By Christopher Monckton of Brenchley
The good news is that in most of the countries we are tracking the downtrend in the growth rates of both confirmed cases and deaths continues. It is important that people should see this at the moment, because in many countries record numbers of cases and deaths are being recorded, and these large figures tend to conceal the good news.
For instance, in the United States, where a passivist confidently told me only last week that there would be only 10,000 deaths in total, there have been 19,000 deaths already, of which more than 2000 occurred only yesterday.
Some commenters are still trying to maintain, in the teeth of the evidence, that the Chinese virus is no worse than the annual flu, and that no excess deaths compared with the same week in previous years are occurring or will occur.
Even though the cumulative-case growth rates continue to decline, offering real hope that healthcare systems will not, after all, be overrun, there will be many more cases and many more deaths before this is over: therefore, making comparisons now between last year’s and this year’s death rates, for instance, will make the Chinese virus falsely appear less harmful than it will prove to be. Cumulative-case growth rates must fall close to zero (and self-evidently not to less than zero, as nodding Homer carelessly wrote yesterday) before we can feel confident that the worst is over.
Fig. 1. Mean compound daily growth rates in confirmed cases of COVID-19 infection for the world excluding China (red) and for several individual nations averaged over the successive seven-day periods ending on all dates from March 14 to April 10, 2020. A link to the high-definition PowerPoint slides is at the end of this posting.
Fig. 2. Mean compound daily growth rates in reported COVID-19 deaths for the world excluding China (red) and for several individual nations averaged over the successive seven-day periods ending on all dates from March 23 to April 10, 2020.
The compound daily growth rate of total confirmed cases throughout the world excluding China and occupied Tibet, where the data have been widely and justifiably criticized as unreliable, is running at 6.6%, and the daily growth rate in deaths, a lagging indicator, at 8.7%.
If cases were to continue to grow at 6.6% compound every day for a month, the 1.7 million cases reported to date would exceed 12 million; for two months 80 million. Note that this is not a prediction, for it is very likely that governments will continue their control measures at least for another month or two.
On the other hand, it is very likely that true cases of infection exceed reported cases, perhaps by 1-3 orders of magnitude. Until antibody testing becomes possible, we shall not know for sure.
Happy Easter to one and all, and keep safe.
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Dread Lord Monckton wrote:
“For instance, in the United States, where a passivist confidently told me only last week that there would be only 10,000 deaths in total, there have been 19,000 deaths already, of which more than 2000 occurred only yesterday.”
Well, well, there you have it folks… The reason that lockdowns and destroyed lives are necessary.
If you would have listened to my confident prediction you would know that I predicted a 0.05+/-0.03% infection fatality ratio for the disease. And low and behold, looking at the recent German study, it is likely to come in somewhere around 0.025% for a maximum mortality in the United States of 80,000 and I am sure you are one of the people who loves to decry this as an everyone disease, but for the most part 95% plus of all deaths are to the already sick and infirm and 95% are over the age of 50. With an average age of death calculated to 74.48 years. Compared to a national average of 78.69 years. The United States has 8 deaths to people 0-24 years of age. And I would not be surprised to learn that they really died from something else, but just tested positive and wallah Chinese Kung Flu killed them, we swears it!
Sensors are in full kill alternative views mode today! I guess every day for this used to be open website.
Never mind, you can kill this post, for some reason my prior post disappeared for a while and several others ones.
Yeah, that’s because it hadn’t been posted publicly yet. Some browsers seem to display your pending post and then if you close out and go back in, you see what the public sees.
and of course bear in mind with your figures- how many are misdiagnosed?
“The President of the German Robert Koch Institute confirmed on March 20, 2020 that test-positive deceased are counted as “corona deaths” regardless of the real cause of death: “We consider a corona death to be someone who has been diagnosed with a coronavirus infection was, «said the RKI President when asked by a journalist (see video below).
According to experts, the number of deaths is severely relativized, since the patients die in many cases from their previous illnesses and not from the virus. Data from Italy show that over 99% of the deceased had one or more chronic medical conditions, including cancer and heart problems, and only 12% mentioned the coronavirus on the death certificate as a cofactor.
A look at the statistics of the German test-positive deaths shows that the median age of the deceased, similar to Italy, is over 80 years and that there were usually one or more serious previous illnesses. The so-called over-mortality caused by Covid-19 is therefore likely to be close to or close to zero in Germany, similar to other European countries.
The German virologist Hendrik Streeck gave the example of a 78-year-old, previously ill man who died of heart failure without lung involvement, but was subsequently tested positive for Covid19 and included in the statistics of Covid19 deaths. Streeck suspects that Covid19 will not lead to over-mortality in Germany by the end of the year.
A recent French study found that “Covid-19 is likely to overestimate the problem” because “Covid-19’s mortality is not significantly different from ordinary coronaviruses (common cold viruses) tested in a hospital in France.” Studies come to a similar conclusion even for the city of Wuhan.
Internationally recognized experts such as the president of the World Medical Association Frank Montgomery, Yale professor David Katz or Mainz professor Sucharit Bhakdi are therefore calling for radical measures such as curfews to be lifted quickly. These are counterproductive and would ultimately kill more people than the virus itself. Risk groups should be protected”
Vs Neil Ferguson – “Several researchers have apparently asked to see Imperial’s calculations, but Prof. Neil Ferguson, the man leading the team, has said that the computer code is 13 years old and thousands of lines of it “undocumented,” making it hard for anyone to work with, let alone take it apart to identify potential errors. He has promised that it will be published in a week or so, but in the meantime reasonable people might wonder whether something made with 13-year-old, undocumented computer code should be used to justify shutting down the economy. Meanwhile, the authors of the Oxford model have promised that their code will be published “as soon as possible.”
Believe Neil and we have to believe Michael Mann.
I am of the opinion that it is very likely all cause mortality will be way down for the year, because of the reaction.
This is not an indictment of the reaction, but an acknowledgement that it changed what would have happened had there been no reaction.
For one thing, hardly anyone is driving, so few driving deaths.
Some guys just drove from New York to LA in about 26 hours, smashing the old Cannonball Run record.
Average speed if they took the most direct route would have been over 100 mph.
