of those many recovered people are still politely sitting out their 14 days and many others have just, based on the lack of symptoms and time already spent in isolation, have ‘self released’ themselves back into the outside world.

      Hence there could be a large percentage of ‘recovered’ people still listed as active cases because no one has formally signed off on their individual condition.

      So with these questions in mind, just how well can we trust worldometers?

      • I beg you to compare this data against any data sets out there. It’s just the most convenient. But it is also the best / easiest compilation I have found. Compare it against any source. I have. It ties perfectly.

      • last I read the SA and maybe others arent testing for recovereds
        why not?
        shortage of tests
        seeing as many seem to have a month or more to recover and others appear to be hospitalised for more than 4 weeks too
        its maybe why the 1/3 or so listed as recovered is as low as it is?
        bit of a disparity tween dead but NOT well yet or “recovered” but left with lung or other damage

      • So you think the US has taken the same measures as a country as South Korea ?? Hmmm … care to share your support for that?
        And oh, have you tried to do an exponential fit to the early part of the curve ? I guess not because you would see how good the fit it ?
        Yeah … the doubling period was 2.5 days and the R^2 was 0.995 … sound familiar.

        Please, please,please … take this seriously

        • No, different locales are taking different approaches which will lead to different initial conditions and rates, but the beauty of the thing is that qualitative behavior is the same everywhere.

      • A quibble, but the post, following reference 3, uses a lognormal. Like a Gompertz with a longer tail. In fact analyzing the tail is one of the key points in the exercise.

    • I suggest you use WA State & Italy as possible analogs . . .

      Apparently you know nothing about the Washington State – – Life Care Center of Kirkland – – fiasco.
      This is an analog for a horror movie, nothing more.

      • Nice emotional response. I encourage you to dig a bit deeper with data.
        Datum post Kirkland – 3/9/20 is a good place to do that.. find the equivalent point in the US total curve (at ~ 24 deaths) & watch how the death totals compare
        WA St is the dream … the US is the horror.
        Post-Kirkland, WA St total mortality doubles every 6.0 days with an R^2 of 0.992 (of course, R^2 doesn’t matter, right ?)
        And the US over the same time period, total mortality doubles every 2.6 days with an R^2 of 0.996.

        But like I said, go ahead & tear me up without having done any work. Wish it away. Be part of the problem. And when someone close to you dies, reflect on this.

        • Jeff L
          YOU need to read Willis Eschenbach’s evaluation of Italy. Please do that. Then get back . . .

          • How could Willis know when doctors decided the individual was too sick or too old to bother caring for. Their medical system was clearly overwhelmed. At 26 March they have 7503 deaths and 9362 recovered. Compare that with Germany with 206 deaths and 3547 recovered.

            Willis’s analysis may have some analytical merit but has no relationship with reality where front line medical staff where unpalatable choices.

        • Have you done the work to determine what percentage of WA’s cases are due to vaping illness (EVALI)? I’m quite certain that vaping cannabis in WA is very popular. EVALI has the same symptoms as CV and appeared just a few months before CV, so most doctors have no experience with it. EVALI is known as a diagnosis of exclusion because there are no markers or tests for the illness, which means a diagnosis is made only if everything else has been ruled out. If an EVALI patient tests positive for CV, an EVALI diagnosis will not be made, but vaping, not CV, caused the illness.

    • It is refreshing to see someone presenting reality on WUWT. This site seems to be overwhelmed by cavalier dingbats who think this is an old man’s disease and they are bullet proof.

      Any dingbat advocating “let it rip” is denying clear evidence.
      China crushed the spread using draconian measures internally, crushing their noncompliant dingbats with the required force. People living in northern Italy now wished their authorities had acted faster in locking down the regions.

      US is on the cusp of devastation. Its CV19 death toll should surpass China by the weekend. Its unrelenting rate of increase of 3days/doubling appears a long way from control. By mid April it is likely US death toll will exceed Italy’s toll.

      The statistics from Italy looking at age and other risk factors did not even consider the reality that the doctors in intensive care were simply making choices about who should be treated; 60yo and above may have been denied intensive care. That is what happens when the system becomes overwhelmed. There are plenty of 20 and 30yo in intensive care with CV19 across the globe. Let it rip and 20 and 30yo will not get intensive care. Then the death toll in the younger age groups will rise.

      • “There are plenty of 20 and 30yo in intensive care with CV19 across the globe“

        Where do I find this data? Do you know if any of them have other conditions?

        Thanks

        • Here is the situation for UK at the point they had 200 CV19 patients in intensive care. 5% (10 people) were in 30s, 10% (20 people) in their 40s.
          https://news.sky.com/story/coronavirus-first-analysis-reveals-trends-in-uks-critical-cases-11962457

          This link has recent data on hospitalisation and outcomes for various age groups for Spain with comments on other locations:
          https://www.vox.com/2020/3/23/21190033/coronavirus-covid-19-deaths-by-age
          In Spain 183 people in their 20s and 1083 in their 30/40s (20%) have been hospitalised. 8 in their 20s ended up in intensive care, 55 in the 30/40s ended up in intensive care.

          • I don’t believe data from the shambolic USA $$health system.
            Where is the CDC when we need them? Why aren’t they running the show now?
            It seems very very clear this has run wild for months in the USA and most people can’t afford to even get tested.

          • Do the young people in ICUs vape or smoke? Are they alcohol abusers? Are they on ACE inhibitors or ARBs? Are they immigrants with latent TB that has become active TB because of CV infection? So many factors to consider, so little consideration being done.

          • Derg, you are very good at asking questions without providing any answers or alternative data.
            ie a troll.
            Of course you may not be a troll in which case I am sure you would like to present your alternative analysis and raw data it is based on?

          • I saw a video of a young woman (20-ish-30ish) hooked up to a ventilator gasping for air as she pleaded with everyone to take this illness seriously, because if it happened to her, it can happen to anybody. Then she let it slip that she was a smoker.

      • We’re on track to exceed China’s reported death toll, though it will not be by the weekend. It could be Sunday night but more likely it’ll be on Monday.

        China largely confined their outbreak to Wuhan. We have one outbreak about the same as Wuhan and several smaller ones. Most assuredly our number of cases will exceed Italy’s but our deaths are likely to be significantly fewer.

      • “It is refreshing to see someone presenting reality on WUWT. This site seems to be overwhelmed by cavalier dingbats who think this is an old man’s disease and they are bullet proof.”

        Not an “old man’s disease”, but a mild illness to most of the population, but a severe to deadly one for various risk groups (e.g., pre-existing morbidities, air pollution, smoking, drinking, ACE2 upregulating drugs, vaping, etc). There are numerous examples of old people surviving this illness with no problem. It will appear that more young people will have serious cases and die because other illnesses, like vaping illness, sepsis and typical pneumonias, are being conflated with CV to inflate the case rates.

      • RickWill
        There have been an estimated 20,000 to 40,000 deaths from seasonal flu in the US. Even before quarantines were put in place, there was evidence that seasonal flu had peaked and was starting to decline. The quarantines should accelerate that beyond what is typical in the Spring.

        https://www.npr.org/sections/health-shots/2020/03/09/813641072/u-s-flu-season-beginning-to-ease-modelers-say

        That means that the demand for ICU facilities for seasonal flu cases will decrease at a time that the COVID-19 cases are still ramping up. I suspect that the worst-case scenario will result in extending the ‘flu’ season. Although, I have seen no reason to believe that the warmer weather won’t also suppress COVID-19 infections as it does with other corona viruses. What is of concern is whether both flues will come back simultaneously next Fall and really hammer the medical system. That would be catastrophic.

        • Currently in NY the average time on ventilator for COVID-19 is 11 – 21 days (vs. 3 – 4 days for non-COVID-19 patients). That’s why this current outbreak is more dangerous than the seasonal flu, as well as the seasonal flu cases are spread out over a significantly longer period than the present COVID epidemic. Just over a week ago when the number of US deaths was 167 by looking at the growth curve I posted that I expected the number to pass 1,000 by the end of the month. Turns out that was an underestimate, probably nearer 2-3,000 by then! While the inflection is in sight in the Italian death stats there’s no sign of it yet in the US, and while I expect NY to start to tail off other states are still in the early exponential phase.

