[No Politics] What you need to know about CoVID-19 by SARS-CoV-2 [No Politics]

[Thomas Savage]

In the last hour, I just attended a Zoom funeral for a guy who was 91 and in the last stages of senile dementia. Sometimes death is not the worst outcome.

Of course, his death got counted as Wuhan virus. He wasn't even tested, it was "presumed." So I'm learning that I can't trust even obvious stats like number of deaths, much less the clearly unknown number of infections.

It was bizarre to see the rabbi all alone in the columbarium, but wearing a mask. Perhaps he was worried about infecting the ashes of the corpses?

The only stat that will present something valid is the overall death count . I posted this from our office for national statistics earlier in the thread.

You can discount all stats that claim to have recognised covid19 , they are meaningless especially when one wants to play national covid top trumps with them.

So it's , how many people have died this week , month , year Vs how many normally do in a comparable period in the past. Not perfect but as good as we will ever get.

 

[Willem]

So it's , how many people have died this week , month , year Vs how many normally do in a comparable period in the past. Not perfect but as good as we will ever get.

This is indeed the best number that we have. Registered deaths from Covid is a problematic number, because there can be both under registration and over registration/attribution, and neither is a conspiracy. The magnitudes of these two biases are likely to be different between countries, bureaucratic regulation, and cultures.
In the Netherlands many people prefer to die at home, and those deaths may go undetected as Covid19 deaths, particularly if they were not tested (why waste scarce test kits on those who are obviously dying or have died?). On the other hand, there may be over registration/attribution if, as is almost always the case, there is a high level of serious comorbidity. Sometimes these biases may cancel each other out, but for many countries the underregistration is much larger than the over registration. So as absolute measures these 'data' are not very good. Questioning the seriousness of the epidemic by pointing to only one bias in the data is disingeneous. On the other hand, as times series data, these numbers can be pretty informative, although that does not apply to the number of detected infections, because testing effort has increased enormously over time.
To estimate the death count the best estimate is indeed the excess mortality at this time of year compared to more normal years. This shows that in the Netherlands the number of registered Covid19 deaths is only some 60% of the excess mortality for the season - we are mising quite a few. The same applies to the numbers from some other countries. But since nobody dies twice, the number will go down below normal mortality at some later time, depending on normal remaining life expectancy for the group. All in all the numbers are pretty grim, with excess mortality that is a lot higher than during the bad flu epidemic of early 2018, even though current measures have been far more intrusive.

 

[Wes]

Initial epidemiological model predictions were used to predict medical equipment needs and to determine the need for prophylactic measures, such as social distancing.

The models worked.

If the models had not worked we would see death counts in the tens of millions by now.

There are a number of modelling efforts underway and many of them are not population based models: e.g. models of ACE2 binding, yada yada

 

[Ratatoskr]

 

[MarcT]

US FDA approves remdesivir for emergency use for covid-19.

https://www.cbsnews.com/news/fda-authorizes-remdesivir-for-emergency-use-as-coronavirus-treatment/

 

[Xulonn]

US FDA approves remdesivir for emergency use for covid-19.

Good explanation of the statistics behind this in the Dr. Seheut two posts up. (Dr. Seheult's videos are the best I've seen on the science related to Covid-10. Thanks @Ratatoskr.)

 

[Dave Zan]

Sorry but...

After some consideration I think you have a valid point.*
There is surely a bias in the early cases to overestimate the case fatality ratio.
I still do think that the effect I proposed occurs too.
Yours probably dominates early data, mine presumably increases in importance as time passes.

*(Waits for divine wrath or Internet to collapse.....There must be some reason that this sentence is never seen)

until sufficient data was available to show that it was fractions of a percent, not full percents.

Well, it's not that it is an immutable constant, like π or the e/m ratio of an electron.
Depends on the treatment, how old the patient and so on.
The Australian data is about the best, that is most reliable and accurate, currently available and is 1.4%.
May creep up a little from deaths to current critical cases.
That number is also what the Centre for Mathematical Models of Infectious Diseases at the London School of H&T Medicine came up with.
Their number was before the Australian data settled down, so was independent.

...the Ozzy...data is very noisy (small sample size?) but here is the plot:

Thank you.
I expected the data to be noisy from small sample size, "quantisation noise" when you only have zero or one death on the better days.
Your plot confirms this and so I think your interpretation is correct.
The numbers are a bit more than I expected, I went back to your US numbers and noticed they are also somewhat more than I would have expected.
I may do have done my own manual estimate, "nail my colours to the mast" for criticism by people who claim we can't do a useful model.
Based on Worldometer data (different cutoff time than US local numbers but internally consistent) 1.5 million cases, 95 thousand deaths by your date.

