Coronavirus

[AlanSubie4Life]

You assume every single person in the country would get the virus and there’d be a 5% death rate? You must watch cable news all day

Yikes, sounds like you may be one of those armchair epidemiologists we were warned about earlier in this thread, falling right at the local maximum of the Dunning-Kruger curve. Do try to keep up; there are a lot of pages to read here!

 

[Causalien]

Yahoo has an article titled “Shock claim: Deaths will top 80,000 in the next four months”. That’s shocking?
Why didn’t we shut down the economy in 2018 when 60,000+ died in the US from the flu? Why didn’t we spend $6 trillion when 43,000 people died from opioid overdose in 2019?

"Not just a flu bro"

 

[linux-works]

Hmmmm …. "USA USA USA" is trending on twitter.

in tech, there's a common phrase known as 'the race to the bottom'.

I think we just redefined that ;(

 

[Right_Said_Fred]

USA 81,864 +13,653
Active cases 78,827

Looks like it's official. More cases than China. Wonder how long this 13k cases a day trend goes on....

I'm sure someone's convinced that without the 46 cases from the Diamond Princess the number is really not that bad.

 

[Norbert]

Yeah that was the milestone mentioned in the briefing today. Not nearly enough at this stage of the epidemic - it may not be enough to keep up with case growth. Possible we're fighting a losing battle at this stage if we don't lock everyone down nationwide, unless they have a plan to double capacity by tomorrow or something. Hopefully NY rates will slow down after another week when the effects of the shutdown start to show up in force - that is sucking up a lot of capacity right now.

Well, "not enough to keep up" was my point, including my second post on that: testing capacity is already not enough to keep up.

Since all tests are done on fever+symptoms cases only, testing capacity is smaller or equal to case growth. The numbers from the last 3 days or so, may simply reflect the increasing test capacity. And we have no, or only very incomplete, info about the actual growth of would-be-positives.

 

[linux-works]

more tech to the rescue (lol)

 

[Dr. J]

I'm sure someone's convinced that without the 46 cases from the Diamond Princess the number is really not that bad.

Beautiful numbers!

 

[Open Interest]

We have a 5% to 11% ICU rate right now. Actual numbers. South Korea had a 10% hospitalization rate and they're pretty close to tracking every infected case.

You unleash millions of people on the hospitals at the same time, and almost all of the ICU cases, and a large percentage of the hospital cases turn into fatalities instead. So it's pretty easy to then foresee an overall fatality rate of up to 5% in such a scenario.

This is anecdotal, but at the San Diego hospital where my son is a physician, 50% of COVID-19 admissions are not in ICU. Not “almost all”.

 

[nwdiver]

Only in 'Merca; This country really is a pathetic embarrassment...... FIX THIS NOW!!!!!!

Woman who died of COVID-19 refused to go to hospital, worried about bills, her son says

 

[deonb]

This is anecdotal, but at the San Diego hospital where my son is a physician, 50% of COVID-19 admissions are not in ICU. Not “almost all”.

Didn't say they were. Re-read.

 

[AlanSubie4Life]

50% of COVID-19 admissions are not in ICU. Not “almost all”.

I think you may have missed the point.

In the past day or so, I've been thinking about this and I'm reasonably convinced that tracking cases to gauge the inflection point and determine when we have a handle on SARS-CoV-2 spread is not really providing us as much information as we hope. I'm not advocating we stop, just that the data is very misleading if you are trying to make policy decisions from it. The reason I think this is that we see everyone using different protocols to determine testing criteria. Some hospitals won't test unless you are sick enough to be admitted, a few are testing anyone that drives up and asks. This leaves a very incomplete picture.

Don't get me wrong, we still need to do the testing, but here is what made me think that:
United States Coronavirus: 68,802 Cases and 1,037 Deaths - Worldometer

Because deaths lag cases by 2-3 weeks, and we have a reasonable estimate of the Case Fatality Rate (2-3%) and the Infection Fatality Rate (0.5-1%), when you look at the above state by state, it is clear that the number of cases is grossly under-reported compared to the number of deaths.

Let's take NY and WA states as examples. We know NY has done a lot of surveillance, more than probably any other state. At the time of this writing, that is 366 deaths, 33,013 cases. Now, I am making an assumption here that NY and WA had SARS-CoV-2 introduced into the population by travelers at approximately the same time. WA state shows 132 deaths, but only 2,588 cases.

Because cases lag deaths by, lets say, 14 days, that would mean 14 days ago the states had approximately the following number of cases (assuming a CFR of 2.5%):
14,640 - NY
5,280 - WA

Now, if you look at the US as a hole, with 1036 deaths at the time of this post, that means 2 weeks ago (assuming a CFR of 2.5%), we had 41,440 cases. That's a crap ton more than are reported.


Anyway, morning ramblings before I finish my first cup of coffee. Feel free to tear it apart if I am wrong.