Empty roads mean over people out driving are much safer than usual.
Other accidents are surely way down too.
As are drug overdoses, crime related deaths (crime is down sharply all over the planet! I predicted this weeks ago right here), and I am guessing people sitting at home taking vitamins and eating less because they are steering clear of stores, are less likely to have a heart attack or a stroke, and that what is being done has curbed transmission of other communicable diseases perhaps ever better than the one we are trying not to get.
In fact, I am thinking that hundreds of millions of people suddenly being careful about their health and not going out much and paying attention to staying alive…will succeed in just that…staying alive.
In the long run maybe a lot of it will even out…the strokes and heart attacks and long term chronic illnesses at least.
But some others may stay lower for a long time, maybe forever, because I do not recall ever a time when people were so focused on protecting their health in my life.
Waaaay back in one of the first WUWT posts on this disease, I am pretty sure I was the first one who broke out the CDC mortality stats, posted them by category, and opined that the likely long term effect may well be a drop in the number of elderly folks in the world, especially unhealthy ones. And maybe a lot less cigarette fiends as well.
I have modified that view somewhat, as I never saw this staying and home and closing up shop on the world dealio coming.
And I think also some additional statistical evidence has emerged that mostly old and sick people are not surviving, but a proportion of the deaths are people that would not have died anytime soon.
But as detailed at the outset of this overly long post, there will also clearly be some folks who would have died that have not.
And it may far outweigh the deaths from COVID.
If no one did anything different, the deaths from COVID would certainly be more, and the people who have not died, because they stayed at home and took vitamin D and C all day while binge watching The Gilmore Girls…would instead have kicked the bucket too.
People not doing any physical exercice, over eating junk food from stress, and not drinking any wine, is good now?
LOL
Yeah, that is what I said.
Not.
Making take some classes in reading comprehension.
Or just read what people say.
Where did you hallucinate I said any of those things you imagine?
It’s easy enough to get a handle on the numbers form a relatively simple S-I-R model. Ferguson’s model is likely more complex because it handles different intervention scenarios and handles a range of geographical locations.
The Oxford model is meaningless. It basically fits a range of parameters to the death toll (March 19th) and spits out a very wide range of estimates of what proportion of the population are infected. To summarise their results:
(a) With low mortality rate & high disease attack rate – lots of people are/have been infected
(b) With high mortality rate & low attack rate – not many people are/have been infected.
Thanks for that, Oxford.
PS I suspect (a) is already implausible since the assumption was that the majority of the country had been infected (low mortality/high infection) & there had only been 144 deaths. There are now close to 10000 deaths.
Lord mockton has been steadily walking back his extreme predictions re this coronavirus situation just look at his last post and the one before. He wants to save his reputation re climate calculations ~1.5c warming which I now believe to be complete bokum best of luck to him at least he has colorful languasge and has managed to entertain us for years/ This is a very nice kind man and I respect him.
Eliza is out of her depth here. Her comments have been, and continue to be, wild, immature and unsubstantiated. I made it plain from the start that I was not making predictions: merely publishing the available data in a form that allows an instant visual check on when we can bring lockdowns to an end. That the lockdowns were necessary is evident in the extreme pressure on hospital systems in countries such as the UK. As soon as it is clear that there is enough capacity to treat everyone likely to become seriously ill, the lockdowns will be progressively dismantled.
As to Eliza’s childish speculation about my “wanting to save my reputation”, that is a characteristically pathetic and unjustifiable ad-hominem remark.
The truth is that those of us who argued for timely control measures have been proven right; governments have acted on our advice; lives have been saved, perhaps by the million; and the likes of Eliza are furious. She is contemptible. And she snipes from behind a cowardy screen of anonymity.
Experts are certainly walking back the claims in Europe- when will you?
“For instance, in the United States, where a passivist confidently told me only last week that there would be only 10,000 deaths in total, there have been 19,000 deaths already, of which more than 2000 occurred only yesterday.” — CM of B
From Oct 1, 2019 to Apr 6 the CDC estimates are from 39,000,000 -56,000,000 illnesses fore the standard old run-of-mill flu; 18,000,000 -26,000,000 medical visits; 410,000 -714,000 hospitalizations; 26,000 – 62,000 DEATHS. Now this is in America.
There have been 207,000 deaths from Influenza in the last four flu seasons in America, combined totals… and nobody shut down economies. Or lock people down.
TURN THE ECONOMY ON, THIS IS OLD FAKE NEWS AND WE HAVE DONE IT ALREADY. BACK AT CHRISTMAS 2019.
“Chinese virus”: stop calling it a Chinese virus, your prejudice is showing, it was here in the USA in November of 2019.
Hi M.B. – I was in Calif. in Nov. Late in the month I had one of the mildest “flu” episodes for me & I usually only get cases that quickly resolve anyway.
So far I’ve only read speculation this what-cha-ma-call-it virus was stateside in Nov. If you have a source for your assertion please let me/us know. (Maybe when testing gets readily available my results would be illustrative what my Nov. case was & could contribute some context.)
For all we know it’s been here for years.
In response to Klem, we know that the Chinese virus has not been here for years because a) its genome was only sequenced for the first time in December/January; b) the genome, though 80% similar to other bat coronaviridae, is not identical to any other such pathogen; c) if it had been here for years the pattern of intensive care necessary to care for it would have become widely known; d) control measures would have been introduced.
Mr Burns makes the elementary mistake of assuming, on no evidence, that without control measures the Chinese virus would have been no worse than the annual flu. Figures from Britain’s intensive-care monitoring agency, published here yesterday, show that that is wholly false: the Chinese virus is considerably worse than the flu; it is more infectious; it is more fatal; it requires more hospitalizations in intensive care; it requires costlier, more advanced and more prolonged interventions.
And, whether Mr Burns likes it or not, I call the Chinese virus the Chinese virus in exactly the same way, and for exactly the same reason, as I call a spade a spade. If Mr Burns is a Communist, that’s just too bad.
[snip. feel free to criticize the author, but this was just way over the top with pejoratives, including a few banned words.~ctm]
“On the other hand, it is very likely that true cases of infection exceed reported cases, perhaps by 1-3 orders of magnitude. Until antibody testing becomes possible, we shall not know for sure.”
