By Nic Lewis
Introduction and summary
A study published two weeks ago by the COVID-19 Response Team from Imperial College (Ferguson20[1]) appears to be largely responsible for driving UK government policy actions. The study is not peer reviewed; indeed, it seems not to have been externally reviewed at all. Moreover, the computer code used to produce the estimates in the study – which on Ferguson’s own admission is old, unverified and documented inadequately, if at all – has still not been published. That, in my view, shows a worrying approach to a matter of vital public concern.
However, even in the absence of computer code, it should be possible to check some of the key estimates in Ferguson20 – in particular those based on a ‘Do nothing’ scenario – and hence establish if there are any obvious problems with the study. Since there is no evidence that anyone in government has performed such a verification exercise, I decided to do so. The results suggest either that Ferguson20 has misstated or omitted key assumptions, or that their model does not correctly derive the numbers of people infected, hospitalised and/or dying from the COVID-19 coronavirus.
I use the relevant input assumptions for Ferguson20 (without expressing any opinion on them), along with UK population data, to calculate fatality and hospitalisation figures. The resulting calculated fatality and hospitalisation figures can be expressed as percentages of total infections and compared with the equivalent Ferguson20 values. I also use estimates given in another paper (Verity20[2]) by the same team at Imperial, from which the Ferguson20 assumptions that I use were largely derived, in order to estimate the age-dependency that Ferguson20 assumes for the “attack rate” (the proportion of the population that contracts COVID-19) and then cross-check the Ferguson20 hospitalisation rates. Details of my calculations are set out in the Methods section appended to this article.
Infection and fatality rates and numbers
As Table A shows, the Ferguson20 estimate of 81% of the total population being infected in a ‘Do nothing’ scenario corresponds to nearly 54 million people in the UK contracting COVID-19 over the course of the epidemic. On that basis, Ferguson20 estimates that 510,000 people would die,[3] implying an infection fatality ratio (IFR) of 0.948%. That is consistent with the rounded figure Ferguson20 gives[4] of 0.9% (the authors ignore the potential negative effect on mortality of the health system being overwhelmed).
However, using Ferguson20’s stated assumptions, I calculate a 30% higher death toll of approximately 660,000 people (Column A7), implying an IFR of 1.23%.
In order to cross-check the Ferguson20 hospitalisation rates I need the relative attack rate by age-group used, however Ferguson20 does not state this. I therefore estimate the relative attack rate by age-group from the ratios of the Ferguson20 attack-rate adjusted IFRs to the unadjusted Verity20 IFRs on which they are based. I then use those estimated Ferguson20 relative attack rates (the accuracy of which is validated by comparing the figures in Column A8 with those in Column A7) in my hospitalisation rate analysis.
Table A: Infection Fatality estimates derived from Ferguson20 assumptions and UK population data compared with those stated in Ferguson20.
Notes
(1) For each age-group, the implied number of people infected is the product of 81% of the population in that age group (Column A2) and the estimated relative attack rate (Column A5).
(2) For each age-group, the number of fatalities in Column A7 is the product of the Ferguson20 attack-rate adjusted IFR (Column A4) and 81% of the population (Column A).
(3) For each age-group, the number of fatalities in Column A8 is the product of the Verity20 estimated IFR (Column A4) and the implied number of people infected (Column A6). These close match between these fatality numbers and those in Column A7 validates the estimated relative attack rates in Column A5.
Hospitalisation rates and numbers
As Table B shows, the Ferguson20 estimate of 81% of the total population being infected by COVID-19 on a ‘Do nothing’ scenario and two-thirds of them suffering symptoms corresponds to nearly 36 million people in the UK being infected symptomatically over the course of the epidemic (Column B2). On the basis of Ferguson20’s attack-rate-adjusted estimates of symptomatic cases requiring hospitalisation (Column B3), almost 2.8 million people would require hospitalisation (Column B8).
Using Ferguson20’s stated assumptions, I thus calculate that 5.17% of infected people would be hospitalised, a 17.5% higher rate than Ferguson20’s 4.4%.
Moreover, Ferguson20 states that its hospitalisation rate assumptions are based on figures for estimated proportions of infections that would be hospitalised from Verity20. Applying those Verity20 estimates (after adjusting from a per-infection basis to a per-symptomatic-infection basis, and for non-uniform attack-rate) (Column B7), suggests that almost 4.5 million infected people would be hospitalised (Column B9), 89% more implied by Ferguson20’s figures, and 61% more than the almost 2.8 million people I calculate on the basis of the Ferguson20 stated assumptions.[5] This suggests that Ferguson20 substantially downscaled the Verity20 hospitalisation rates. There is a hint that this may have been done to adjust for the use of input data ultimately derived from a Chinese context into a GB/US one: the paper speaks of scaling the data so that the hospitalisation rates for the 80+ age group matched those expected in a GB/US context.[6] However, since the Verity20 hospitalisation rates were already adjusted to a UK context,[7] it is not clear why the Ferguson20 authors considered it necessary to take this step.
Table B: Hospitalisation estimates derived from Ferguson20 assumptions and Verity20 data compared with those stated in Ferguson20.
