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COVID-19: Data - NYC Health

9,101 + 4,582 = 13,683 deaths
13,683 / 8.4 million = 0.163% mortality in New York City, as of April 20, 2:30pm.

EDIT: A common assumption is that even with "probable deaths", there is still an undercounting of deaths.

In New York City, mortality, deaths per population, today crossed the 0.2% mark:

COVID-19: Data - NYC Health
(11,708 + 5,228) / 8.4 million.

It was 0.13% not so long ago.

Since not everyone is infected (yet), true IFR in NYC must be a multiple of 0.2%, refuting any theory that claimed unknown infections are so high that we could reach herd immunity we less than 0.2% fatality. With hard evidence, not speculation or estimates.

For those following the NYC numbers, these are the numbers from this Monday and last Monday.

The ratio is 1.24x, an increase of 24% in one week.

The first antibody test is dated 4/22, in NYC with 21.2%.
The new antibody test is dated 4/27, in NYC with 24.7%.

This is a ratio of 1.165x for 5 days, which as an exponential increase translates to a ratio of 1.24x in 7 days.

Thus the "naive" IFR (corresponding to the term "naive CFR") remains the same.
 
The "Mutter" is one of the little gem museums that can be found in Philadelphia. Their multi-year exhibit "Spit" is happening now (sort of - since they are closed).

Spit Spreads Death: The Influenza Pandemic of 1918-19 in Philadelphia

In August of 2019 the Mutter decided to focus on the role of disease/pandemic. They started with 1918-19 flu pandemic (3 waves BTW). Last night I spent some time on Zoom in a program presented by a Mutter exhibtor on the 1918-19 pandemic. They are moving to online to make it available often through libraries.

It was instructive in unexpected ways. The war (WW I) had proceeded to a point there was need for money and the Govt assigned each city a goal toward bond/loan sales. Philadelphia decided to hold a parade down Broad street to draw attention to the need for citizens to chip into the funding goal. The popularity of the parade took off and a couple hundred thousand people crowded into the streets to participate.

Whiskey was considered a possible help for the flu. All this in a time before antibiotics.

After the flu exploded, they closed the sale of alcohol. NJ did not. Camden, NJ was flooded with Philly residents for 2 days (further spreading the flu) before NJ ceased alcohol sales. The local press criticized public health efforts.

It is like a text book study in what to be avoided. PA (this time) very early closed the state liquor stores and Delaware (this time) stemmed PA residents from crossing state lines for liquor.

The Mutter museum is unique. It holds a record of the human organism from a medical perspective - hard to explain but unusual(disturbing) and at the same time so valuable to understanding ourselves.

Philadelphia was an early center of medical research and education. This exhibit is a record of societal behavior in one of the more medically enlightened cities of the world in the grip of a pandemic.
 
How about deaths per 1M population.

View attachment 536701

BTW According to IHME Sweden is on pace for 14,608 deaths which is equivalent to 481k US deaths.
To be fair:
- the most efficient and inclusive public health system will have a more accurate morbidity and mortality count;
-Some countries/jurisdictions record "death with", while others only record 'death due to", and still others count "excess deaths". Those various techniques produce vast differences in these data without anybody falsifying anything. The different methods produce gigantic distortions in data. Even more consequential is that various jurisdictions count "only testing in government facilities", "deaths occurring in public hospitals" and other such limiting criteria. Throughout the world deaths which occur in homes or among homeless people are often not counted at all, nor do that have formal diagnosis.

I am a fan of Worldometer for global data because they always link their sources, so one can adjust for all those discrepancies. Without source information it is not possible to have faith in conclusions.

For the partisan advocates among us I strongly suggest refraining from suggestion of nefarious deceptive tactics behind these data. Politicians use statistics to justify their lies, and we know a few who don't both even to use any factual basis at all.

I think a few examples might illustrate this:

Iran- One of the most popular places for conspiracy theories, within and without. I admit to bias from having lived and worked there before and during The Revolution. The first case recorded was in Qom, on 19th Feb, a merchant who traveled frequently between Qom and Wuhan. That frist case happened in the single most visited city in the Shia'a world, about a month prior to Nowruz (Persian new year) by far the most heavily travelled event of the year. No surprise, lots of politicians, senior and not, became among the first infected as they are among the most publicly devout. 23 MP's and another 12 senior politicians promptly were infected. quick spread resulted in prison outbreaks, jailbreaks and more infections. Realistically, their health system is still quite good, and reporting is mostly not too bad, but, prisoners, poor people and even major cities like Masshad and Qom are so stuffed with tourists that accurate counts are improbable. OK, watch their daily reports and say they're cheating somehow. IMHO, not likely, they're just overwhelmed. That's not to say they wouldn't mislead us, only that we needn't resort to conspiracy to understand what's happening. Iran is not secretive.

US-
-NYC reports on 'excess deaths' by including such an estimate in both mortality and morbidity even if no test happened. the rest of NYS reports only tested and diagnosed with death certificate confirmation (usually, county and even city practices vary).
-WV has no idea. Several regional hospitals have closed recently leaving no way to access testing or medical care for many people. Nobody knows how many people have died at home without attention.
Just as in NYC, except these are remote.
-Some States count only tests done in/by public facilities and exclude those done in private hospitals. Others count every one they can find out about. Some count only residents, others include non-residents. Example: ~40% of Detroit, MI nurses are commuters from Canadian suburbs. Many of those have become infected and have been treated in Canada. Are they counted in Ontario or Michigan or both? In that there is a confused situation.
Brasil- the testing rate is very low, public health facilities are overrun, ICU's are few and vastly overloaded. Morgues cannot process the new cases in any major Brazilian city. Nobody can reliably estimate infection rates or even detach rates. That description is similar in many countries, and parts of most major countries.