I totally agree that we will not know for sure on the true cases until antibody testing becomes available. But the clues from two different sources imply the mortality rate is less than 1%.
Diamond Princess: The death rate is less than 2% of the passengers but since the above 50 crowd is disproportionately represented the actual death in the US should be less than 1%
This German study in one of the first towns infected. They randomly tested 1,000 people and determined 15% of the people had anti-bodies. They than calculated the case mortality rate in that town was only .37%.
The antibody test used in the German study is unreliable and tends to report false positives therefore generating a too low death rate.
Death rate in Germany and South Korea is around 2%. Both have a good negative tested/total test ratio arguing for a low number of undetected cases.
Germany appears to be going out of their way to avoid calling a death as being caused by COVID-19.
So they are not recording deaths the way most everyone else is.
Are the only counting the ones where the patient was outwardly healthy when they became infected?
Getting information how deaths are counted in Germany is sparse. The RKI is not the most transparent institution and rightly criticized for that.
Only thing that is certain is that at first even people dying of pneumonia who were not tested for SARS-CoV-2 before they died were not tested post mortem. Don’t know if this is still the policy though as testing really ramped up I would expect that people being hospitalized are tested now either way.
As evidence is accumulating that SARS-CoV-2 can affect the heart and brain as well just counting pneunomias might be underestimating CFR so counting all positive tested patients in the ER if they are not dying because of a car accident etc. might be the honest thing to do.
New York State has a good overview about comorbidities:
https://covid19tracker.health.ny.gov/views/NYS-COVID19-Tracker/NYSDOHCOVID-19Tracker-Fatalities?%3Aembed=yes&%3Atoolbar=no&%3Atabs=n
Seems a significant number of 10% dies without any comorbidities and also a significant number of people under 60y who have at least one.
Both of Lowell’s samples – a town in Germany and the Diamond Princess – are unreliable, and are not capable of generalization.
But let us suppose that the death rate in the U.S. is about 1%. Then, assuming that everyone will eventually contract the infection, 3.3 million will die of it, and most of those deaths would occur this year in the absence of control measures.
No responsible government would take the risk of allowing so many excess deaths to occur in so short a time.
My own calculations, based on casting back the known number of deaths by three weeks, show that deaths will probably constitute only 0.34% of cases of infection in the U.S.A., but even that would mean 1.1 million deaths.
Better to take some elementary and temporary precautions, so as to buy some time to find out which pre-existing or new medications are efficacious.
I found out something interesting in my researches today. I set out to answer the question: Why are the “hot spots” in the Netherlands, with the most (hospitalized) COVID cases per population, mostly in rural areas in the south-east part of the country, that I’ve never heard of? Even though I lived there for three years, albeit 40 years ago? I chose the Netherlands, partly because I know the country and can still read the language, and also because their data is both comprehensive and believable.
What I found was that the 10 municipalities which have been hardest hit in proportion to population (175 to 300+ hospital cases per 100,000 inhabitants) have something in common. They are in the Catholic areas of the country (except Oudewater, which has a long history of tolerance towards Catholics), and several of them are renowned for their Carnival festivities. Moreover, they’re not so far away from Tilburg, where the first confirmed case of the virus in the Netherlands was reported on February 27th. The Carnival week-end was February 28th/29th. Confirmed cases of the virus multiplied by 8 or so between March 4th and 9th, by which time a third of those cases were in the Noord-Brabant province, which includes Tilburg.
In contrast, in the highly populated areas, the cases per population are far lower. I looked at the statistics for the 15 most densely populated municipalities in the country, including Amsterdam. They ranged from 20.3 per 100,000 in Krimpen aan den Ijssel (coincidentally, where I lived when I was there) to 43.2 in neighbouring Capelle aan den Ijssel. Odd! Two places on opposite sides of a river, connected by a short bridge, with such different infection rates? And in both cases, a lot of their working residents do their work in Rotterdam? Mmmm… Capelle, 40 years ago at least, was mostly blocks of high-rise flats, each surrounded by greenery. Krimpen, while closely packed, was low-rise; mainly conventional two-story houses.
What this suggests to me is that the virus spreads most rapidly when there are a lot of people in close proximity, as at Carnival and in high-rise blocks. It isn’t how far you keep away from the next person that matters; it’s how far you keep away from crowds. And that may provide a reason why the Austrians have done so well, relatively, in this epidemic. When they had a major problem with patients who had been to Ischgl, they quarantined the whole town. The Icelanders also took this approach, banning large public assemblies, but only putting individuals into lockdown in one small area.
Am I on right lines, or am I way off base?
“Catholic”
Think: going to church every Sunday
Stand in line for Holy Communion
Very close to the priest who gives you the host which you put in your mouth
And you and he will breathe on each other – he’d be a good source of infection.
Just a speculation – I have no idea how religiously these people take their obligations for weekly mass.
Church – and the choir people singing and spitting.
I think this spread of the epidemic was caused by Carnival, not by singing in church. Carnival in the southern Netherlands is a giant series of street parties.
Mr Lock is quite correct that any new and infectious pathogen, to which there is no general immunity, and to which everyone is therefore susceptible, will spread most rapidly where the mean person-to-person contact rate is highest. Large gatherings and tightly-packed, high-rise cities are of course examples of factors that greatly increase the person-to-person contact rate and therefore the rate at which infections will spread.
And, of course, his observation also illustrates why lockdowns work. They reduce the mean person-to-person contact rate – and do so by 85 to 95%, according to the anonymized cellphone data available to HM Government.
Yes, my reading of the conditions under which this virus spreads most effectively are:
(1) large public gatherings,
(2) high-density housing (e.g. large blocks of high-rise flats),
(3) public transport.
I find it interesting that the UN’s WHO, on grounds supposedly of protecting us against harmful health impacts from air pollution, recommends “prioritizing rapid urban transit”, “rail interurban freight and passenger travel” and “making cities more green and compact.” In the name of protecting our health from pollution, they want to force us all into compact cities, that are perfect breeding grounds for infectious diseases! Hasn’t the WHO shot itself in the foot here?