    • This is a very useful epidemic simulator with which to play ‘what if’ scenarios.
      I’ve compared it to death rate increments in various countries, and with a bit of tweaking, it matches up well.
      It shows time to peak infection, delay to peak deaths, eventual peak deaths, and so on.
      https://gabgoh.github.io/COVID/index.html
      I’m an anaesthesiologist in Australia, with a good friend who is in the same professional role in Milan, Italy. Their high level isolation strategy is very strong but only just enough to slow it a little.
      Anyone at risk needs to isolate hard, right now, make sure your Will is up to date, visit any at risk folks you know while you can, insist they follow strict isolation until there’s a vaccine, and take great care of yourself.
      Reading these comments that suggest this is trivial or not as bad as the flu… well, don’t say you weren’t warned.
      The best thing, most likely, is to strongly isolate those at risk and let everyone else get it as quickly as possible. This may stop if very quickly with least damage to the economy. All the young healthy people just get a bad cold and keep the country running. The main problem with this is that it is near impossible to strongly isolate the at-risk, ie if there is an at-risk person in a home with teenage kids, say. So those kids run a good risk of losing that person.
      The next best alternative is really hard isolation, a total shutdown, as China did. They have done all the right things; bit slow starting, but after that, they solved their problem completely. But I don’t think that any Western country can achieve this.
      If I was a strategist in China, once the virus really hit, I would have exported it around the world, so that it wasn’t ever going to be that China alone would suffer. I predict that China will make the first usable vaccine also.

      • thanks Chris;-) stay safe youre now in the at risk mob even if youre young.
        so far in Vic its confined to mostly suburbia but I see a creep to rual areas as the travellers from the last few weeks have probably carried it, as well as return homes from I state as well;-(
        friend kids from share house in goldcoast have come to town for safety..well maybe not so, as their poor mums not young or fit herself but couldnt say no.
        not a wise choice.
        our towns full of aged retirees from farms and treechangers moved here too
        Im not that young and in the at risk group as well.
        towns pretty much shut down tight and were hoping to stay clear.
        I approve the border closures, and feel for the chaps doing the work there as I had to cross to a vets appt today

  5. still fascinating to me that such a low percentage of people, skewing older than the general population, with undoubted extensive exposure to the virus, actually became infected. 80% didn’t. The only explanation I can come up with after some research is that they must have had antibodies to some coronavirus variants that also worked against this one. And that is a little odd to me, for the medical texts I have read suggest that coronavirus antibodies generally don’t appear to be as long lasting as antibodies for influenza viruses for example. But somehow, despite exposure to the virus large numbers of people aren’t even showing infection. Seems consistent too with what we know now to be the likelihood that larger number of people than we initially believed had early exposure to the virus in the US, but infections were relatively low. The random antibody presence tests which are now proposed or underway in several countries will be very informative I think. Be interested in others’ thoughts on this slight conundrum.

    • Another explanation is that the viruses evolve to be less virulent. The ones that are too deadly die with the infected.

      • The explanation is simple look up details on the receptor Covid19 binds to in the lung ACE2. It’s numbers drop off with age and slightly faster in males than female. It has nothing to do with the virus it is human physiology.

        Then all you need to understand is why lower ACE2 receptors numbers means you are more likely to contract the severe form … I will leave you to read that on your own.

        • Some are saying that Japan and Taiwan preferentially use calcium channel blockers as standard blood pressure reduction therapies but we in Western societies tend to use ACE inhibitors and angiotensin receptor blockers. Supposedly this allows the coronavirus an easier means for entry. I don’t follow the details.

          I personally know that the air pollution in Wuhan is terrible. Around the power plant it’s hard enough to breath with healthy lungs, and most Chinese men tend to smoke very nasty cigarettes. The air in the Italy epicenter is also reported to be bad.

          Other than empty buses driving around the Denver area (the driver’s union must have insane power as it wasn’t a month ago that they were complaining about overworked drivers but have yet to cut routes) the traffic is really down around here and the air is especially clean.

      • Much of the spread occurs before the patient begins to feel any symptoms, regardless of whether they recover or not.
        When symptoms get serious, they go to the hospital. At that point, regardless of what happens latter, spread stops.

        • Mark, you’re on to something there 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 will have a familiar ring on this site even if inexplicably neither can have happened historically, leaving us here to further converse. Like so much that is biological (and earthly), 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.

          Now as you say, therapeutic sequestering the extremely ill along with their most invasive viral intruders pulls them out of the continuing action populated by mutated viral strains that contribute to the number of less severe/asymptomatic afflictions that become supernumerary and also contribute to the herd immunity that eventually suppresses contagion. And not just incidentally, there are 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 ‘garbage in’ to our handy math model. But certainly beyond social distancing and hygienic measures in a 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, which plainly deserves similar attention during each yearly flu season. And should we identify effectvie 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 attribution, in the end as ‘the bard’ reminds us: “live we how we can, yet die we must”. But meanwhile I’ll at least offer unsettled elitists on either coast this comforting reassurance about human survival despite this very epidemic: those isolated deplorable preppers in what is so disdainfully regarded as ‘fly over country’ in the vast stretches between are the most likely to survive and then repopulate that republic they so bitterly cling to. So again there is ‘hope and change’ on the horizon.

    • the normal coronas are colds
      this brute and SARS and MERS are a whole different ballgame I gather.
      and there is NO “IMMUNITY” in the populace
      its Novel aka new not seen/known to our systems
      and our bodies DO see the common corona but we still get colds yearly
      seems any immune response isnt long lasting

      • ozspeaksup
        You remarked, “but we still get colds yearly seems any immune response isnt long lasting” I believe it is a high mutation rate that is responsible for our immune systems not being as effective as we would like. However, those same mutations tend to favor less virulent strains that don’t kill the hosts as quickly.

  6. Statistics question because it isn’t really my skill set;

    Given the sample size of Diamond P what sort of error margins are we really talking about?

    I mean this article sounds very positive so I guess I am really asking for some discussion about it before I start quoting from it in my own arguments.

  7. There are now 10 dead from the Diamond Princess and around 15 still critical. Could be more people die in near term. Using Diamond Princess data seems only partially useful. Worldwide deaths still increasing by 10% a day or more. Unless this rate of increase declines we may eventually have tens or hundreds of thousands dying every day. I am watching to see if the extreme measures taken start to slow the increases.

    • The Princess data is meaningless, especially given the importance of co morbidities
      and the early intervention with the best medical care

      • Stephen, not only that, the whole of the ship were put in Isolation in their cabins which slowed the spread.
        I don’t know what filtration the ships air circulation has, but that also might have helped.
        Nic using the February report is also not a good idea as it is still not complete until all the cases in ICU are either cured or dead.
        They are still there 1 month later, which shows the load it puts on ICU units.

    • Most of the countries contributing to the large increases in cases and deaths have seen a peak growth rates or will shortly. What happens in India is very important and is uncertain at this point and could be disastrous.

      The rate of increase will decline, as it always does, it’s just a matter of when.

    • 10 dead so far, exactly, and with over 100 still not in the “recovered” category. If there are 15 still critical, per your post, the ten is very likely to increase, possibly even double.

      Which renders the original post irrelevant (or misleading?) since they assumed less than nine would die eventually.

      And, as far as I can tell from scanning quickly, you’re the first to point that out. No one is discussing the original article–just off on tangents of their own choosing, which is fine of course.

      Mod: The article should have a note appended indicating that the analysis is now outdated and that the main assumption it is based on (<9 deaths) is demonstrably incorrect.

  8. If just a single >60 yo death can be prevented by trashing the entire Free World’s economy … then it would have been worth it.

    Because Orange Man Bad, no-work good, ALL dependent on government good. Time to “transform” America just like SHE would have done. You see. DETAILED mathematical and statistical analyses will be ignored and resisted in favor of shallow emotionalizing and political posturing. The media and the government can’t help themselves.

  9. Epidemic modeling expert Dan Yamin expects ~0.3% fatality rate.
    Pragmatic estimates from a world class epidemic modeler.
    For the US take So Korea’s ~ 0.45% of total, then multiply by ~50% as typical of epidemic infection.
    ‘Trump Is Right About the Coronavirus. The WHO Is Wrong,’ Says Israeli Expert

    You probably would have met the same people you met today. We move across networks of social contact. So, from a certain stage, it will be difficult to infect even those who bear a potential for becoming infected, because the carriers don’t wander around looking for new people to infect.”….
    “If, 40 or 50 years ago, epidemiology researchers came exclusively from the field of medicine, today we understand that in order to predict the spread of diseases, it’s also necessary to understand how humans behave as a collective, to be able to analyze big data and to have the ability to create models and perform mathematical simulations – and for that you need engineers.”
    “…The basic principle is that a virus with an R0 of 2 in a non-immune population can be expected to infect 50 percent of the population. After that the R0 will reach a value of 1 or less, and the disease will be contained. By the way, it will recede in a converging exponential; in other words, the coronavirus can be expected to disappear from this region with the same dizzying speed with which it entered our lives.”
    …South Korea has been coping with corona for a long time, more than most Western countries, and they lead in the number of tests per capita. Therefore, the official mortality rate there is 0.9 percent. But even in South Korea, not all the infected were tested – most have very mild symptoms.

