Corona Virus

[gcstomp]

The pure pie in the sky under 1% guesses are not backed by actual numbers of closed cases worldwide. worldwide https://www.worldometers.info/coronavirus/ link updated every few hours as countries supply their actual numbers. So of 445k cases we would not look at the death rate and compare it to overall infections. After all it takes 2 to 3 weeks from infection to critical or death. Of 131k closed cases, a good sized sample, 112k recovered (85%, and near 20k died (15%).

WHO stated a 3.4 % mortality rate on march 3 https://www.worldometers.info/corona.../#who-03-03-20 but that was based on very limited numbers as of that time, on a novel virus. This is hitting people over the age of 80 like a ton of bricks. We will be near 10% death rate for those over age 80. And we have not had 1 day of total country lockdown, so comping it to china and their current new cases isnt at all same. Odd even this, a pandemic, a strain new to the planet, the expected outcomes are viewed along party lines. Trump announcing all will be peachy by easter and he hopes churches are packed at that time and we will all be back to work is a call to multiplying this disaster to insure we dont have a recovery along lines of china.

[Kevin Seitzer]

Again I don't agree with this logic. It's like being in a golf tournament with 100 golfers and 10 have finished and are in the clubhouse - 5 of which are under par and the other 5 over par, with the remaining 90 still on the course. In this case saying 5% of golfers will shoot over par today makes no sense. We have to wait for the others to finish.

Mortality rate based on active cases doesn't make any sense.

I saw one good way to look at it based on the average duration to mortality of 14 days. Basically, on average those who die will do so 14 days after they get it.

So to calculate mortality rate you look at the active cases 14 days ago and the deaths in the last 14 days.

In the US, 14 days ago there were 1,248 cases. Since then there have been 742 deaths. Now, unfortunately that overestimates the mortality rate because there are so many new cases every day that we have a moving target, and we have people who are dying at less than 14 days, but it gives us a better idea than the 1.5%.

I think 1.5% is wayyyy too optimistic, the mortality rate will be much higher.

Right after I wrote the sentence you quoted, I mentioned that both the numerator and the denominator are bigger than the numbers in the quote. You go on to argue why the numerator is much bigger, without acknowledging that the denominator is also much bigger. The epidemiological models try to estimate both effects. I don't know how accurate they are. For your logic to be helpful, you would also need to make some estimate of how much bigger the denominator is.

[Judge Jude]

fwiw, more than half of the 795 U.S. deaths so far are in 2 states - NY 285 and WA 123.

next up are CA 52, LA 46, NJ 44, GA 38, MI 24.

[Kevin Seitzer]

The pure pie in the sky under 1% guesses are not backed by actual numbers of closed cases worldwide.

That's correct. They are based on evidence from previous epidemics as well as this epidemic that many people with mild cases or asymptomatic cases do not get tested and are therefore not included in the case count.

My point to my conservative friend on Facebook was that EVEN if you are optimistic and assume a 0.5% mortality rate, given how quickly the disease spreads and lack of immunity in the population, the consequences to our country would be disastrous if a substantial fraction of the population were allowed to catch the disease.

[Ken]

Right after I wrote the sentence you quoted, I mentioned that both the numerator and the denominator are bigger than the numbers in the quote. You go on to argue why the numerator is much bigger, without acknowledging that the denominator is also much bigger. The epidemiological models try to estimate both effects. I don't know how accurate they are. For your logic to be helpful, you would also need to make some estimate of how much bigger the denominator is.

You are correct, and that is fair.

Personally, I don't think anyone can accurately estimate the denominator based on those who are getting sick but unreported which I believe is what you are referring to. But does that number even matter in this case. If we follow the numbers based on positive tests, and look at the growth of those tests and compare it to the mortality rate of those individuals we can almost ignore the unreported cases at least for the concept of looking how this thing is going to grow. Basically we treat the unreported as unknown.