Credit to Randall Munroe XKCD

Best wishes
David

 

[scott wurcer]

Scott this is not appreciated, this can be a emotive subject so we need to try and approach it with a good degree of tolerance and build in room for the effects of diverging opinions and personalities.

We are all arseholes at some point in time.

Yes my apologies, my personal situation is extremely stressful I have a hot bed 100' outside my back yard (assisted care facility) and watch the body bags go out as I walk my dog

 

[Wombat]

FYI

https://www.theguardian.com/austral...tals-to-receive-experimental-coronavirus-drug

 

[andymok]

Oh
It's actually straight 13 days, 0 new local cases here in Hong Kong.

 

[DChenery]

After some consideration I think you have a valid point.*
There is surely a bias in the early cases to overestimate the case fatality ratio.
I still do think that the effect I proposed occurs too.
Yours probably dominates early data, mine presumably increases in importance as time passes.

*(Waits for divine wrath or Internet to collapse.....There must be some reason that this sentence is never seen)



Well, it's not that it is an immutable constant, like π or the e/m ratio of an electron.
Depends on the treatment, how old the patient and so on.
The Australian data is about the best, that is most reliable and accurate, currently available and is 1.4%.
May creep up a little from deaths to current critical cases.
That number is also what the Centre for Mathematical Models of Infectious Diseases at the London School of H&T Medicine came up with.
Their number was before the Australian data settled down, so was independent.



Thank you.
I expected the data to be noisy from small sample size, "quantisation noise" when you only have zero or one death on the better days.
Your plot confirms this and so I think your interpretation is correct.
The numbers are a bit more than I expected, I went back to your US numbers and noticed they are also somewhat more than I would have expected.
I may do have done my own manual estimate, "nail my colours to the mast" for criticism by people who claim we can't do a useful model.
Based on Worldometer data (different cutoff time than US local numbers but internally consistent) 1.5 million cases, 95 thousand deaths by your date.

Credit to Randall Munroe XKCD

Best wishes
David

Just a final note on these types of extrapolations, in the spirit of your reply. And also, truly appreciate your comments. Nice to have a discussion without degrading the the LCD. Kinda why I really appreciate the folks on this blog!

Note that Total data is from worldometers while the individual country data is from ourworldindata. Slight differences, but I would expect more from cutoff times than anything else.

 

[maty]

Spain, a country full of irresponsible people, especially in big cities.

https://www.diaridetarragona.com/ca...er-dia-de-deporte-y-paseos-20200502-0009.html

Passeig Marítim, Barcelona (Catalonia, Spain).

Where I live (Tarragona city), these days there are more and more people on the street. Few with the mask on and without touching it. Today more people, many without masks entering a bakery / pastry shop, queuing earlier. Too many people without keeping distances. If the mask is wrongly put on, you can contaminate your hands or the other way around (door knobs). I am ashamed of my fellow citizens but it does not surprise me.

https://twitter.com/x/status/1256498221150613505

 

[DChenery]

Epidemic Modeling 101: Or why your CoVID-19 exponential fits are wrong
https://medium.com/data-for-science...ovid19-exponential-fits-are-wrong-97aa50c55f8

Sort of a one-trick-pony here, but for some reason I have become slightly obsessed with tracking the WoohooFlu. This is a brilliant little series of articles that explains how basic epidemiological models are derived and their results interpreted. While the articles cover the simplest implementation of a model formulation, remember that a model should never be more complex than the input data it is using.

IMHO, this is the problem that has been facing our elected (or unelected depending are where you currently reside) officials. The models and interpretaion of those models has far exceeded the validity of the input data used. That is, predictions are being made on insufficient input data, and the predictions seem (reading the articles published by the MSM anyway) to be accepted as absolute truth.

I realize that constant"adjustment" is fairly common when using models to determine socioeconomic impacts, but people seem surprised/angered that revisions to projections (both positive and negative) happen on a regular basis. We're used to it with weather forcasting, so why is everyone so surprised when the epidemiological models are out of date and need revising?

 

[maty]

https://twitter.com/x/status/1255449234968543233

Spain, a country full of irresponsible people, especially in big cities.

https://www.diaridetarragona.com/ca...er-dia-de-deporte-y-paseos-20200502-0009.html

Passeig Marítim, Barcelona (Catalonia, Spain).