    “The actual number of people who are sick with the virus in South Korea is at least double what’s being reported, so the chance of dying is at least twice as low, standing at about 0.45 percent – very far from the World Health Organization’s [global mortality] figure of 3.4 percent. And that’s already a reason for cautious optimism.”…
    South Korea has one of the highest proportions of elderly people in the world, whereas Israel tops the graph in fertility, and we have a very young population. So, if we use the upper limit [of mortality] of South Korea and normalize the mortality rate for the population in Israel, we are talking about the probability of a mortality rate of 0.3 percent among those who have been infected. …
    So in the worst-case scenario, we are talking about 4.5 million Israelis who will become ill with the coronavirus. Multiply 4.5 million by 0.3 percent and you get 13,500 Israelis who are liable to die from the disease. By comparison, 700 to 2,500 Israelis die every year of complications from other respiratory ailments.”
    “Now we’ll go to a severe scenario in which no one is immune and every second person is sick, so that the disease is incapable of spreading further – namely, a situation where there’s a maximum infection rate of 50 percent….
    So, with a high probability, we can say that our situation is not good – but it’s not apocalyptic.”

  10. The low death rate on the Diamond Princess compared to what we are seeing with US and Europe seems to imply that there is a very large number of people infected that haven’t been recorded; something like ten times the number of cases listed.

    • Many thanks,TRM.
      I suspect the terminally troubled in the population, will not regard sane highly respected medical professionals, are qualified to speak about how to deal with imaginary pandemics. This latest virus, is simply the latest. It will not be the last, sadly our response to this particular one will set the scene for future government response
      I fear for mankind’s sanity, if this latest policy of overreacting to a new virus becomes the standard response.

  11. Neil Ferguson was doing the (lead?) modeling under Roy Anderson during the FMD 2001 crisis. If I recall Anderson may have referred to this as Neil ‘s baptism of fire. Apparently he passed with flying colors and was highly regarded by politicians as a result.
    In addition Sir David King then newly made Chief Scientist, claimed that the great success of the modeling team (which he advocated for and sponsored) in helping manage the FMD crisis, made his reputation (with the politicians) as Chief Scientist.

    Here is the Veterinarian’s post audit of the modeling issues

    Carnage from a computer
    https://web.archive.org/web/20061109213956/http://www.warmwell.com/06oct10magnus.html

    Use and abuse of mathematical models:
    an illustration from the 2001 foot and mouth
    disease epidemic in the United Kingdom
    R.P. Kitching (1), M.V. Thrusfield (2) & N.M. Taylor

    https://www.oie.int/doc/ged/D3278.PDF

  12. So as more people are tested and found to be positive or with antibodies and with the death rate % reducing accordingly what does that do to the fear factor? We’re still in the early stages and so far the MSM hype is winning.

    • I am not sure the fear reduces until you have a vaccine. Even as you get enough with antibodies to flatten the curve everyone that doesn’t have the antibodies is still a target walking. The non antibody group becomes a bit like an anti-vax community, a demographic hiding in the immunity shadow of the immune group but prone at any instant to get it. So without a vaccine you have people falling off the perch to the virus (but at lower levels) into the future and so the fear remains.

  13. ‘The virus isn’t going anywhere,’ says Ontario doctor
    CBC March 22, 2020
    Dr. Richard Schabas, the former chief medical officer of Ontario, says lockdown measures are ‘unsustainable.’
    https://ca.news.yahoo.com/virus-isnt-going-anywhere-says-121720522.html

    This is what Dr Schabas said in 2009. Unfortunately the there has been no probing
    July 22, 2009
    I’ll end with a challenge to the media. The media love this story and accept the pundits’ gloomy predictions uncritically. If this turns out to be the fourth pandemic false alarm in six years, as I think it will, it will be time to start asking some probing questions.
    https://www.thestar.com/opinion/2009/07/22/h1n1s_oink_is_proving_to_be_far_worse_than_its_bite.html

  14. My own analysis is much more pessimistic. It is based on South Korea, where the most extensive relatively reliable testing regime has been employed.

    The S. korean data as of yesterday (their 3/24) is the following verifiable: 357896 tested.
    Case load 9137. So infectious rate given aggressive contact tracing, testing, and social distancing to suppress R0 is per Korean data 2.6%. Bad, but that is still more than flu at about R0 1.3 given haphazard flu vaccine. Bad.

    Given the very large Korean test tracing denominator, their CFR (case fatality rate) is as close as we can now get, since the CFR case denominator is thanks to S Korean testing as close as possible close to known: 126/9137~ 3.4%. More infectious despite vaccine flu is about 0.1%.

    This has a knock on. Korea tracing/testing says 11% of positives proceed to serious(supplemental oxygen)/ critical (ventilator). That means about 1/3 of those unfortunates will eventually die. More in overwhelmed Italy.

    • How does 126/9137~3.4%? My calculator says 1.4%

      Current US is the same 1024/68387~1.5%

      Looking like ~ 1.5% is the number sans extreme circumstances like a nosocomial situation as what may be the case in Italy described by Willis.

        • I’m not sure what they are doing across the US. It is such a big place. I’d think it difficult to implement S Korea across the US. I live in a very rural area. We have the drive up testing going on, but we have relatively very few cases. With 1/2 the US cases in NY, I’m sure they are handling it very differently, …. or … maybe not. I mean, even NJ is just a fraction of NY. But even at that, NY current mortality based on Rud formula is only 1.1%, though I expect that to rise a bit over time. Georgia and Washington are the only 2 States in the top 10 with high rates above 2%.

          • That is exactly the problem, those countries that test, track & isolate & test again and use social distancing and masks from the start have the control.
            Those that wait until they have 1000s or even hundreds of cases it is too late because of the the exponential spread.
            Which is most of the rest of the world.
            Those that experienced the full severity of SARS & MERS new exactly what to do.

      • You cannot use total cases because ‘active’ outcomes have yet to be determined. Now that we know the disease course—5day mean incubation, 9-10 days symptoms, then either recovery or serious/critical, the best CFR proxy is Fatalities/ recoveries. 3.4%. Moreover, of active unresolved cases, 11% in Korea are S/C, implying that about 1/3 of those S/C die and 2/3 eventually recover in a m medical system that is not overwhelmed.

  15. I’m 68 and I am telling you that a disease that kills the elderly but spares the young and middle aged is a lot less tragic than, say, motor vehicle accidents, which kill and injure people of all ages. When you project the deaths of the elderly from COVID-19 onto the normal baseline for deaths in the elderly, it isn’t that much of a deviation.

    When I was ten years old, in 1962, the mean life expectancy of Canadian adults was 70. Now it is over 80, but the ten year increase is mostly due to surgeries and medications. You get to live an extra ten years, but your quality of life is pretty bad.

    My parents died of diseases of old age. What was that like? It was as if they were being held down and slowly smothered to death over a period of months, after being stripped of everything that made life worth living, including their capacities to understand reality. So my point is: Death in old age is not the tragedy that the young seem to think it is.

    • On what basis are you determining that CV19 kills the elderly but spares the young?

      When hospitals become overwhelmed, the front line staff need to make choices on who get the best care and who gets death’s door. No one can say how such decisions have skewed the statistics.

      What we do know is that CV19, untethered, rapidly overwhelmed medical centres. Also there are plenty of 20 and 30yo in intensive care globally.

      As of March 26th, Germany has recorded 200 deaths from CV19 and 3,547 recovered. It would be the best place to look for fatalities across age groups as it appears to offer the best medical care. As of same date US has recorded 934 deaths and 394 recoveries. So deaths outrunning recoveries by 3 to 1. US is a long way from control; heading toward the highest death toll from CV19 for all nations.

      There is no reasonable argument against taking the most draconian steps to lock down interpersonal contact across the globe. Anyone suggesting otherwise is a true dingbat.

      Allowing people to travel out of China after their new year celebrations was a crime against humanity. They were locking down internally with draconian rules while exporting the virus to the rest of the world.

      • Whether you die directly from CV19 infection or could have survived but died because you missed out on the best treatment [triaged] you are still dead.

        So if the elderly are missing out on treatment then for all intents and purposes… “CV19 kills the elderly but spares the young”.

      • “ Also there are plenty of 20 and 30yo in intensive care globally.”

        Source please. Also do these people have other conditions?

        Thanks

      • “What we do know is that CV19, untethered, rapidly overwhelmed medical centres. Also there are plenty of 20 and 30yo in intensive care globally.”

        Germany’s hospitals are not being overwhelmed, neither are Japan’s. Italy’s hospitals are normally 85-90% filled every winter, so they are already near capacity every year. Their system collapsed in the winter of 2017-2018 from the heavy flu season. Sounds like a capacity problem there.

        • So is Spain, France & the UK.
          What all those who say it is only the old fail to realise is that all the young or middle aged that need ICU treatment won’t get it because they will be full of COVID19 patients.
          There are a lot of other illnesses & accident victims that require ICU treatment.
          Plus in China, Italy & Spain many Medical staff are also getting COVID19 as well, some of them are also dying.

    • Ian Coleman
      It is good that you remind people that there is nothing unusual about old people dying. What disconcerts me in Ireland is that many people expect doctors to play God. The politicians continually encourage them do all they can to extend life – irrespective of the quality of that life.

