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
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.
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.
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/
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.
Young people getting pneumonia for various reasons is not unusual. Just because the rabbi has pneumonia and tested positive for the virus doesn’t mean that the virus caused the pneumonia. Even the CDC admits that in their Instructions for Use for their test.
It is not just pnuemonia, have you looked at the xrays/CT scans of those with COVID19?
I just wish you people would get real, when it takes hold COVID directly attacks the lungs and other organs in the body.
https://www.businessinsider.com/china-coronavirus-diagnosis-ct-scans-lungs-2020-2?r=US&IR=T
And it’s not just CV attacking the lungs. Vitamin E acetate in vape smoke creates a coating over the pulmonary surfactant layer leading to serious illness and death. I’m quite confident that no vaping illness now is diagnosed as that if a person tests positive for CV.
https://www.leafly.com/news/health/vape-pen-lung-disease-vitamin-e-oil-explained
https://www.npr.org/sections/health-shots/2019/12/20/790154919/cdc-confirms-a-thc-contaminant-vitamin-e-acetate-the-culprit-in-most-vaping-deat
and the actual numbers of people vaping the contaminated cbd oils?
fairly low.
until then there were NO cases of lung issues known or recorded from vaping the usual NON vit E acatate blackmarket stuff.
and theres been around 15yrs for issues to have shown up..none did.
Nope, most of the cases have been THC vapers, but not all. Cases have been around since at least 2017; 2019 was just a large outbreak that got the CDC’s attention. THC vaping may be more damaging than flavored/nicotine vaping, though.
These Are The 7 Most Toxic Vaping Flavors, According To Science
https://www.bustle.com/p/these-are-the-7-most-toxic-vaping-flavors-according-to-science-9432319
Are Flavored Vapes Bad For Your Health? A New Study Suggests These Chemicals Are “Toxic”
https://www.bustle.com/p/are-flavored-vapes-bad-for-your-health-a-new-study-suggests-these-chemicals-are-toxic-8069212
Kid almost died. Mango flavor
https://www.abc.net.au/news/2019-09-22/how-one-teen-survived-vaping-related-illness/11535282
Of course it is pneumonia (and what do you mean by “just”? Ever seen a case?) The severe viral pneumonia then progresses to Adult Respiratory Distress Syndrome in the worst cases, and this is how death occurs.
You are right about posters on this site needing to get real. Endless anecdotal, evidence-free and sometimes delusional arguments to prove we don’t need to do what we are doing, or that the disaster unfolding in Italian Hospitals isn’t happening, or won’t happen elsewhere, because someone vaped cannabis and got a totally different disease, or someone who might have taken chloroquine in a subtherapeutic dose for 20 years was fine afterwards, or some other unscientific cobblers (Cockney rhyming slang , derived from Cobblers’ awls, for those in the US..) It really would be better if the site stuck to climatology, which is supposedly its purpose.
Regards, John Cherry, M.B., B.S., (London) F.R.C.S. (England)
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
Oops wrong thread.
Wrong thread, but it’s something I wanted to know, nevertheless. Thank you ferdberple.
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.
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..
Ferguson still hasn’t AFAIK released his thousands of lines of undocumneted C code written 13 years ago. There were a lot of sceptical voices among programmers responding to this tweet:
https://mobile.twitter.com/neil_ferguson/status/1241835454707699713
Post-Normal Science and Epidemics
Dr. Jerry Ravetz – on Willis, epidemics, rough & tumble debate, and post normal science
Jerome Ravetz
“I believe that epidemics of any sort provide examples of PNS.”
https://wattsupwiththat.com/2010/04/12/dr-jerry-ravetz-on-willis-epidemics-rough-tumble-debate-and-post-normal-science/
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
FMD2001 UK
There was a real outbreak, however the GIGO epidemiological modeling made it much worse. See upthread
https://wattsupwiththat.com/2020/03/25/covid-19-updated-data-implies-that-uk-modelling-hugely-overestimates-the-expected-death-rates-from-infection/#comment-2947452
I should have said made the slaughter of animals much worse
Following the outbreak of SARS, one thing was certain: Professor Roy Anderson of Imperial College would soon be hitting the headines.
https://web.archive.org/web/20130922025814/http://www.warmwell.com/2may1pe.html
“All models are wrong, but some are useful”
George Box
https://www.azquotes.com/author/22390-George_E_P_Box
Here’s a slight revision :
“Wrong models are useful to Politicians”
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.
UK data for Wednesday
http://www.vukcevic.co.uk/UK-COVID-19.htm
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?
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.
Hydroxychloroquine was developed as an alternative which didn’t have such bad side-effects.
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.
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.
Will China, that caused the pandemic be hel to account?
Of course not.
It’s a rare situation where the G20 should write off the economic harm.
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?
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.
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
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
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.
responsible for the mass over reaction to fott and mouth disease in 2001
https://pdfs.semanticscholar.org/8951/e59ad3931dce8dbfd8cda6cb96f0663afefb.pdf
Can’t get the letter itself, sorry.
However it does seem to be limited to the Greater Glasgow and Clyde Health Board (the largest in the UK, never mind in Scotland).
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.
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”.
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.
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!
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.
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)
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.
China now has less COVID infections per capita than the rest of the world:
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.
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.