Where I live (Tarragona city), these days there are more and more people on the street. Few with the mask on and without touching it. Today more people, many without masks entering a bakery / pastry shop, queuing earlier. Too many people without keeping distances. If the mask is wrongly put on, you can contaminate your hands or the other way around (door knobs). I am ashamed of my fellow citizens but it does not surprise me.

https://twitter.com/x/status/1256498221150613505

La Policía expulsa a centenares de corredores y paseantes de los parques y zonas verdes de Madrid
[Spanish] https://www.elmundo.es/madrid/2020/05/02/5ead2e13fc6c83480d8b461c.html

The Police expels hundreds of runners and walkers from Madrid's parks and green areas
https://translate.google.es/translate?sl=es&tl=en&u=https://www.elmundo.es/madrid/2020/05/02/5ead2e13fc6c83480d8b461c.html

[ "It has been chaos, the seals have been broken and citizens have entered Madrid Río and Casa de Campo without attending to instructions," said an agent. In some areas such as the Ermita del Santo, the Police have placed the cars to drive the runners or walkers from Madrid Río which has caused them to crowd on the sidewalks. "People have not respected social distance. This is real nonsense and it is not understood that citizens cannot use parks to play sports," added another neighbor. "In all the places you can go to the parks and they have enabled sidewalks but here nothing," said another person.

The Municipal Police officers assure that there is a contradiction between what the order of the mayor of Madrid says and the royal decree that allows exercising in green areas from May 2 between six and ten in the morning and from eight the afternoon at eleven at night. "There are people who continue walking at 10:30 and are not older," explains an agent who does not stop asking citizens to respect the departure times according to age. "It is 10.40 and this is full of young people, they do not know or do not want to know that you can only walk until 10.00," adds another police stationed in Madrid Río... ]

 

[maty]

https://www.lavanguardia.com/vida/2...o-alarma-ultimas-noticias-hoy-en-directo.html

[ 08:28 CATALUNYA | Catalonia has reached the figure of 10,401 deaths from Covid-19 since the start of the coronavirus pandemic in Spain, having added 90 new victims in the last 24 hours, according to data provided by funeral companies collected by the Department of Health of the Generalitat. ]

Catalonia (2019) 7,566 millions inhabitants

10,401 / 7,566.000 = 0.001374 -> 1,374 deaths by Covid-19 per million inhabitants

The first country is Belgium, counting almost Covid-19 deaths: only 664 deaths per million inhabitants

https://ourworldindata.org/grapher/...DEU+ITA+JPN+NLD+ESP+SWE+GBR+USA&region=Europe

 

[Willem]

As I have said earlier, we live in Groningen, in the North of the Netherlands, and in our region there have been very few infections, and least of all in the town itself. Here is an article that explains most of the reasons why we have been so lucky: https://www.irishtimes.com/news/wor...oLkHrXLJJpN5p0JnqxDPUreeoUlvrcqdMqobaLblu905c

This about summarizes it. Although two things have to be added to the story. The first is that Friedrich realized much earlier than others what was coming and decided to expand testing capability in a big way and buy testing kits from a number of suppliers to avoid dependence on one manufacturer who might not be able to supply sufficient testing material as indeed happened elsewhere. The second is that there is now emerging evidence (but no more) that the concentration of infections in the east of the Dutch province of North-Brabant is related to the high levels of air pollution from intensive animal husbandry. Perhaps connected to this: the same area had very high incidents of #Q fever some years ago and that too is related to intensive animal husbandry. Research into the connection between #Covid-19 and small particle pollution has been started.

 

[Frank Dernie]

In the last hour, I just attended a Zoom funeral for a guy who was 91 and in the last stages of senile dementia. Sometimes death is not the worst outcome.

Of course, his death got counted as Wuhan virus. He wasn't even tested, it was "presumed." So I'm learning that I can't trust even obvious stats like number of deaths, much less the clearly unknown number of infections.

It was bizarre to see the rabbi all alone in the columbarium, but wearing a mask. Perhaps he was worried about infecting the ashes of the corpses?

This sort of thing is definitely dependant on which country you are in.

Edit:
Just looking at international news there seems to be not only big differences in the approach but also to the general populace's confidence that the approach is correct or reasonable.
This probably depends on how the proposals are presented, and how consistent the advice is.