      Our politicians could have gone the route of isolating the elderly and them being cared for by family or friends or even volunteers. They could have restricted those infected to an adapted type of hospice situation with volunteers and those mildly sick caring for the sick. They could have followed the hospice example of simply seeking to ease the pain of those dying. This way the virus would have been allowed to move far more quickly though the nation and greatly reduced the economic hurt.

  16. My biggest fear for the people in NY is that this will become a nosocomial situation like in Italy, as Willis described. The biggest fail of the US and the World for that matter, is we did not have a predefined plan to isolate pandemic cases from the general hospital population. Testing and care should have been done offsite, protecting the non infected from being infected. There is no amount of social distancing, travel bans or economic suicide that will prevent a skyrocketing death toll due to a nosocomial scenario. I’ve seen this scenario play out before in a diminished capacity with certain bacteria that become resistant to antibiotics.

    • Hence TB Sanatoriums that used to be everywhere when that disease was prevalent. They didn’t take them to the hospital otherwise they would have infected the entire hospital with TB. How soon we forget. It appears to me we got a lot of this backwards by trying to lock down the entire population, which is probably an impossibility anyway. Isolate the elderly and susceptible, since the virus will run its course no matter what we do. Sure, we can kill the economy and try and lock everybody down, but in the end all we do is commit collective economic suicide while maybe lengthening the duration of the curve and resultant economic carnage. President Trump will be vindicated in the future when we understand what is happening and what we should have done, especially if this creates significant permanent structural damage to the economy which it already has begun to do. Just think if we now had a real emergency, like an extreme major power outage, ice storm or an earthquake on the left coast. This is what they will try and do someday with all the Climate Emergency declarations, when the leftist Marxists are finally in charge.

    • I doubt that. Why weren’t these case being picked up during testing. They can’t have all recovered,

      The only explanation I can see is there might have been an earlier less virulent wave.

      • Without antibody testing we simply don’t know.

        There are more than she that suspect this virus already swept through the world.

        But suspicions are nothing until testing is available to either confirm or deny.

  17. Dr. Lewis is a statistical wizard. However, I suspect the relative health of 70-plus passangers aboard the Diamond Princess is not representative the relative health of a typical national population of 70-plus citizens.

    We can be fairly certain of this, as the weak, sick, and non-ambulatory are loath to embark on a sea voyage where enjoyment is derived through mobility.

    While his correction to Ferguson at al. Is logical, both Ferguson and, Lewis are trying to extrapolate mortality rates using unrepresentative samples.

    • I wouldnt be certain of that at all. I would have thought exactly the opposite , that cruises attarct people who dont want to engage in active travel, cant negotiate airports and transfers anymore and just want to sit is relative luxury while being carted from place to place with tours arranged when you get there. Exactly a recipe to attract the less physically able and well.

      • Plus 100. All the people I know that have taken to cruises are the ones who are less physically active. Most enjoy a wealthy not always healthy lifestyle, most are over sixty.
        If Covid-19 was the viral Armageddon it is being treated as, then the passengers on the Diamond Princess would have been the low hanging fruit for such a killer.
        Be sensible be practical be safe.

    • Rob – can we be so sure about the health levels of the elderly?

      I have been lead to believe there are a sub class of ‘Grey Nomads’ who in practical terms now live on cruise ships. Apparently the relative cost difference between taking endless ocean cruises and moving into an old person’s home are very much in favour of an ocean life. If nothing else the food and staff are better.

      Either that or they just wish to spend all their life savings before their selfish offspring get their greedy mits on it.

      All this is largely hearsay but if it is an urban myth very few people I have spoken to have been interested in disproving it.

      So I am not completely convinced that all the elderly on ocean cruises are sprightly fun lovers. I think it is an assumption we cannot safely make either way and the only thing we can be confident about is that they are ‘elderly’.

      • Craig,
        We might find several oddities aboard the Diamond Princess including; people missing an eye, a terminal patient, and the odd person with eleven toes.

        My original point relates to a high degree of mobility is required to enjoy a sea voyage and port calls. Since walking speed is one of the key indicators of morbidity, It is not illogical assume the 70-plus crowd aboard the Diamond Princess carried less risk factors than the 70-plus population of any nation.

        In other words, 70-plus survival rates are skewed to the low side, as folks with morbidity risk factors can’t (to a large degree) take pleasure from going out to sea.

    • Yes. That was my immediate reaction to Nic’s analysis. The only thing we can be certain of is that the entire population of the elderly is likely *more* susceptible than the elderly people on a cruise ship. Italy is showing the effect of infection more accurately: Almost all the elderly who die have other significant infirmities, and those people dominate the death total.

      • Steve,

        If you have read Willis’ statistical analysis of Italian morbidity, you will recall he posits that a large percentage of the afflicted were infected inside the hospital.

        If we add my supposition regarding relative good health of the passangers aboard the Diamond Princess; we have a partial explanation for the disparity in mortality rates between the two populations.

        The final piece of the puzzle hinges on the availability of respirators. The Italians were overrun with cases and forced to triage older patients.

  18. The US had its first death on Feb 29. The US is currently following Italy’s death trend since their first death on Feb 21 and doing much worse than South Korea since there first death on Feb 20th.

    The following link is my plot of data similar to Willis which indicates each countries daily death toll since the first death in each country. The data for the US ends on 24 March. If anyone can embed that link as a picture I would appreciate it.

    https://i.ibb.co/D70m2h9/COVID-19-data.jpg

    I am not saying that we will end up like Italy, but it is clear with the new outbreak in NY, and other hot spot states, that we are on that same trajectory. Can we bend the curve quicker than Italy, Sure, but we have not demonstrated that to date. I think this country needs an internal travel ban from these hot spot states before the rest of the countries states get out of hand.

    This is not over for the US and to think we can get back to normal is not good policy as of yet.

    • Hi Go Home, – W.Riccardi the past president of Italian National Institute of Health pointed out that hospitals are recording deaths of patients with WuhanVirus as viral fatalities. When the Institute checked the data apparently only 12% of those reputed virus fatalities were directly attributable to the virus (88% of the reputed virus fatalities had 1 or more pre-existing conditions).

      My assumption is this can also be the case for USA hot spots. For the Obamacare mandated electronic records there are codes for everything & currently under pressure without time for autopsies the cause of death box for virus is clicked.

      • The CDC admits that a positive CV test does not mean that the virus caused the illness. But by law the positive test result must be reported to the CDC, and they of course count it as a CV case.

    • whatever is, wont be good.
      already famine from drought seriously bad health care and the usual suppression of info, guess the fatlad wont mind a few thousand or million less to feed though
      as long as hes well fed and everyone agrees with him hes happy.

      Africas going to be bad already people doing runners elsewhere and india wont be great either
      meanwhile the idiots in the EU are allowing boaties to land

  19. It is enough to produce a protein that is in the envelope of the virus so that the human body produces antibodies. Such a vaccine is possible in a shorter time.

    • Ren, the first part is maybe true. Not the lipid envelope, just the S spike protein. Big visible target. Already have one candidate vaccine in human phase one.
      BUT, it still takes about another 18 months to show anything safe AND effective.

  20. I think that antiviral drug slow down the virus when given at the first symptoms, e.g. loss of sense of smell and taste. Five days after the symptoms may no longer be effective.
    Jo Nova
    March 26, 2020 at 1:59 pm · Reply
    Could be effective if given to all close contacts, but this is tough regarding medical approval since they are not even sick yet.

    But this would potentially reduce the rate of spread if it works.

  21. The same day that New York Gov. Andrew Cuomo announced the initiation of a clinical trial using blood plasma from patients who have recovered from COVID-19, the U.S. Food and Drug Administration (FDA) announced wider support for the practice.

    The FDA said Tuesday that it will allow physicians to use what is referred to as convalescent plasma collected from recovered COVID-19 patients in an attempt to treat patients who are critically ill from the virus that was declared a pandemic. The idea is that the plasma, which contains antibodies against the virus, will be administered into patients who are critically ill. In a guidance announced Tuesday, the FDA said it is possible that the treatment could be effective against the infection, although there is scant evidence to support that as of now. The use of convalescent plasma has been studied in outbreaks of other respiratory infections, including the 2009-2010 H1N1 influenza virus pandemic, 2003 SARS-CoV-1 epidemic, and the 2012 MERS-CoV epidemic.
    https://www.biospace.com/article/fda-expedites-use-of-convalescent-plasma-treatment-for-covid-19-patients-with-life-threatening-conditions/
    https://www.biospace.com/article/fda-expedites-use-of-convalescent-plasma-treatment-for-covid-19-patients-with-life-threatening-conditions/

  22. Diamond Princess:
    712 infected
    10 died already
    15 still on vents, will die later
    makes lethality of 3.5%
    10 were “cured with remdesivir”. adding these enhances lethality to 5%.