As to lockdowns: Large public gatherings have been banned almost everywhere affected, even in Iceland – and in my view, rightly so. And that should continue until the virus is all but gone from each country. But other aspects of the lockdowns are more dubious, for example forcing prolonged closure of “non-essential” shops in smaller towns. And what is deemed “essential” is, ultimately, a rather subjective choice. The question is, do these aspects of the lockdowns “work” (whatever that means), or will they cause more damage in the long run than they save in the short run?
Was ist das?
2020-04-08 US CDC Pneumonia Deaths – Weekly:
https://pbs.twimg.com/media/EUyBMdvWAAEZAwX?format=jpg
Note the down-trend about week #3 onward. NOTE the difference in thousands by week #11.
Since when does pneumonia translate into something else? Is it when Covid-19 can be cited, be blamed, for um … government stats purposes? Cost reimbursements? What?
I’d like to see covid deaths added to that graph. Would be pretty revealing.
Well, I’m not among them. I don’t know anything about epidemiology. And, being a sickly old man, I’m taking a lot of precautions.
Still, you have to wonder. Suppose, for example, that a couple of infected people arrived in the U.S. on January 3rd.
And suppose that infections thereupon doubled every 3 days through February 12th, to make 20,000 infections by that date.
And further suppose that infections thereupon doubled every 3.65 days to make 18,488,000 infections by March 19th.
If it takes an average of 22 days between infection and death, that would mean that the 20 deaths we saw by March 5th and the 18,488 we saw by April 10th would imply an infection fatality rate of only 0.1%
Yes, yes, I know I’m whistling past the graveyard. But it does seem to me there’s a lot we don’t know.
There is an awful lot we do not know, however, we do know a certain percentage of people are coming down with a nasty form of viral pneumonia which is rather distinctive.
And these people, for whatever reason, began to fill ER’s at a certain point in time.
Is it reasonable to suppose that none of those severe cases in about the same proportion occurred until suddenly in the beginning of March? First a trickle, and then a stream , and then a flood.
Not everywhere, just some places.
There are people infected who spread it all over the country in a short time, and apparently did so without being outwardly sick, so obviously a lot of people have had it for some time prior to when it became evident it was here and spreading.
And this virus does have an unusual pattern of illness and what seems to be an unheard of interval between exposure and when people wind up on life support in an ER…for some people.
Not for others
Some people are known to get infected and be dead about 5 to 10 days after showing symptoms.
Including some people not especially old or in poor health.
It seems reasonable that since these patterns have been documented in diverse locations, that it is a characteristic of the disease the virus causes, and can anyone think of one single possible way this pattern was absent for a few months and then suddenly appeared?
It could be that people in ER’s the hotspots of first infection in several locations around the country did not notice anything, or make note of a strange severe pneumonia that dragged out for many weeks instead of the typical several days…but then we have to account for the fact that the whole world was aware of what was happening in China by Late January, and doctors in ER’s knew about it before that.
“but then we have to account for the fact that the whole world was aware of what was happening in China by Late January, and doctors in ER’s knew about it before that.”
But could they already test for it? Have really all been aware of the symptoms to detect it and distinguish it form other pneumonias before mid of February? I doubt it. Might just have been around a lot time longer before ERs were filled. The lag phase is just so dangerous in spreading and underestimating it.
If 20,000 people had it February 12th, what we know about the number of people who get very sick very quickly, and very sick within two to three weeks…it does not appear likely.
There probably were some cases that showed up in hospitals that were not enough to alert anyone, but ER’s look for clusters of a unusual disease no matter what and no matter when.
An odd on here and there…no, easy to miss.
But five in one area in a week and every alarm in an ER doctors head would explode.
Even if only 2% of people are getting sick enough to go for help at a hospital (the rate is higher than that), and one tenth of them dying, by 20,000 patients that is 400 people. Some of whom would have been sick weeks earlier that Feb 12th.
I do not dispute million of people by mid to late March.
I said as much back then, but no one seemed to believe me.
Here it is, On march 18th.
Mosher had guessed 60,000 to 100,000 in a post on teh 17th.
I responded the next day that the number was very likely well over a million:
Nick sez
“My guess is that the cases in the US, if it were somehow possible to find out how many people have been exposed and either never got sick, had mild illness and recovered, or got very sick but thought they had the flu…etc…that total cases in well over a million.
The state of New York is estimating several tens of thousands in that state alone.
I am figuring it very simply: People all over the entire country who have no known contact with anyone who is infected are turning up with the disease.
All socioeconomic strata, all sorts of occupations, just a broad cross section, and spread all the way out.
So there are chains of transmission occurring…as of weeks ago…in every part of the US, and it is a big place.”
And a lot of other stuff around then that a lot of people only got around to in the past week or two.
I have been way out in front of this.
I do not normally say things like that, but people are jumping on me and they are saying things I said for back in February.
Not you Ron. You and a bunch of others were right there with me back then as well.
Mosher wants to pretend he was the only one who knew what was going on yesterday, last week, last month, February.
https://wattsupwiththat.com/2020/03/17/an-effective-treatment-for-coronavirus-covid-19-has-been-found-in-a-common-anti-malarial-drug/#comment-2941125
Nicholas, I for one don’t think your theory – that a lot more people have had the illness than the experts reckon – has been disproved. I myself had an illness with symptoms similar to a very mild coronavirus attack (5 day fluey cold, then 1 day remission, then a nasty but luckily short-lived cough), starting on January 30th, the very day that the first confirmed case was found in the UK (someone from China).
Yet even by the end of February, there were only 23 confirmed cases in the UK, and transmission from person to person within the UK was only established as a fact by 28th February. It wasn’t until early March that the UK government even seemed to wake up to there being a real problem. The official “risk level” wasn’t raised from Moderate to High until 12th March. That’s 4-6 weeks in which the virus may have been spreading, without being picked up for what it was. If most people who got it didn’t get sick at all, or had a mild flu-like illness and didn’t bother to report it (like me), and those who did get sick and report it were diagnosed as having something else, that could have set going huge chains of infection all over the country. And the same could have happened anywhere else, including the US.
“If 20,000 people had it February 12th, what we know about the number of people who get very sick very quickly, and very sick within two to three weeks…it does not appear likely.”