 

[maty]

Uri Alon: «Hay que trabajar cuatro días y encerrarse diez para prevenir el rebrote»
https://www.elcorreo.com/internacional/oriente-proximo/trabajar-cuatro-dias-20200501200842-ntrc.html

Uri Alon: "You have to work four days and lock up for ten to prevent regrowth"
https://translate.google.es/translate?sl=es&tl=en&u=https://www.elcorreo.com/internacional/oriente-proximo/trabajar-cuatro-dias-20200501200842-ntrc.html

[ - What does your exit strategy from confinement consist of?

- We want to find a balance between health and economy and we have developed a model that consists of cycles of four days of work and ten days of confinement. One of the weaknesses of the virus is that it has an incubation period of three days in which if you have it you are not contagious, but then yes. With the work by cycles you would be able to infect when you are already at home and it would be more controllable. You have to work four days and lock up for ten to prevent regrowth... ]

[ - So four days of work weeks ...

- Yes, and it is also important to divide the community into two groups so that while one is home, the other works, this will help to maintain the activity continuously. The cycle strategy can be applied on a small scale in companies, schools or towns, and on a large scale, throughout a country. The goal is to reduce infectivity, the number of people that each of us can infect if we have the virus. The Covid-19 has an infectivity of two or more people and every effort must be made to keep it below one.

- Does your model get it?

- If we return to normality with well-organized cycles, we will end the pandemic. We believe that in order to maintain infectivity to a degree less than one, total closure is not necessary, which is a disaster for the economy. Our proposal is an intelligent partial closure that allows us to maintain activity, it is obvious that the total closure eradicates the virus faster, but seeing how businesses sink and unemployment increases also has a huge medical cost due to deaths, depression ... ]

[ Two groups in the classrooms

- Back to school is one of the key issues in misconduct, how do you deal with it in your model?

- The reopening of schools is essential for this to work, but they also have to adapt to cycles. So parents can go to work while their children are at school, and then they can do homework together. Austria is the first country to have reopened its academic centers with this strategy and the children will return on May 18 with classes divided into two groups that will attend the centers for half a week alternately. The Ministry of Education in Israel will also do it in this way inspired by our method and next week the classrooms will be reopened. The model that we propose has been recommended to the State by the Gertner Institute of epidemiology... ]

 

[DChenery]

As I have said earlier, we live in Groningen, in the North of the Netherlands, and in our region there have been very few infections, and least of all in the town itself. Here is an article that explains most of the reasons why we have been so lucky: https://www.irishtimes.com/news/wor...oLkHrXLJJpN5p0JnqxDPUreeoUlvrcqdMqobaLblu905c

This about summarizes it. Although two things have to be added to the story. The first is that Friedrich realized much earlier than others what was coming and decided to expand testing capability in a big way and buy testing kits from a number of suppliers to avoid dependence on one manufacturer who might not be able to supply sufficient testing material as indeed happened elsewhere. The second is that there is now emerging evidence (but no more) that the concentration of infections in the east of the Dutch province of North-Brabant is related to the high levels of air pollution from intensive animal husbandry. Perhaps connected to this: the same area had very high incidents of #Q fever some years ago and that too is related to intensive animal husbandry. Research into the connection between #Covid-19 and small particle pollution has been started.

While it has been quite a while (more than 15 years), I used to live in Rolde (village just outside of Assen). Yep, Oil Patch Trash working for Shell. The one thing I knew about Drenthe and Grongen Provinces, was how young the average population was compared to the south (Brabant, Zeeland and Limburg). I may now be completely incorrect, but could this explain the discrepancy in "kill rate". Also, the area is significantly less populated than the south of Kaasland, even though it still has a higher population density than most of NA (excluding the costal areas such as LA, Miami and NY).

 

[Willem]

how young the average population was compared to the south

It will be true for the town of Groningen which is a university town with two institutions that between them have some 60,000 students. But it does not apply to the rest of the area. The difference in infections, moreover, is massive, with virtually none in the North (and continuing so even though testing is more intensive than elsewhere) and horrific rates of infections and fatalities in some parts of the South of the country (i.e. some 40 times higher). Interestingly urban infection rates also seem to be quite a lot lower everywhere than many rural ones (this needs more statistical research).
So the question about the explanation remains. It is probably all of these: a lucky timing of local school holidays with people going on skiing holidays in Austria and Italy earlier than in the South, and before the epidemic got much bigger there, no carnival festivities, more timely intervention by a highly proactive university hospital, and much less air polution.
On a side note, the exploration of natural gas is being phased out because of the resulting earth quakes.
It continues to be a beautiful area, with plenty of space, nice housing stock, great cycling and hiking trails and a good research university that employs both of us.