    Everything depends on the virus strain you catch.

    https://www.timesofisrael.com/moscow-congregation-to-self-isolate-after-synagogues-rabbi-gets-coronavirus/

    Rabbi Gershon Lisus, 36, is in the hospital in stable but serious condition.
    He was young and healthy. No pre-conditions.
    His lungs now look like a piece of swiss cheese. Full of holes.

  23. From what I can determine, windmills cost about $1.5 million per megawatt installed, and have about a 15 year lifetime on average once maintenance and interest us accounted for.

    The value of electricity produced at the US wholesale price of $0.03 kWh over 15 years at 30% capacity factor is: =24*365*15*0.3*0.03*1000 = $1.2 million.

    So it would appear that each windmill over its lifetime is able to produce slightly less energy than it takes to produce a windmill. In other words, windmills are not a sustainable source of energy

  24. It appears that many US doctors are treating serious C-19 cases with HC&AZ cocktail. Anecdotal results are positive but are not being reported by mainstream media due to TDS. Heads will explode if the cocktail saves lives.

  25. I have just read the Ferguson report.

    Though we are interested in the maths of the infection rate, this report considers these as an afterthought. It is NOT a research paper considering the actual threat.

    Instead, it reads far more like a typical civil service briefing document, considering and comparing various courses of action. The actual data supporting these is invariably chosen ‘politically’ – with an eye to ensuring that the civil service preferred course of action can be mathematically justified.

    What seems to be happening is that the ‘Something Must Be Done’ brigade have commissioned a paper to justify the various ‘Somethings’ that are available. If we argue from the data we are approaching the problem from completely the opposite direction from the administrators..

    • Britain’s most expensive myth
      Everyone knows that the claimed link between BSE and the singularly unpleasant disease “new variant CJD” set off the greatest and most expensive food scare in history. In the days that followed the health minister Stephen Dorrell’s fateful announcement in March 1996, predictions of deaths from eating beef ranged from 500,000 by the government’s chief BSE scientist, John Patteson, to many millions (The Observer).
      With very few exceptions (this column being one), the media unquestioningly accepted that there was such a link. As one result, #3 billion of public money was spent on incinerating elderly cows. The costs to industry and the UK economy, not least from a consequent thicket of further regulations, have been many times that, and are still continuing.
      The chief reason for doubting a link between beef and CJD lay in the epidemiological evidence, which even in 1996 suggested that the promised epidemic was a fantasy. Over the past seven years, as the incidence curve has begun a steady fall, that has seemed ever more certain. Now, after reviewing the evidence, Professor Roy Anderson and his Imperial College team have published a revised estimate of the total number of victims likely to die of vCJD in the future (link available through http://www.warmwell.com). Their figure? Not 400,000, or 40,000, just 40.
      As Britain’s farming and food industry grapples with the latest regulatory insanity inspired by the BSE scare, the EU Animal By-Products Regulation that is predicted to drain billions more pounds from the UK economy, it is clearer than ever that Mr Dorrell’s monumentally foolish statement in 1996 was the most costly blunder ever perpetrated by a British minister.
      https://web.archive.org/web/20140429192225/http://www.warmwell.com/2may18booker.html

    • Public Release: 19-May-2003
      Scientists predict swift end to vCJD epidemic
      Dr. Azra Ghani, who carried out the work with other researchers from Professor Roy Anderson’s department, writes, “Our results suggest that the vCJD epidemic will continue to decline with a best estimate of only 40 future cases”. These are expected within the next five years.
      Snip
      Updated projections of future vCJD deaths in the UK
      Azra C Ghani, Christl A Donnelly, Neil M Ferguson and Roy M Anderson
      BMC Infectious Diseases 2003 3:4 (published 27 April 2003)
      https://www.eurekalert.org/pub_releases/2003-05/bc-sps051903.php

      May 20, 2003:
      The World Reference Laboratory confirms the cow had BSE. Within hours, the US announces a ban on all imports of Canadian beef. In Canada, federal and provincial agriculture ministers take to the airwaves to reassure the public that the diseased cow didn’t go into the food system and that the animal’s home ranch is quarantined
      https://web.archive.org/web/20031231043111/http://www.cbc.ca/news/background/madcow/timeline.html

      brent comments.
      Note dates carefully. Canada had first case of BSE confirmed on May 20 2003, immediately AFTER Anderson’s revised estimate were released. Yet panic set in immediately in Canada and US.
      UK Cumulative cases had been huge
      https://www.oie.int/animal-health-in-the-world/bse-specific-data/number-of-cases-in-the-united-kingdom

    • More Post Normal Epidemiology? Sars, Avian Flu, Swine Flu wave I, Swine Flu Wave II

      Latest flu outbreak is shaping up as fourth pandemic dud in the past six years
      Jul 22, 2009 04:30 AM
      DR. RICHARD SCHABAS
      MEDICAL OFFICER OF HEALTH IN HASTINGS AND PRINCE EDWARD COUNTIES
      H1N1’s oink is proving to be far worse than its bite
      Toronto is gripped in a frenzy of worry about the dreaded “second wave” of H1N1 now scheduled for this fall. A severe “second wave” of H1N1 is possible, in the same sense that it’s possible the Blue Jays will win the World Series this year. Science and public policy need to look beyond possibilities and also consider probabilities. Our appreciation of probabilities should be based on evidence, not speculation.
      The evidence strongly suggests that a severe “second wave” of H1N1 is very unlikely. It will almost certainly be merely the latest instalment in a growing list of pandemic false alarms.
      Let’s begin by putting this warning in some context. This is the fourth pandemic alarm in the past six years. The first three have been wrong.
      http://www.thestar.com/comment/article/669727

  26. 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.

    Otherwise, if we don’t develop a herd immunity to slow transmission, how can we come out of quarantine? The pandemic will simply reinfect us due to widespread air travel, and our sacrifice will have been in vain.

    We don’t quarantine for flu because it is a pandemic, not an epidemic. It is too widespread to halt by quarantine unless you quarantine the whole world.

    • Do you have any idea how long it will take to get to herd immunity and how overwhelmed hospitals will become, it is not just over 70s that need ICU care.
      Over the last couple of days healthy 21 year, 34 year & 37 years old UK citizens have died.
      Why do you think all the countries that have 1000s of cases have gone for the Lockdown route and the worst ones have still been overwhelmed.
      The world seems to have lost the common sense of Quarantine and Isolation.
      These days Isolation means a small unit in a normal hospital instead of proper Isolation Hospitals like we had when we had TB, Small Pox and all those other very infectious deseased that killed.

      Mr Eschenbach had it right the other day, we need to get back to isolating COVID victims from general hospitals like we used to, but that takes time.

  27. Scientists believing in models in spite of evidence and perhaps even against their beter judgement. What’s new? Could it be that ‘flatten the curve’ is in the same category as ‘hide the decline’; making the real world complying with a model?

  28. Just as with the myth of Climate Change, lets stick with proper data concerning this Virus.
    The best would be that from the Cruse ship “” Diamond Princes “”. Models are used by people who “”Believe”, that is not proper Science.The cruse ship was perfect, a closed enviorement and a good mix of people.

    Another thought concerns the anti malaria drug, the Chplooqueenene. Its out of patient , used since 1944, no side e effects, we took it for 18 years in PNG, and never got Malaria, . Make e it available for everyone, no harm from it, an hopefully u it will block this virus, its cheap, far cheaper than wreaking the economy.

    VK5ELL MJE

    • “…no side e effects, we took it for 18 years in PNG, and never got Malaria, . Make e it available for everyone, no harm from it, an hopefully u it will block this virus, its cheap, far cheaper than wreaking the economy….”

      Not quite true. There are known side effects and contraindications. Prescribed by a doctor, it’s fine. But if you self-medicate without paying attention to the contraindications or the dose, you could harm yourself. Apparently the levels are quite important, because the overdose level is quite low.

      If you could rely on people behaving sensibly – fine to offer it for general use. But in a time of panic there will be people who overdose on it. Much better initially to provide it to front-line medical staff to prevent Covid infection which would spread to patients.

      • Some people in the US have already died.
        And elsewhere in the world as well.
        Lagos Nigeria has had an epidemic of people overdosing and showing up in emergency rooms and morgues, including at least one whole family.
        I think anyone who asserts publicly that this medicine ought to be obtained and taken by one and all sounds a lot like dangerous medical advice from someone not licensed to offer such advice.
        People go to jail for that in some places, including the US.
        This comment should be removed.
        It is as irresponsible and pin-headed a comment as I have ever seen.

    • No, the Diamond Princess is not perfect, yes it was a closed environment except it had Total Lockdown, everyone isolated in their cabins.
      Plus the results are still not known because their are still patients in ICU and twhen tested the ship’s surfaces were still infected with the virus.