My point was that even if physicians knew about the symptoms they may not had the possibility to check for SARS-CoV-2 because they didn’t have tests available before mid of February.
I would also not be surprised if most clinicians didn’t know much about COVID-19 before end of January. The so called patient zero in Italy was just tested by chance by his doctor when his symptoms got worse. But he was never in China.
All the reported cases on worldometer are after that time though it is impossible that there were no cases before that.
I did not discount the possibility, just my opinion that it is unlikely that this many might have been overlooked.
Not impossible.
ER physicians are constantly on the alert for clusters of such things as viral pneumonia.
I would have to go back and check the timeline, but I think by that point in time everyone was aware that there was a new virus causing huge problems with viral pneumonia in China.
However, I have also been very vocal in pointing out that while the CDC was reassuring everyone, they were actually doing, apparently, nothing at all in terms of surveillance or testing, when it might have mattered.
So…yeah…who knows.
But hospitals keep records…at some point there will be plenty of time and people will go back and comb through blood tests and hospital records and such.
Anyone that sick gets blood drawn repeatedly and sent to labs, who are supposed to save some of it for retesting if there is a problem.
It is often the case after a crisis that someone with all the time in the world will be able to construct a timeline and a history that reveals details no one knew about at the time.
Anyway, what it amounts to is the number may have been smaller at first, and it grew more rapidly. Steeper infection curve, such that by the time enough people had been infected that many of them were in the group that became very ill, it was widespread.
Another possibility is that it was spreading among a demographic known to have a very low chance of getting a severe case…like younger people.
If it was burning through younger people, they might have been passing it around for a nice long time before it got to a large number of older people who then, a few weeks later, started progressing to the third and more severe stage.
My recollection is that one of the first known cases of community transmission was a teenager who felt really sick, went to a couple of urgent care clinics, was sent home after being tested, and by the time the results came back several days later, he was feeling better and sitting in a classroom. They wisked him out of there and closed the school for disinfection.
Around that time, also in Washington state, a cluster that had been the subject of numerous paramedic calls at a nursing home was recognized after many days of a whole bunch of paramedics visiting the home.
So by then it is very likely a whole huge amount of people had gotten it from those people, and no one even knew or knows now how it got to that nursing home or that teen.
And still the CDC was discounting asymptomatic transmission, after it was literally impossible for there to be any other explanation.
A few days after that, someone in that area had gotten on a cruise ship, which was now off the coast of California with a rapidly spreading chain of transmission.
I think it it is likely there are populations of people, like college kids and high school kids, that have a lot of close contact within their peer group, but not so much with older people…so it took longer than a homogeneous mix of average population demographics would suggest it would take for a large number of old people to get it…
In response to Ron, the Chinese knew of their virus as early as November 2019. By mid-December they knew it could transmit from person to person, but they first tried to conceal the infection and then tried to lie to the effect that it could not transmit from person to person, and they leaned upon their wholly-owned subsidiary the World Death Organization to disseminate their lie, which it faithfully did for several days before eventually being persuaded that it would retain no remaining shred of credibility if it continued to act as China’s poodle.
I don’t know what the Chinese really knew or were suspecting at which time point exactly. That might be a topic for intelligence agencies.
There are just doubts from my side how much clinicians in Europe and the US were already prepared by end of January of what was coming and how to detect it.
In response to Mr Born, we now have data from the intensive-care monitoring agency in the UK, which shows that the Chinese virus is more infectious than your average flu or other respiratory infection, and is more fatal, and requires more intensive-care references, and requires costlier and more advanced and more prolonged intensive care, and with a far less chance of success. We also have evidence of a surge in excess deaths for week 14 of this year from the European mortality monitoring agency, which attributes the surge to the Chinese virus.
It is true that we do not yet know the case fatality rate. However, the Imperial College modeling concluded that, this year alone,there would be 7 billion infected in the absence of control measures, and 40 million deaths, implying a case fatality rate of approaching 0.6%. My own calculations, based on casting back deaths by 21 days and then applying the known case growth rate forward, indicate that in the United States the case fatality rate would be approximately 0.34%. Even if it were only 0.1%, there would be 331,000 deaths from the Chinese virus this year in the absence of control measures.
However, since at this early stage we do not know which of these figures is correct, governments could not take the risk that my estimate rather than that of Mr Born might prove correct.
In the early stages of a pandemic, the usual approach is to calculate a first estimate of the case fatality rate from the closed cases: i.e., CFR = deaths / (deaths + recovereds). However, governments – which are not numerate – have taken insufficient care to update their numbers of recovereds. Therefore, in the world excluding China and occupied Tibet, where the numbers are entirely unreliable, the case fatality rate on the closed-cases basis is currently running at 24%.
Perhaps the simplest thing that governments can do that they are not at present doing is to update their count of those who have recovered. That would at least give us an estimate of the case fatality rate among those cases that tend to be more serious and have, therefore, come to governments’ attention even before widespread testing was introduced.
CFR of Germany and Austria is closing on a value of ~5% according to worldometer data. Both countries are counting closed cases. That would be bad if true.
I still hope the real CFR would be close to 2% as that is what is the estimate for South Korea using deaths/total cases. Undetected rate in South Korea has to be lower than 10% otherwise containment policy would not work. All other CFRs are probably too high cause of undetected cases but could also be higher than the 2% from South Korea due to overwhelmed health care systems (Italy, France, Spain).
“…yesterday marked the highest number of new deaths in the United States reported yet: 1,941, almost 50 percent higher than the previous peak, which came just on Saturday. In New York, the epicenter, 800 patients died yesterday of COVID-19, twice as many as on any day before, and now, in addition to those deaths registered by hospitals, 200 New Yorkers are dying at home each day, uncounted in the official statistics, perhaps ten times as many as died during a typical day before the pandemic arrived.”
https://www.msn.com/en-us/news/opinion/best-case-scenario-for-coronavirus-is-that-it-s-more-infectious-than-we-think/ar-BB12qWLs?ocid=msedgntp
Once again: the reported cases mainly tell you how many tests and being done and what kind. The reported death stats are skewed by the method of counting a Covid-19 death. Your analysis is based on faulty data.