Going off the known numbers, we are in for some big jumps in mortality coming up. Yesterday 225 died, based on the model I'm calculating for the US I expect to see ~360 die today in the US. And in 5 days that number will be > 1000 daily.

The US is tracking on ~8% mortality based on known cases and an offset of 6 days (14 days average from illness onset to death - I'm assuming 1-2 days from feeling sick to get tested and ~6-7 to get a positive result back = 6 days offset)

[gcstomp]

For weeks, sick people who wanted to be tested, just could not get it done. Even now, sick people who want to get tested, but cant. Many people have died in this country or worldwide past month who had coronavirus but will never show in stats. I read the material re: Italy with many cases that couldnt get tested but ultimately passed on. Down the line we could look at typical deaths in a year in say italy, spain, u.s. and project that the higher numbers we will see this year relative to past likely is will be due to coronavirus even if not diagnosed.
Again, not everyone who dies of coronavirus will be diagnosed.

But what we do have are the coronavirus updated statistics, hard numbers not relying on projections assumptions, just updated every few hours hard numbers https://www.worldometers.info/coronavirus/ and we can say each additional case is an additional data point to which we can read the virus. Just on ww closed cases, I think this is a substantial data point of 400k and though I do think that the 15% mortality rate of course does not include lots of people, both infected who are not reported who get well, and infected who die, both are under reported, it is still more info than the world has prior day. The 3.4% WHO from march 3rd is reasonable but would not surprise me if virus is a couple percent higher when this is all said and done. The spread, if it ends up being 50% of U.S. pop is terrifying.

[Kevin Seitzer]

You are correct, and that is fair.

Personally, I don't think anyone can accurately estimate the denominator based on those who are getting sick but unreported which I believe is what you are referring to. But does that number even matter in this case. If we follow the numbers based on positive tests, and look at the growth of those tests and compare it to the mortality rate of those individuals we can almost ignore the unreported cases at least for the concept of looking how this thing is going to grow. Basically we treat the unreported as unknown.

Going off the known numbers, we are in for some big jumps in mortality coming up. Yesterday 225 died, based on the model I'm calculating for the US I expect to see ~360 die today in the US. And in 5 days that number will be > 1000 daily.

The US is tracking on ~8% mortality based on known cases and an offset of 6 days (14 days average from illness onset to death - I'm assuming 1-2 days from feeling sick to get tested and ~6-7 to get a positive result back = 6 days offset)

Yes, I agree. I expect the mortality rate on known cases in the United States to end up somewhere between 4-10%, assuming we do not do a massive expansion of testing to the point where we are testing significant numbers of asymptomatic people (e.g., the strict contact tracing that some other countries are doing).

[Kevin Seitzer]

For weeks, sick people who wanted to be tested, just could not get it done. Even now, sick people who want to get tested, but cant. Many people have died in this country or worldwide past month who had coronavirus but will never show in stats. I read the material re: Italy with many cases that couldnt get tested but ultimately passed on. Down the line we could look at typical deaths in a year in say italy, spain, u.s. and project that the higher numbers we will see this year relative to past likely is will be due to coronavirus even if not diagnosed.
Again, not everyone who dies of coronavirus will be diagnosed.

But what we do have are the coronavirus updated statistics, hard numbers not relying on projections assumptions, just updated every few hours hard numbers https://www.worldometers.info/coronavirus/ and we can say each additional case is an additional data point to which we can read the virus. Just on ww closed cases, I think this is a substantial data point of 400k and though I do think that the 15% mortality rate of course does not include lots of people, both infected who are not reported who get well, and infected who die, both are under reported, it is still more info than the world has prior day. The 3.4% WHO from march 3rd is reasonable but would not surprise me if virus is a couple percent higher when this is all said and done.

I agree with everything you wrote up to here.

The spread, if it ends up being 50% of U.S. pop is terrifying.