  29. Will the politicians and the doctors who insist on the shut down lose their jobs or have a substantial pay cut when the virus passes? Certainly not.

    Will the average, productive private sector worker be the hardest hit? Most certainly.

    Will the frugal worker who budgets carefully and spends wisely have to bear the brunt of foolish political decisions encouraged by medical alarmists? Most certainly.

    Will those who have been spreading the alarmism, fanning its flames and cheered on by the media be held to account? Most certainly not – though I hope I am proved wrong.

  30. Accordingly, the Verity et al central estimate for the Diamond Princess death toll, of 12.5 eventual deaths, is 50% too high.

    Not yet, Nic. Your 8.34 figure is now definitely too low since the DP death toll now stands at 10. There are still 15 who are in serious/critical condition.

    a high proportion of people killed by COVID-19 will have serious underlying health conditions, and would be much more likely than average to die from non-COVID-19 causes.

    Correct which is why we need to take care with the Diamond Princess data. A fit 75 year old might not be any more at risk than a not very fit 50 year old. Do we have the medical history of the DP passengers? If so, how does it compare to the general population?

  31. Accordingly, the Verity et al central estimate for the Diamond Princess death toll, of 12.5 eventual deaths, is 50% too high.

    Not yet, Nic. Your 8.34 figure is now definitely too low since the DP death toll now stands at 10. There are still 15 who are in serious/critical condition.

    • John,
      If we wait long enough, all those who were passengers on the Diamond Princess will die.
      The big question, is how serious if Covid 19 compared to the normal challenges of life’s infections/age related death.
      So far the numbers are telling us Covid 19 is not that unusual, as far as winter viruses go, but it is being treated as though it is.
      It would be interesting to know why?

      • If we wait long enough, all those who were passengers on the Diamond Princess will die.

        Yes – but if some of those who contract the virus are then admitted to critical care facilities for emergency treatment but die while undergoing treatment – I thin it’s safe to assume that the virus and the death are linked.

        The big question, is how serious if Covid 19 compared to the normal challenges of life’s infections/age related death.

        The seriousness is related to the fact that it’s NOVEL, i.e we have no immunity, either acquired naturally or by vaccine, to the virus. This means we are all susceptible to virus with a transmission rate which is faster than seasonal flu. Medical treatment can probably keep fatalities to levels similar to flu but the case numbers will be much larger in a shorter period of time. If healthcare services can’t cope then people might not get the treatment they need.

        I don’t know what you mean by “unusual”. MERS isn’t unusual but it is deadly (35%CFR).

      • World data.
        Total Cases = 373,481
        Cases with outcome = 146,914
        Recovered = 123,321 (84%) of outcomes
        Dead = 23,593 (16%) of outcomes.

  32. Accordingly, the Verity et al central estimate for the Diamond Princess death toll, of 12.5 eventual deaths, is 50% too high.

    Not yet, Nic. Your 8.34 figure is now definitely too low since the DP death toll now stands at 10. There are still 15 who are in serious/critical condition.

    a high proportion of people killed by COVID-19 will have serious underlying health conditions, and would be much more likely than average to die from non-COVID-19 causes.

    Correct which is why we need to take care with the Diamond Princess data. A fit 75 year old might not be any more at risk than a not very fit 50 year old. Do we have the medical history of the DP passengers? If so, how does it compare to the general population?

    (Rescued from spam bin) SUNMOD

  33. New York Governor Cuomo says:

    Peak number of cases is still 2 to 3 weeks away in New York
    “We’ve procured about 7,000 ventilators. We need, as a minimum, other 30,000 ventilators. This is a critical and desperate need for ventilators [..] We need them in 14 days. Fema is sending 400 ventilators only. Federal action is needed to address this now through the Federal Defense Production Act”
    “The numbers are higher in New York because it started here first, it has a lot of international travelers and has high density, but you will see this in cities all across the country, and in suburban communities. Where we are today, you’ll be in 4 weeks or 6 weeks.
    Probably “hundreds of thousands of people” have already had Covid-19, didn’t know they had it, and recovered. Should be tested for antibodies so they could go back to work and keep the economy going

  34. A GP friend of mine wrote me the following:
    “Today I received a letter from authorities about the changes in death certification from now on. There are several changes that I don’t want to go through in detail. The bottom line is that from now on, everyone who dies with any other reason but had cough and fever as well, will be labelled as COVID 19 related death! Anyone with suspected but not confirmed disease will also be reported as COVID 19 death, and furthermore, if I don’t have a foggiest why a person died, I am demanded to put COVID 19 as a suspected cause of death ! I am shocked once again!”

    I replied: This is politics … (and probably money too). It is not medicine. It is in somebody’s interest to have as high a COVID 19 recorded death rate as possible. Why? To panic the public and politicians? To keep the economy screwed down for as long as possible?

    Somebody is making a bid for power (and/or money). The question is: Who?
    Who wants the public frightened? Who wants the economy trashed? Who stands to gain?
    Do these instructions emanate from the Glasgow Health Board? The Scottish Government? From London?

    There is an intelligence behind this, I think – and not a benign one.

    • Further to my post above, I am informed that the new rules do not apply in Lanarkshire, where absolute accuracy is demanded – and after the serial killer Dr Harold Shipman. no wonder.
      So it seems Glasgow has the problem

      • Photios,
        That is a very troubling comment from your Dr friend. Do you have any way of corroborating this story?

        • I must protect her position, but I will ask.

          However here’s a thought: If “everyone who dies with any other reason but had cough and fever as well, will be labelled as COVID 19 related death”, then all fatalities from the flu (ie: influenza virus) will be labelled as COVID 19 related; and Glasgow will seem like a plague spot compared to Rutherglen just up the road.

          • That’s exactly the way it works. During the swine flu epidemic a tipped-off investigative reporter asked the CDC for patients’ test results. They refused, even though it’s public info. So she requested that data from all 50 states. She discovered that very few had tested positive. When they were exposed, the CDC doubled down on their bogus numbers.

            https://www.cbsnews.com/news/swine-flu-cases-overestimated/

        • They did the same thing with AIDS in Africa; no test necessary. Cough due to cold? AIDS. Why? Every AIDS case brought in money; boring illnesses didn’t. They may still do it there for all I know. They’re did, or are still doing, it in China too. Chest X-ray is sufficient for a positive diagnosis of CV; no test necessary.

          • The AIDS scare of the 80’s was no where near as panicked as CV is today. I guess we have instant media feeds now to breed fear in people.

      • Please publicise this at The Times, Guardian, FT – preferably with a copy of the letter.

        I got shouted down at the Times when I said the massively different mortality rates should be examined. There had been some notes by Italian doctors that all deaths where the patient had the virus were being labelled as caused by the virus.

        I also see from elsewhere here that the Ferguson from Imperial College was also responsible for the mass over reaction to fott and mouth disease in 2001 and the exaggeration of Sars.

  35. Ferguson et al IFR estimate is 19.4 times as high as the best tCFR estimate based on Diamond Princess data, for the 70–79 age group it is 8.3 times as high, and for the 80+ age group it is 2.1 times as high.

    Nic, are you sure you’re representing the Ferguson figures correctly?

    For example the Ferguson calculation assumes about half of critical care case will die (based on expert clinical opinion). The rest of his calculation appears to be based on SYMPTOMATIC cases only, i.e.

    27% of symptomatic case require hospital treatment
    71% of hospital cases require critical care

    i.e. about 19% of symptomatic cases require critical care. The same applies to the other age groups.

  36. This point may have been posted but the vast majority of figures showing “flattening of the curve” are totally misleading. The two curves start at (0,0) and are shown to proceed on different paths.
    In reality the two curves will coincide for the first few weeks and as restrictions take hold they start to diverge.
    This shows up in the Italian data.
    May just be occurring in the UK data, which is a couple of weeks behind Italy.
    And is nonexistent in the USA data.
    A series of interesting plots are to plot the percentage changes from day to day.
    The Italian Cases the rate of increase is dropping at 1.1% per day.
    The UK Cases by 0.6% (although there is an acceleration to about 1.6 % recently)
    The USA Cases by by 0.6% but again a recent acceleration occurring to about 4% but basic figures are higher than Italy or UK.
    With respect to deaths
    Italy is on a reduction in the rate of increase of about 1.5% per day
    UK by 1.6 % but increasing recently
    BUT in USA the rate of increase day on day is INCREASING at about 0.9 %.
    None of the curves have reached the point of inflection yet when the ratio between successive days drops to 1.0 and so as peaked on the flattened curve.
    These facts are best visualized by carrying out simple plots of the daily percentage changes as listed in the various Wikipedia sites such as “2020 coronavirus pandemic in Italy”.

  37. The uk model has large uncertainties.

    what would you do? the risk is people die. do nothing the risk is lots die and you are wrong, close everything down, maybe only a few die, but you risk looking a fool.