There's actually a paper that sort of touches on your hypothesis above. They even include some code if you want to play with it. They use this to estimate underreporting. Obviously if reporting behavior changes over time, the true number of CURRENT cases is still hard to determine, but it's just an estimate...a model...so it can be thrown off by a phenomenon not accounted for in the model.

Using a delay-adjusted case fatality ratio to estimate under-reporting

It looks like they use a lognormal distribution of delay to death, with a mean of 13 days.

They conclude that in the US, we have reported about 15% of our cases.

So if I'm reading the conclusion correctly, that would suggest we have about 550k active cases in the United States right now. Obviously there are some error bars on that. Anyway, just something to peruse - it is interesting.

Our testing situation has improved quite a bit over the last 13 days, so I definitely think this estimate is on the high side (I still guess the real number is closer to 250k as of today), because our current case number is much higher than it would have been, if we still had the pitifully undersampled testing regime in place that we had 13 days ago.

Anyway, it's basically the same method I've discussed before, and you also discussed above. Just with a more sophisticated model for the distribution of delay...

May be of interest to @TheTalkingMule and @Norbert as well, as they have discussed this.

 

[bkp_duke]

Only in 'Merca; This country really is a pathetic embarrassment...... FIX THIS NOW!!!!!!

Woman who died of COVID-19 refused to go to hospital, worried about bills, her son says

Details details details

You going to tell people that she was visiting her son from Bulgaria and wasn't a citizen?

Just saying, important tid-bit of information there.

 

[EVNow]

Disaster preparedness is something I would ask experts to plan for.

Pandemic teams in CDC and various public health departments of universities had created many simulations.

No one ever thought to include a case where the administration completely messes up preparing enough working test kits.

ps : Not a joke. Actual quote in an article on statnews.

 

[hcsharp]

The VA Told Employees to Keep Coming to Work – Now Several Have the Coronavirus - Voice of San Diego

Employees at the Department of Veterans Affairs in San Diego say they’re not being allowed to work remotely and have been required to use personal leave in order to quarantine themselves at home – even as several employees have tested positive for the novel coronavirus and many others await test results.

Voice of San Diego spoke with more than a dozen employees from multiple departments in the regional VA.
Employees in departments like mental health and social work, which are doing most of their work by phone and by video, have been asked to come in, despite employee requests to work remotely. Employees who wanted to quarantine or were told by their doctor to do so said they were forced into an unappealing dilemma: Either use annual leave or take time off unpaid, or come into the office to work.

“It just feels like no one is looking out for us,” one of the employees said. Voice of San Diego is withholding the names of individual employees because they fear retaliation from their employer.

sometimes, I really hate the human race. ;(

Not all VAs are the same, and most have changed their tune. My wife is a nurse at the VA in White River Jct, VT. She was sent home to quarantine for 14 days after taking care of a patient who tested positive the next day (considered moderate exposure). She did NOT have to use sick leave or annual leave. She received "administrative leave" for the home-quarantine period, meaning she got paid for it without having to use her normal sick time.

She has a lot of ICU and critical care experience, including patients on ventilators. I'm expecting that she will be working around the clock in a few weeks. They already have a shortage of protective equipment. We already have a stay at home order in our state. I'm hoping it was implemented early enough to avoid what's happening in NYC. In any case our household is gearing up for the worst. Our son is in Seattle and is sick now and his condition is improving. He never got tested but all symptoms match C-19.

 

[Daniel in SD]

Just some info from Gov. Cuomo's press conference this morning
Right now New York has 37,000 positive tests, 5000 hospitalized, 1290 in ICU.
The biggest issue is that people are spending 11 to 21 days on ventilators (way longer than the 3-4 days of most respiratory infections).

 

[linux-works]

My wife is a nurse at the VA in White River Jct, VT.

health care workers are the NEW HEROES. full-on total respect for what they are doing and putting up with.

hope you and she stay safe.

 

[alloverx]

Washington Post has their page of stats.
-Love the mathematics and medical details in this thread.

 

[AlanSubie4Life]

Germany's numbers show a .5% mortality rate. This will likely dwindle down toward .2% when all is said and done just like SARS.

so check back on their mortality rate in about 2 weeks (assuming they actually continue to flatten the curve in the next couple days). It'll be about 1%.

I don't think it's a coincidence the only two countries that tested properly are inducating a mortality rate on par with the .2%

Check back in a week. It'll be close to 1%. And rising.

Germany's numbers have "dwindled down", and are now up to 0.6%, even though they added 6000 cases to the denominator today, a 16% increase. No surprises there of course. Check back tomorrow! Up, up, up we go.

 

[BornToFly]

$2T is quite a bit of money. It's 10% of the GDP - if the economy is stalled by 50%, it can sustain us for 10 weeks.

Sustain us how? I'm not going to see a penny. I'm going to lose a tremendous amount of income this year, which will greatly affect my ability to make purchases.

 

[AlanSubie4Life]

Sustain us how?

I think the idea is to make sure people have food and shelter, and can maintain a minimum living standard, so that they don't have to roam the streets panhandling and scavenging for food and spreading the virus around.