Mr Jones is of course correct that the data are inadequate. But science starts with the data that are available and tries to improve their reliability. In the meantime, while bearing in mind that the data are incomplete and defective, it must try to draw what conclusions it can.
What the graphs in these postings show is that despite the increase in testing the compound rate of increase in reported cases is declining. That is most encouraging, for it holds out hope that lockdowns can be progressively and carefully phased out.
All the talk about the models and deaths predictions going up and down is just meaningless. How any of the people doing the models having an agenda even more so.
Only number that is important is the real CFR with a not overwhelmed health care systems which might be anywhere between 0.5-5%. That number determines how many will die if one goes down the path of herd immunity. They will die!
So just do the math, at least 60% with antibodies for herd immunity means 984k-9.84M will die in the US without a vaccine or a very rigid tracing and isolation regime that eradicates the virus. Though then you still need border control that no second wave arises.
All the flatten the curve nonsense is just about not overwhelming the health care system and not increasing the CFR by lack of treatment. It’s not about preventing any of the deaths of the real CFR of SARS-CoV-2 if you aim for herd immunity. It just saves the lives of the people who would die because of an overwhelmed system. The rest determined by the real CFR will die if infected anyway.
The only way to prevent deaths is to eradicate the virus from the population or keep the numbers low until we can vaccinate the population sufficiently to reach herd immunity.
That’s how bad it is.
Presonally I set aside anything out of China and look at the rest of the world. Its a trust thing.
Is it possible to find out what is happening re Covid in the US outside of NYC? how are things going for the the other 280 million-ish people?
Christopher. I share many concerns as you. However, given the differences in calculating mortality rates, the uncertainties in numbers infected, the uncertainty in tests results especially viral loads, reporting requirements (deaths with Covid 19 Virus vs deaths because of Covid 19 virus) etc, the only way that we can assess the impact of the Covid 19 virus at present is to examine the deaths by all causes surveillance weekly reports. Having just about emerged from the influenza season when simultaneously coupled with deaths because of Covid 19 there should be a clearly defined peak and possibly a double peak as in the Winter of 2017/18 well in excess of most previous years. However, that is not apparent at present and last weeks results appear to show the beginnings of a decline having reached a peak lower than last Winter and well below that of the Winter of 2016/17. This is difficult to reconcile with your picture of massive increases in mortality through Covid 19 plus Influenza which is unlikely to have just disappeared this Winter. Do you have any thoughts on this matter? At present it seems impossible to obtain mortality rates for influenza this season as all is focussed on Covid 19. Influenza seems to have been forgotten about.
Mr Harrison raises a fair question, to which one answer will be found at the website of the European mortality monitoring agency, Euromomo, which shows a severe excess all-causes death rate in several European countries and specifically attributes it to the Chinese virus.
Christopher. I had seen last week’s surveillance figures for the UK and did not observe any noticeable increase as I would have expected but this week the picture was, sadly, completely different. Why the sudden and desperate increase this last week is puzzling but undoubtedly trustworthy. Thank you for your response, I was not expecting one but you have impressed me with the manner in which you have attempted to respond to all comments and particularly with the patience you have shown in your responses to those which one would be forgiven for thinking as not being worthy of a civil reply.
What exactly is compound daily growth rate? I understand compound interest, but this must be something different, no?
I’m not sure but it was explained in the forst post by Lord Monckton.
A bank might give you a certain interest rate but only put it back into your account yearly (or some other interval). But with a true exponential growth rate, the interest is put back in immediately. “compound daily” is how we look at the published numbers. Close enough.
In response to Tom, here is how cumulative cases would increase daily if there were 1000 cases on March 14 and the daily compound growth rate is, as it was up to that date in the world outside China, 20%, and if no control measures had been introduced it would have continued at that rate, thus:
March 15 1200 cases; March 16 1440 cases; March 17 1728 cases; March 18 2074 cases; March 19 2488 cases; March 20 2986 cases; March 21 3583 cases; and so on.
To obtain the mean daily weekly-smoothed growth rate, which is what is shown in the graphs, take the cases on day 1 and then 7 days later, divide the latter by the former and take the seventh root.
To get the mean daily case growth rate over the entire week from March 14 to March 21, just
“Debt eventually gets ‘inflated away’ nowadays … I don’t think there is much worry. My opinion.”
Be careful what you wish for. High inflation is an insidious disease. I lived and worked through it in the 1970’s – 80’s. It degrades the basis fabric of society
M
I live in Pattaya in Thailand. For the last couple of years, me and my wife would go for a walk in the mornings along the beach and back – about 4 miles/6.6 km give or take. On the way we would be literally fighting through countless hordes of Chinese tourists. This continued until the end of January when my wife decided it might be wise to “social distance”ourselves. The tens of thousands of Chinese tourists continued to throng in and out of Thailand until after Chinese New Year in February.
December through February is Pattaya’s busiest time of year and hundreds of thousands of tourists from all over the world visit. All through this time people from all over the world intermingled with the Chinese tourists and then flew back to their respective countries and their respective homes.
One of my best friends thinks he had CV-19 in January. He says he knows a lot of people who also think they had it. In late January one Thai person died and the death was attributed to CV-19. (He was also suffering from Dengue Fever – which nearly took me out in August 2012.)
The current case number in Thailand is 2518 of which a total of 35 have died. And we know that the disease has been here since at least late January. The daily case numbers have peaked and appear to be falling – a max of 188 now down to 45 yesterday. Now – “we can’t believe the numbers” seems to be the cry. OK – maybe not. But the bodies are not piling up in the streets and the hospitals are coping fine. There is no sign of anything untoward happening here. The country is all but locked down and the daily death rate on the roads has dropped dramatically from the usual 50 or so. More people have not died here every day because of the lockdown than the total of deaths so far from CV-19.
I can think of a couple of reasons why Thailand hasn’t been hit. The people may be generally mroe resistant to these kind of things than we pampered Westerners – and those people who would have been susceptible to CV-19 in their older years have already died of something else first.
I left Thailand to work offshore Myanmar on 18th March. I got back onshore Yangon on the 5th April. I am stuck here until who knows when.
“The country is all but locked down and the daily death rate on the roads has dropped dramatically from the usual 50 or so. ”
I have been pointing out that this is surely the case every place there is a lockdown.