    • I think that a prolonged shutdown will kill rather more than “only a few”. We’ve already had a suicide of a young woman that hit the papers. People will be killed through social unrest, murder (domestic murders sharply up as people find being cooped up intolerable), added disease (reduced bin collections soon, can’t afford or find medications for things that otherwise might not have been fatal etc.), not being able to afford to keep warm next winter, drug overdoses and poisonings and so forth. Wealth destruction looks highly likely. High or even hyper-inflation with all that brings far from impossible.

  38. What I am gonna do is come back here after the markets close with a pad of sticky notes and a Sharpy, and I am gonna make my “Big Wall of Doom” prediction whiteboard.

    Shall we agree to discuss it at some certain intervals of time and see how various people are doing?
    We ought to make some guidelines for maximum allowable levels of gloating and I-Told-You_So-ism, and on the other side of the coin, for the acceptable levels of badmouthing and finger pointing ridicule.

    Cheers, and lets all remember…It is ON!

  39. Another metric overlooked is “life shortening” from the mortality actuarial tables. (e.g. an 80 y/o on average lives 4 additional years). China estimated that 50% of those that died from covid19 would have died within the next 12 months. Not sure about how true that is, but the cost to remianing actuarial years would be a good metric for severity of the disease.

    • I agree, I think we’ll also find that deaths from pneumonia/flu will have gone down displaced mainly by Covid-19. But it is a nasty disease. Several youngish doctors have succumbed to it mainly it’s hypothesised because of exposure to an excessive load of the virus before their immune systems can deal with it….so I’ve read.

  40. Dr. Birx just destroyed computer models. In 3 minutes she explained that the virus models assumptions don’t match observations.
    Climate modelers have to be panicked. Their scam has been exposed

    • I’ve just seen a short presentation by Dr. Birx, The very first statement she makes is WRONG. The UK modellers haven’t adjusted the numbers. The numbers relate to different scenarios. The 510k figure for the UK was a projection based on a “Do Nothing” scenario. There were several other figures quoted which corresponded to different combinations and levels of intervention.

      Dr. Birx gave a misleading statement and then built her case on that. Given that she should know that modellers provide projected results based on different scenarios, she has no excuse.

      • Ferguson has been amending his figures. His projection now is for under 20,000 deaths, of which 2/3rds would have occurred anyway. Rather different to the 250,000 figure from his March 16 publication seized on by the papers as the most likely scenario.

        • He has not been amending his figures. I have a copy of Imperial College paper. The various figures relate to different scenarios. This is from the paper (page7)

          In the (unlikely) absence of any control measures or spontaneous changes in individual behaviour ………. in an unmitigated epidemic, we would predict approximately 510,000 deaths in GB and 2.2 million in the US, not accounting for the potential negative effects of health systems being overwhelmed on mortality.

          Is that clear enough? The 510k figure was in the event of an UNMITIGATED epidemic. Read the paper here

          https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf

          • https://thefederalist.com/2020/03/26/the-scientist-whose-doomsday-pandemic-model-predicted-armageddon-just-walked-back-the-apocalyptic-predictions/

            But after tens of thousands of restaurants, bars, and businesses closed, Ferguson is now retracting his modeling, saying he feels “reasonably confident” our health care system can cope when the predicted peak of the epidemic arrives in a few weeks. Testifying before the U.K.’s parliamentary select committee on science and technology on Wednesday, Ferguson said he now predicts U.K. deaths from the disease will not exceed 20,000, and could be much lower.

            Bad computer models panicking stupid politicians (E.G. Gavin Newsom – 56% of Californians to be infected)
            Dr. Birx clearly explained that computer models are based on assumptions. In this case bad assumptions that don’t match observations.

            Ferguson screamed fire in a crowded theater!

          • https://thefederalist.com/2020/03/25/inaccurate-virus-models-are-panicking-officials-into-ill-advised-lockdowns/

            Here’s another model based on Fergusons work – it’s be used to panic the public and politicians.

            “Founders of the site include Democratic Rep. Jonathan Kreiss-Tomkins and three Silicon Valley tech workers and Democratic activists — Zachary Rosen, Max Henderson, and Igor Kofman — who are all also donors to various Democratic campaigns and political organizations since 2016. Henderson and Kofman donated to the Hillary Clinton campaign in 2016, while Rosen donated to the Democratic National Committee, recently resigned Democratic Rep. Katie Hill, and other Democratic candidates. Prior to building the COVID Act Now website, Kofman created an online game designed to raise $1 million for the eventual 2020 Democratic candidate and defeat President Trump. The game’s website is now defunct.

            Perhaps the goal of COVID Act Now was never to provide accurate information, but to scare citizens and government officials into to implementing rash and draconian measures. The creators even admit as much with the caveat that “this model is designed to drive fast action, not predict the future.”

            They generated this model under the guise of protecting communities from overrun hospitals, a trend that is not on track to happen as they predicted. Not only is the data false, and looking more incorrect with each passing day, but the website is optimized for a disinformation campaign.”

          • Tom Kennedy March 27, 2020 at 5:28 am

            Tom, I’m not interested in the incorrect opinion of ajournalist with no knowledge or experience of the issue.

            READ THE FERGUSON PAPER . There is a link to the paper in an anothe rof my comments.

            Imperial College presented several scenarios using different R0 values. The 510k figure for the UK relates to a ‘Do Nothing’ scenario. In other words if the UK took no action to mitigate the virus a death toll of 510k was projected.

            I’m sorry you’re finding it difficult to understand this but the paper makes it perfectly clear what scenario each projection refers to.

          • The terrifying model shows that as many as 2.2 million Americans could perish from the virus if no action is taken, peaking in June.

            However, that model is likely highly flawed, Oxford epidemiologist Sunetra Gupta argues.

            Professor Gupta lead a team of researchers at Oxford University in a modeling study which suggests that the virus has been invisibly spreading for at least a month earlier than suspected, concluding that as many as half of the people in the United Kingdom have already been infected by COVID-19.

          • Tom Kennedy March 28, 2020 at 7:11 am

            The terrifying model shows that as many as 2.2 million Americans could perish from the virus if no action is taken, peaking in June.

            Ferguson stands by that figure but the model also shows that intervention will reduce that figure significantly . The US has taken action to slow down the spread.

            Note US coronavirus deaths have been doubling every 3 to 4 days. After 40 days that’s 10 doublings which is 1024 times the current number (2^10). This would bring the total close to 2 million.

            Professor Gupta lead a team of researchers at Oxford University in a modeling study which suggests that the virus has been invisibly spreading for at least a month earlier than suspected, concluding that as many as half of the people in the United Kingdom have already been infected by COVID-19.

            Gupta’s model also projects results under several different assumptions. The one you refer to in which half the UK population has already been infected is a wild outlier. The model was run when the death toll was just 144. It’s clear that the projection you refer to is already very wrong.

            In any case, if half the UK population had been infected it would have shown up in early tests. In the first 20,000 tests (up to March 6th) less than 1% were positive.

            One of Gupta’s projections could have a small chance of being correct. It shows about 5% have been infected.

          • Is everyone forgetting that we have treatments now – the one is virtually 100% effective – and that on people with underlying health conditions, like weighing 300# and diabetes. None of his patients had to go on respirators. He mentioned the chances of that happening were somewhere in the neighborhood of .000something. We can stop catastrophizing now.

    • Sorry the data is actually deaths. But anyway – they’re a more reliable index of virus prevelance than measured infections which just depends on who you’ve measured.

  41. What we are seeing is what Danny Kahneman and Amos Tversky found in how we perceive certain events.

    There will be an acute spike in deaths over a short period of time but the total number of deaths will be comparible to the flu. There will be deaths irrespective of ventilators or not. And it’s heartbreaking yes, but is it any different when someone you love dies in general. Especially for an illness?

    Our perception is skewed for acute events. We focus in on them. And that is exactly what the media is doing.
    Talking about exponential growth is also a misdirection as Willis’s flu level on his graph points out. You can have exponential growth but still be insignificant compared to a mortality level of which you don’t undertake the current measures.

    We don’t think about overall damage, or cumulative damage which is way worse. And after this, are there going to be law suits? Radical change? Acceptance of reality and all those things?

    Are we going to start taking the flu itself more seriously?

    • Are we going to start taking the flu itself more seriously?

      No. We won’t. If history proves right that is. What we’ll have is, “well thank goodness it’s just the flu” instead.

      The problem is comfort level. Labeling something as ‘new’ when in fact it may not be (we need more data) or it may actually be (again, we need more data) is what is novel about this media storm. News thrives on “NEW”. And the flu is the same old story we all know.

      In response to the rest of the thread and commentators (I read every single one), I want to say just 1 thing, Thank You. Thank you for the links, the videos, the perceptions, and the bravery to post. I am on the fence about the entire situation. I want more data. I want to know what the transmission rate really is, I want antibody testing, and I want to know the data point that flattening the curve graph has assumed the most.