Without going into very long discussions I hope this makes it obvious that there are serious weaknesses in data everywhere. No need to demonize anybody at all. That is the lesson of epidemiology, the bane of all serious users of such data.

So, we all will use the charts we can get. Just don't even imagine anybody knows the peaks or downward slope unless comprehensive testing is happening. Remember that a large part, maybe even ~50% or more, are asymptomatic. Am I one of those? After all, three of my relatives have succumbed and friends have died. I did have a headache and mild throat discomfort a while ago. Of course I cannot get tested and I'm not about to knowingly risk infection by going to a place where known cases are being treated all around me. How many others are like that?

Moral: we have zero honest insight on morbidity without comprehensive antibody testing, using testing that is highly sensitive and highly specific. Most such testing seems to have weakness in one or the other or both. So, for me, social distancing and healthy practice is all I can do. I cannot even see an MD for a checkup; they are all devoted to COVID-19.

Should we count as mortality people who die with heat attack who could not have emergency treatment because of the COVOD-19 crisis? NYC would, and so would I.
 
the 'doc' has a new look:

duck_season.gif


(animated gif, so if you have that disabled, you won't see the full effect)
 
Here is a summary of NewYork-Presbyterian Hospital's update from yesterday:

"Covid 5,521 patient discharges

Snapshot: 1,879 patients Friday, 674 on vents. Today: 1,753 and 614 on vents.

Testing:

Patients- we are currently testing all patients that are being admitted whether or not they have symptoms, and prior to any procedures.

Healthcare workers- anyone that has symptoms can be tested with PCR test. We are looking at expanding testing for Healthcare workers who have been in direct contact with patients.

Antibody test: currently available to healthcare workers who have had symptoms and recovered more than 14 days ago.

We are in good supply with PPE. Keep conserving and follow guidelines for don and doff.

Masks should be NIOSH certified for N95 masks. Be aware of counterfeit masks!"
 
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Correct. There was never any money to be made in a coronavirus vaccine, until now of course. Scientists were close to a coronavirus vaccine years ago. Then the money dried up.

Contrary to popular opinion, vaccines are not big money makers for the companies that make them, and in many cases they actually only break-even because of government subsidies.

If profit were their SOLE motive, it's FAR FAR FAR better for them to make a treatment (i.e. Tamiflu) than a vaccine.
 
Here is a summary of NewYork-Presbyterian Hospital's update from yesterday:

"Covid 5,521 patient discharges

Snapshot: 1,879 patients Friday, 674 on vents. Today: 1,753 and 614 on vents.

Testing:

Patients- we are currently testing all patients that are being admitted whether or not they have symptoms, and prior to any procedures.

Healthcare workers- anyone that has symptoms can be tested with PCR test. We are looking at expanding testing for Healthcare workers who have been in direct contact with patients.

Antibody test: currently available to healthcare workers who have had symptoms and recovered more than 14 days ago.

We are in good supply with PPE. Keep conserving and follow guidelines for don and doff.

Masks should be NIOSH certified for N95 masks. Be aware of counterfeit masks!"

That looks like a plateau, not a down trending, based upon your previous posts of number of patients on a vent. Is that correct?
 
In New York City, mortality, deaths per population, today crossed the 0.2% mark:

COVID-19: Data - NYC Health
(11,708 + 5,228) / 8.4 million.
I think the main problem with this calc is that it does not correct for the fraction of people infected during the period under study who have not yet, but will die from their Covid infection.

I do the following:
1. Take the cum deaths as of 8 - 10 days after the serology study
2. Add 20% of current hospitalizations

(1)+(2) divided into the seropositive population. This works out to ~ 1.1% IFR for NYC
 
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I think the main problem with this calc is that it does not correct for the fraction of people infected during the period under study who have not yet, but will die from their Covid infection.

I do the following:
1. Take the cum deaths as of 8 - 10 days after the serology study
2. Add 20% of current hospitalizations

(1)+(2) divided into the seropositive population. This works out to ~ 1% IFR for NYC

Did you accidentally quote the wrong post?

He was referring to overall population mortality, not IFR - so it has no relation the the serology study.
 
Anyone see the idea of giving people nicotine patch to help prevent COVID-19? Sounds fishy. What are your thoughts?

It's anti-science BS. Just ignore them. Big Tobacco running scared since the WHO told everyone to stop smoking and South Africa banning it as a result of the coronavirus.

Most smokers are young people and young people are less at risk from it.

Most people with severe symptoms are old people, they are old and more fragile. Most of the tests are done on people with severe symptoms, old people who don't smoke.

Remember when Doctors used to advocate smoking because of Tobacco lobbying.
 
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Did you accidentally quote the wrong post?
No, I definitely got that part right ;)
He was referring to overall population mortality, not IFR - so it has no relation the the serology study.
His calc is a lower bound, as if the entire pop was already infected. The serology study is used to normalize the deaths to the entire population.
 
Remember when Doctors used to advocate smoking because of Tobacco lobbying.
Thankfully, no.

I've been a physician for 35 years and I cannot remember a single physician who advocated tobacco abuse. That includes those physicians who smoked. The latter were during my medical school days. Those smoking physicians went away pretty quickly, and I cannot think of a single physician in the last 25 years who abuses tobacco.

If the tobacco industry influenced physicians it was short lived.
 
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