And work place accidents are several times the auto deaths every year in the US…all accidents are 5-6 times as many per year.
Today’s figures have just been release for Thailand. The decrease in case numbers continues with 33 new cases to give a total of 2551 and 3 more deaths bringing the total to 38. This after the virus being here for 3 months already.
Lockdowns here only started in response to the increasing panic in the west about 3 weeks ago. The peak in daily cases here was reached on around 30th March.
word has it that early on Covid deaths in Thailand were being reported as Pneumonia deaths.
in any case, Thailand is up there on my choices of where to live
Yeah, that would not surprise me.
Well, I have waited over 24 hours, and exactly no one has said anything about Remdesivir except exactly one lukewarm reply to my post last night. (Maybe Greg is not a complete numbskull after all, just way too hardheaded and rude on this issue)
This changes everything.
The worst off patients now have a small chance of dying. 18% If confirmed. High confidence.
The pretty badly off patients have about a 4-5% chance of dying. If confirmed. High confidence.
Patients not on oxygen or mechanical ventilation will likely have zero chance of dying. If confirmed. High confidence.
This is the game changer.
There is zero evidence chloroquine or HCQ has allowed anyone on life support to be extubated and go home.
Now those people have about an 18% chance, if confirmed.
It does need confirmation, but this was a careful and detailed look at the first people who took it when there was nothing else…perhaps the sickest of the sick at that time.
I do not want to be disparaging, but it is obvious almost no one, possibly no one, commenting here has any idea how to read the results of a drug trial.
No adverse events that were attributable to the drug.
The 8 people lost to follow up may have simply recovered and felt no need to go back to the hospital that treated them.
If confirmed, and there is everything to be hopeful for here…even if the results are only half as good…the odds of dying with this disease just went down by about an order of magnitude at least.
And that is average of all stages.
If and when approved, I do not see any reason why anyone would need to be let get to an end stage where the odds are only 18% and they are on a life support machine. If supplies can be stretched. The trial looking at 5 days vs 10 days is going to be a huge one…twice as many courses of treatment worth. Maybe 300,000 people, with another one to two million people’s worth by year end.
But I expect it will be a lot more than that…everyone will start making it under license that has the facilities.
Raw materials may be a bottleneck.
Also…every hospital in the world should have ECMO.
At present, US has a lot of them over 264 hospitals and adding more fast, some in B.C. Canada, a very few in England and Wales, zero in Ireland or Scotland, 40 hospitals in Germany, Poland has 47 machines, Sweden has 7 or more, Russia has a few hundred, Japan has over 1400, and China has at least 400.
No one else seems to have a single one.
You heard it from me first…this is huge, and only the supply will keep almost everyone newly infected from being cured quickly…although it is like there will be some non-responders, as there almost always is.
Even if only half as good as these initial results a game changer.
Il-6 drugs will save still more.
No one wants to pour too much cold water on malaria drugs, because anything is possible.
But if these drugs kill this virus, it is literally the only virus ever tested on, that it does that for.
It treats some symptoms, but adverse events may outweigh any benefit.
It is always good to be optimistic, but you have to have a real hard head to ignore all the hard scientific evidence that exists for this drug on other viruses, as well as 70 years of zero epidemiological data despite millions taking it.
And many deaths in places using it, and rising sharply.
And no trials halted by a DSMB for success.
And recall the place that had the first trial that started this?
Here is one of the doctors from there:
“Chinese Doctors at Coronavirus Hub Say Evidence on Chloroquine Is Inconclusive”
https://www.wsj.com/articles/chinese-doctors-at-coronavirus-hub-cast-doubt-on-chloroquine-as-cure-11586448660
Pile on with the insults and rock throwing. Water off a ducks back to me.
Remdesivir – not proven by “real clinical trials.” The one limited bit of testing says “some improvement.” Around $1,000 for the course. If you can get it, manufactured by only one company.
Hydroxychloroquine – also not proven by “real clinical trials.” Several tests, Around $40 for the doses required (that is for the brand name formulations, generic is far cheaper). Add azithromycin and zinc supplements, less than $100 per patient. All widely available.
And, once again – ChiCom source = 0.000001% veracity.
Writing Observer,
Wrong, fake news.
It is experimental.
The company that makes it is giving away all 1.5 million does now in existence or in production.
Typically clinical trial participants also get paid.
But IDK about this one…it depends on the testing site I think.
No remdesivir has ever been sold for any price.
They have not priced it.
What makes you think there is any price on it?
And while they are giving away the entire world’s supply in existence, they are spending billions and billions of dollars to give it away while providing care to every participant.
Stop spreading fake news, eh?
People are dying.
Do you not want them to get a free drug that may well save their life?
BTW…
Are the companies giving away the malaria drugs?
Dang…typo:
“…all 1.5 million *doses* now…”
“Also…every hospital in the world should have ECMO.
At present, US has a lot of them over 264 hospitals and adding more fast, some in B.C. Canada, a very few in England and Wales, zero in Ireland or Scotland, 40 hospitals in Germany, Poland has 47 machines, Sweden has 7 or more, Russia has a few hundred, Japan has over 1400, and China has at least 400.
No one else seems to have a single one.”
China used ECMO with good results I was told.
shocked not to hear more about it
As far as I can tell, I am the first person to say a single word about it on this blog.
I am sure someone can let me know if I overlooked someone else mentioning it.
Steven,
The story of the second US doctor to catch COVID-19 while on the job.
Includes treatment with malaria drug, failed, an IL-6 blocker and high dose vitamin C, some effect but he was still on life support many days after these treatment, and how an ECMO machine may have been what saved his life, by giving him enough time to overcome the infection, and the cytokine storm-like stage, and begin to recover.
He is still wondering if he will regain normal cognitive function.
He was 45, healthy as a horse, 5 sick days in over 20 years, lifelong athlete…and this crap almost killed him despite the best of care and support, and several of the leading candidates for drug treatment.