      My biggest question though is, in this lockdown to “flatten the curve”, why would the hospitals be overrun? Why not as some of you have suggested, create an isolation ward or designate a hospital in the area (or two if need be), should they be needed (hope not), but it would keep the regular hospitals, clinics..etc open to regular health patients. We don’t need to accept everything that happened in the past pandemics, but we can learn from them, what worked, what didn’t work. Instead it’s like NEW has taken over everyone’s panic button. Our approach must be NEW, our situation is NEW….when in fact, it isn’t new at all. Why not learn from the past, isolate those infected and keep everything else moving. If the transmission rate is high, then isolation of those infected becomes a serious issue…away from the “normal” operations of a hospital. We should be looking at isolation, not co-mingling until we know what that transmission rate really is. And if it deems to be un-necessary? Then revert back to regular hospital operations. People can move the change swiftly as we’ve all seen it happen. Last week, I was planning a vacation, this week, I’m on lockdown. Temporary change can move swiftly as long as it is deemed to be temporary, people will move their butts into action. JMO.

  42. https://www.newscientist.com/article/2238578-uk-has-enough-intensive-care-units-for-coronavirus-expert-predicts/
    Ferguson admits his model was flawed, and has hugely scaled back predictions. Also an entirely different model from Prof Sunetra Gupta from Oxford: https://www.standard.co.uk/news/health/coronavirus-half-uk-population-oxford-university-study-finds-a4396721.html
    As to people who go on cruises – it is very often people who are chronically sick and for good reason. Often very good hospitals aboard and lots of care over dietary requirements. Observed this on Queen Mary 2 Atlantic crossing. There were so many mobility compromised passengers at the arrival briefing I remember wondering what would happen if we had to evacuate the ship in an emergency.

  43. Italian scientists investigate possible earlier emergence of coronavirus
    MILAN (Reuters) – Italian researchers are looking at whether a higher than usual number of cases of severe pneumonia and flu in Lombardy in the last quarter of 2019 may be a signal that the new coronavirus might have spread beyond China earlier than previously thought.
    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 hospitalized for pneumonia and flu in the areas of Milan and Lodi between October and December last year.
    He told Reuters he could not give exact figures but “hundreds” more people than usual had been taken to hospital in the last three months of 2019 in those areas – two of Lombardy’s worst hit cities – with pneumonia and flu-like symptoms, and some of those had died.
    https://ca.news.yahoo.com/italian-scientists-investigate-possible-earlier-151108674.html

    • Very good and accurate commentary, Steven. I have no idea why you should receive criticism for posting it. So far this is anecdotal and based on poor science and wishful thinking. John Cherry

  44. Mosher watch and wake up to reality There is no AGW I know your only degrees are IN ENglish MY question is what is an idiot like you even allowed here you havent got a clue about biology either https://www.youtube.com/watch?v=Q7voUXgMCSs this is an actual NY doctor dealing with this every day you are just a F2222 idiot please leave you bother me. Take Mann Muller and all you F@@@@v idiots with you chao.

  45. All the medical authorities are reporting worst possible case. Italians say anybody who died With the virus died From the virus. Everyone is saying deaths versus positive tests gives the rate of fatalities, but, people without symptoms are not usually tested, with many mild or completely asymptomatic cases.

    They are also saying that someone with the virus can transmit it without showing symptoms, but, the way it is transmitted is by coughing and sneezing Droplets, and how is that not a symptom?

    This is not adding up. This could turn out to be a massive exaggeration. 1918 Spanish Flu was a different world…

    • Everyone is saying deaths versus positive tests gives the rate of fatalities, but, people without symptoms are not usually tested, with many mild or completely asymptomatic cases.

      No model has used the “deaths v positive tests” as the CFR.

      Neil Ferguson (Imperial College) made the point that many of those that have died would probably have died by the end of the year anyway. He has been very clear about the results of the model they used.

      The two sides of the ‘debate’ have chosen to highlight the more extreme scenarios to make their case.

      1918 Spanish Flu was a different world

      Not really. The world had no immunity – either natural or vaccine – to Spanish ‘flu and the world has no immunity to Covid-19. We do have modern ventilators and various antiviral drugs which might help but we are still very much relying on our immune systems.

      • From “Business Insider”

        53,340 Germans had tested positive for the coronavirus as of March 28, with 397 deaths. That gives a death rate of 0.74%.

        Spain’s rate is 7.6% and Italy’s is 10.2%.

        • Italy’s is not really that high. They code death certificates funny and they admit it
          “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” Prof Walter Ricciardi, scientific adviser to Italy’s minister of health https://www.telegraph.co.uk/global-health/science-and-disease/have-many-coronavirus-patients-died-italy/

          • The CDC allows for covid-19 on the death certificate as well. *Even if that cause is only presumed.* So how will we ever get accurate figures?

      • No, it was a different world. They did not have the supportive measures that we do now.

  46. Yes, it really is deja vu all over again in Britain:

    ‘The UK experience provides a salutary warning of how models can be abused in the interest of scientific opportunism’

    Kitching R.P. (2002). – Submission to the Temporary European Union Commission on foot-and-mouth disease.European Parliament, Brussels, 16 Jul

    And who was behind those models…………?

    The consequences……estimated to be a cost of £10 Billion and, far worse, the unnecessary slaughter of thousands of much loved animals.

    ‘I distinguish four types. There are clever, hardworking, stupid, and lazy officers. Usually two characteristics are combined. Some are clever and hardworking; their place is the General Staff. The next ones are stupid and lazy; they make up 90 percent of every army and are suited to routine duties. Anyone who is both clever and lazy is qualified for the highest leadership duties, because he possesses the mental clarity and strength of nerve necessary for difficult decisions. One must beware of anyone who is both stupid and hardworking; he must not be entrusted with any responsibility because he will always only cause damage.’

    General Kurt von Hammerstein-Equord

  47. A number of comments have suggested people should look at the previous post “Math of epidemics”

    https://wattsupwiththat.com/2020/03/13/the-math-of-epidemics/

    Looking back at this post we can now see that this was an inappropriate and incorrect use of
    blind curve fitting. The “math” was designed for an uncontrolled epidemic, but the curve fitting was
    applied to China and South Korea where vigorous control measures were in place.

    In an uncontrolled epidemic
    the curve flattens when the epidemic runs out of victims. In Korea and China the curve flattened due
    to policy interventions and continues to rise slowly.

    In particular the post predicted that the South Korea deaths would top out “around 100”. They did not
    and there is no evidence that they won’t keep growing (at a controlled linear pace) until there is a
    vaccine (or everyone has been infected).

    https://www.worldometers.info/coronavirus/country/south-korea/

    The moral of the story is you should not apply curve fitting without also applying the underlying
    theoretical justification for the curve.

    Also note that so far there is no sign of flattening in the US with all the numbers doubling about
    every 3 days. It is correct that this is bound to flatten at the latest when everyone has been infected
    as predicted by the “Gompertz Curve”.

    BTW: I wanted to post this on the original post, but comments are closed.

    • “The moral of the story is you should not apply curve fitting without also applying the underlying
      theoretical justification for the curve.”

      The “theoretical justification” is that all illnesses follow this pattern. There aren’t exceptions. The size of the curve may vary based on policies, but the shape does not.

      ===
      “Also note that so far there is no sign of flattening in the US with all the numbers doubling about
      every 3 days. It is correct that this is bound to flatten at the latest when everyone has been infected”

      The ratio of testing to positive test results has remained fairly constant, so the curve you see says as much about our testing capabilities as it does actual infections.

      And remember that even Fauci, Ferguson, and all the rest, in their *worst case* predictions, don’t have even a third of Americans getting infected. Illnesses just don’t spread universally like that. There are very real “signs of slowing” in the US. Of course, if there were not, that would be damning to all of the quarantines that are in place.

  48. It is correct that this is bound to flatten at the latest when everyone has been infected”

    Only true with the S-I model. That is, when there are only 2 states, in this case Susceptible & Infected.

    With most viral infections there are at least 3 states

    S – Susceptible
    I – Infected
    R – Recovered.

    If no mitigating action is taken curve will flatten well before everyone is infected and will decline after that. The number of people who are eventually infected will depend on the initial R0 value of the infection. If Ferguson et al don’t think one third will be infected it suggests they think the current interventions will be effective.

    • It seems to me there are TWO possibilities.
      1. Everyone* gets it and recovers**
      2. We avoid everyone now, assuming thats works, until everyone who has it already recovers.
      * worldwide.
      ** assuming you can only have it once.

      Because if we all don’t recover, it only takes one to start the “pandemic” over again. Assuming china doesn’t release a followup virus.

  49. It only takes one infected person to start it all over again.
    So either everyone gets it* and recovers or everyone who has it now recovers without infecting anyone new, while assuming you can’t get it more than once, and hope china doesn’t release a followup. *Meaning that all the doomsayers who advise separation will keep us in this limbo for years.

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