This is where you make a leap that is not justified, if you're assuming that that mortality rate can just be projected onto the whole infected population. This is where the number of cases that are mild or asymptomatic matter a lot. If 5% or 8% of known cases die, but that represents only 10% of the actual infections, then the true mortality rate across the whole infected U.S. population would be more like 0.5% or 0.8%. That's still a huge number if 50% of the population is infected. But 0.5% * 50% * 330M = 825,000 deaths instead of 5% * 50% * 330M = 8.25 million deaths. The former is really bad and worth doing everything we can to avoid. The latter is catastrophic.

If we can reduce that 50% of the population being infected down to 5% or 10%, by strictly enforcing and following stay-at-home policies until we find a treatment or a vaccine or some other unexpected miracle happens, no matter what the mortality rate, that's a big deal. I think we agree on that part.

[Ken]

If 5% or 8% of known cases die, but that represents only 10% of the actual infections, then the true mortality rate across the whole infected U.S. population would be more like 0.5% or 0.8%.

I agree.

In the previous discussion I discounted the unknowns, but for this type analysis it's important. I wonder how we determine the accuracy of that 10%? I suspect the cases to infections rate is higher in a pandemic with everyone acutely aware and testing rates higher. What was the source on the 10%?

[Sour Masher]

I agree.

In the previous discussion I discounted the unknowns, but for this type analysis it's important. I wonder how we determine the accuracy of that 10%? I suspect the cases to infections rate is higher in a pandemic with everyone acutely aware and testing rates higher. What was the source on the 10%?

But how can testing rates be higher when there is not enough testing? I couldn't get tested if I wanted to right now. Those being tested right now are at risk patients most likely to die. Younger, healthier people are not tested unless their symptoms progress to critical, in most places in the US right now. So, I don't understand why you guys think the mortality rate being reported now is accurate. It seems to me that it is skewed high because of who is being tested and who is not being tested right now.

ETA: Of course, we do know it is far higher than the flu, and so infectious that even if it is as low as .5%, that could still lead to over 1 million deaths. But those of you suggesting it could be several millions, based on a mortality rate of 10% or so, that seems needlessly pessimistic right now.

[Kevin Seitzer]

I agree.

In the previous discussion I discounted the unknowns, but for this type analysis it's important. I wonder how we determine the accuracy of that 10%? I suspect the cases to infections rate is higher in a pandemic with everyone acutely aware and testing rates higher. What was the source on the 10%?

Pulled it out of my ass to align with what "feels right" to me. Seriously. I wish I had a source.

[Ken]

But how can testing rates be higher when there is not enough testing? I couldn't get tested if I wanted to right now. Those being tested right now are at risk patients most likely to die. Younger, healthier people are not tested unless their symptoms progress to critical, in most places in the US right now. So, I don't understand why you guys think the mortality rate being reported now is accurate. It seems to me that it is skewed high because of who is being tested and who is not being tested right now.

That's fair, I guess I'm just rebelling against the deaths over total cases metric which doesn't make any sense, perhaps I'm going too far the other direction.

[Ken]

Pulled it out of my ass to align with what "feels right" to me. Seriously. I wish I had a source.

WaPo used 10% in this article too https://www.washingtonpost.com/outlo...irmed-testing/

[Sour Masher]

That's fair, I guess I'm just rebelling against the deaths over total cases metric which doesn't make any sense, perhaps I'm going too far the other direction.

It is definitely a flawed method. I think they are just using it, because if they used your method, it would indicate inaccurately high death rates to laypeople, causing panic. Measuring deaths vs resolved cases produces produces numbers more skewed than the way they are doing it now imo.

[Sour Masher]

IDK, I think this is really bad and is going to get far worse. But I can't help but push back on the assumptions of really high mortality rates. The tests we have done so far are not a random sampling at all. They heavily skew toward the most likely to die. So that gives me hope that the actual mortality rate is lower than some fear. I'm thinking it ends up between 1-2%, depending on how quickly we can get ventilators and other essential life-saving equipment made, and how much we can flatten the curve.