I doubt many can expect such a level of care and support, although it is true that there are many places where a random person can expect the same care as the King of Siam:
https://www.msn.com/en-us/news/us/he-was-a-doctor-who-never-got-sick-then-the-coronavirus-nearly-killed-him/ar-BB12zNAs?ocid=msedgntp
Moderation due to the k word:
Steven,
The story of the second US doctor to catch COVID-19 while on the job.
Includes treatment with malaria drug, failed, an IL-6 blocker and high dose vitamin C, some effect but he was still on life support many days after these treatment, and how an ECMO machine may have been what saved his life, by giving him enough time to overcome the infection, and the cytokine storm-like stage, and begin to recover.
He is still wondering if he will regain normal cognitive function.
He was 45, healthy as a horse, 5 sick days in over 20 years, lifelong athlete…and this crap almost
k !illed him despite the best of care and support, and several of the leading candidates for drug treatment.
I doubt many can expect such a level of care and support, although it is true that there are many places where a random person can expect the same care as the King of Siam:
https://www.msn.com/en-us/news/us/he-was-a-doctor-who-never-got-sick-then-the-coronavirus-nearly-k!lled-him/ar-BB12zNAs?ocid=msedgntp
If you use the link you will have to correct the ! in the k word.
Actually it seems to work as is, incredibly.
death counts
https://twitter.com/stevenmosher/status/1249165360613462023
sorry wrong link
https://www.tampabay.com/news/health/2020/04/11/floridas-count-of-coronavirus-deaths-is-missing-some-cases/?utm_source=twitter&utm_campaign=SocialFlow&utm_medium=social&utm_content=%40TB_Tmes
Florida has been very upfront about keeping separate stats for different categories.
People infected elsewhere while travelling, those who arrived with it, those who acquired it elsewhere then became symptomatic once they got here, or tested positive but not symptomatic.
I think they also have Florida residents that are out of the state that have it.
For example, no state wanted to include the repatriated cruise ship people in their states’ tally.
“Florida has been very upfront about keeping separate stats for different categories.”
so when spring breakers returned to infect their states does Florida count them?
They have top men working on it, I am sure.
Both read it and appreciated that you posted it. Showed up today under a LAT “turn off your adblocker, if you want to read our dismal assessment of it” paywall and smiled.
Lot of qualifications and apologies as to deficiencies in the study, but it’s promising as to what might come from the larger ones.
Consider yourself thanked, though belatedly.
Traditionally, compassionate use was for people who were very sick and not expected to survive.
That was the case for the first people it was used on, but that has been gradually and then more generally relaxed over time since February.
All US patients from the Japan cruise ship got remdesivir, but IDK if any of them are included in this data.
Two China studies that were scheduled to be compete first week of April are vs placebo, and one had inclusion criteria to be patients in severe condition. One out of three only would get placebo, which is unusual but a good way to go IMO.
The other in mild to moderate illness cases, and I think that is the one that compares five vs ten days of treatment.
Considering the anecdotal reports of people who were about to die standing up and going home one day after first dose of remdesivir, it may be five days will do the trick for many and possibly all patients.
The next step is combination therapies, although they will likely want to get approval before going out on a limb with combinations.
But once approved, doctors are not constrained to use it alone.
Covid-19 is very insidious. During the first five asymptomatic days, you can infect your interlocutors without your knowledge.
Therefore, medical personnel should receive plasma with antibodies prophylactically. Especially the personle after the age of 50.
“The often shown exponential curves of “corona cases” are misleading, since the number of tests also increases exponentially. In most countries, the ratio of positive tests to total tests either remains constant between 5% to 15% or increases only very slowly”
You are broadly correct, Richard. I’ve only been keeping tabs on numbers tested for a few days (because Worldometers doesn’t show you historical test numbers, meaning I have to collect them every day). I find that in the major affected countries in Europe the ratio of positive tests to all tests since the start of the epidemic is mostly increasing, but fairly slowly. Exceptions are Italy, Austria and Norway, which have been going down over the last few days; and Switzerland and Portugal look fairly stable.
But the ratio does vary wildly from country to country. From 46% in Spain, France 39% (I don’t trust their figures…), Belgium 27%, Netherlands and UK 24%, Sweden 19%, down to Austria and Germany 10%, Denmark 9%, Norway and Iceland 5%.
(because Worldometers doesn’t show you historical test numbers, meaning I have to collect them every day)
They removed the growth factor a few days back that was bubbling along since late Feb and illustrated no exponential growth.
It seems that chloroquine cannot be taken prophylactically.
Chloroquine should be administered no later than 6 days after the first symptoms. Once the lungs are already occupied, it may be ineffective.
Despite numerous claims to the contrary, there as yet is no scientific evidence it is particularly beneficial or therapeutic as a treatment for this disease.
One thing that is clear from limited evidence, is that mostly there is hype, and advocates have exaggerated any possible effect enormously.
Which by itself should be a red flag to anyone who is familiar with how, in the world of climate science for example, such advocates behave the the trustworthiness of their claims.
Most medical professionals are notably circumspect when it comes to drug efficacy, let alone sweeping and grandiose claims of an uncertain nature.
I fully expect that the malpractice attorneys in the US are going to be very busy for a long time before we have heard the last of this aspect.
It is simply outside of the realm of the judicious practice of medicine to treat patients cavalierly, or to regard evidence of the safety and efficacy of a drug as beneath concern.
Anything less than medically sound best practices are considered malpractice here.
The weather will not help in the fight against the virus in the US, because the wave of frosty air from Canada will fall far south of the US.
Deadly coronavirus comes in three variants, researchers find
Types A, B and C are all derived from the pathogen first found in bats but have evolved in different ways, according to a report by British and German geneticists
Findings show the virus has become well adapted to human transmission and mutates as it spreads, Chinese epidemiologist says.
https://www.scmp.com/news/china/science/article/3079491/deadly-coronavirus-comes-three-variants-researchers-find
From 0 to 24:00 on April 11, 31 provinces (autonomous regions and municipalities directly under the Central Government) and the Xinjiang Production and Construction Corps reported 99 newly diagnosed cases, of which 97 were imported cases and 2 were local cases (2 cases in Heilongjiang); none New death cases; 49 new suspected cases, all imported cases (43 cases in Shanghai, 3 cases in Heilongjiang, 2 cases in Inner Mongolia, and 1 case in Jilin).