Conclusions
There may be a perfectly good explanation for the substantial apparent discrepancies in the Ferguson20 estimates of hospitalisation and fatality rates from COVID-19 that I have uncovered. Other than actual miscalculations in Ferguson20, they may have misstated or omitted important assumptions, or I may have misunderstood their assumptions or how they apply, or made an error in my calculations. However, until and unless the Imperial College COVID-19 Response Team show that some combination of these possibilities accounts for the apparent discrepancies, all the results of their study must be treated with care, as they could potentially be significantly in error, even if the assumptions are valid.
Methods Appendix
In the following, I refer to column numbers given in the top rows of Tables A and B.
Ferguson20 gives the estimates of the severity of cases by age-group that they use.[8] The authors say that the percentage of symptomatic cases requiring hospitalisation and the IFR estimates are taken fromVerity20, which were primarily based on Chinese data. However, Ferguson20 states that those estimates were adjusted to account for non-uniformity of attack rate (the proportion of each age-group that becomes infected), with the hospitalisation percentages additionally subjected to an overall scaling to match expected rates for the 80+ age-group in a UK/US context.
Fatalities
Ferguson20 estimates that 81% of the total UK population would become infected in the absence of any policy measures. I therefore apply the Ferguson20 attack-rate adjusted IFRs (Column A3) to 81% of the population figures (Column A2) in order to calculate the number of fatalities they imply (Column A7). Unhelpfully, Ferguson20 does not state the assumed attack rates, which I need later in my analysis. However, for the 50-59 age group, the Ferguson20 IFR is identical to the Verity20 IFR[9] (Columns A3 and A4). I can therefore estimate Ferguson20’s assumed attack rates for other age-groups relative to the 50-59 age-group (Columns A5 and B6). Since the rounded IFR figures available for under-50 age-groups preclude accurate estimation of separate relative attack-rates for each, I have used the same value for all of them, calculated so that the attack-rate for the total population is exactly one.[10] Using that value and the estimated relative attack rates, I can then deduce, based on the latest age-structure of the UK population[11] (Column A2), how many people Ferguson20 estimates will become infected in each age-group (Column A6). I can then use those numbers, together with the Verity20 IFRs (Column A4) to estimate how many fatalities are to be expected for each age-group and overall (Column A8) and hence check (by comparing the Column A8 figures with those in Column A7) that my estimates of the relative attack-rates used in Ferguson20 are sufficiently accurate.
Hospitalisations
The pre-attack rate adjustment number of symptomatic infected people in each age-group (Column B2) is derived by scaling its population (Column A2) by the Ferguson20 assumptions that 81% of the population is infected and 2/3 of infections will be symptomatic. I then estimate, by multiplying those numbers of symptomatic infected people by the Ferguson20 attack-rate adjusted fractions of symptomatic cases hospitalised (Column B3), how many people in each age-group will be hospitalised using the Ferguson20 assumptions (Column B8). I can also use the Verity20 Table 3 Percentage of infections hospitalised estimates (Column B4), by first dividing them by estimates of the fraction of infections showing symptoms per the Verity20 results[12] (Column B5) to convert them to percentages of symptomatic infections hospitalised and then multiplying them by the previously estimated relative attack rates (Column B6). Multiplying the resulting attack-rate adjusted hospitalisation rates numbers of symptomatic infected people (Column B7) then gives the implied numbers of people hospitalised using the Verity20 hospitalisation assumptions (Column B9). That estimate will however not reflect the overall age-independent scaling of hospitalisation rates imposed in Ferguson20.
Nicholas Lewis 1 April 2020
Originally posted here
[1] Neil M Ferguson et al., Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand, Imperial College COVID-19 Response Team Report 9, 16 March 2020, https://spiral.imperial.ac.uk:8443/handle/10044/1/77482
[2] Verity R, Okell LC, Dorigatti I, et al. Estimates of the severity of COVID-19 disease. medRxiv 13 March 2020; https://www.medrxiv.org/content/10.1101/2020.03.09.20033357v1.
[3] Their page 7.
[4] Their page 5.
[5] Further investigation suggests that Ferguson20 in fact applied the Verity20 ‘Percentage of infections hospitalised’ estimates to the Ferguson20 attack-rate adjusted number of people infected, and then scaled the resulting estimates by approximately 0.82 overall, uniformly for ages 40+ but with varying scaling for the (much lower hospitalisation rate) younger age-groups. Since the Verity20 hospitalisation rates per infection were derived by converting rates per symptomatic case using Verity20’s estimates of the fraction of infections showing symptoms, which are age-varying and all lower than the 2/3 estimate used in Ferguson20, it seems to me inappropriate to use the Verity20 hospitalisation rates per infection in this way.
[6] Ferguson20 Table 1 caption.
[7] Verity20 Table 3 caption.
[8] Their Table 1.
[9] Verity20 Table 1.
[10] The calculated common relative attack-rate of 0.936 is consistent, within rounding uncertainty, with the Verity20 IFR to Ferguson20 IFR ratios for all separate under-50 age groups.
[11] Table MYE2 of https://www.ons.gov.uk/file?uri=/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/populationestimatesforukenglandandwalesscotlandandnorthernireland/mid20182019laboundaries/ukmidyearestimates20182019ladcodes.xls
[12] For Verity20, the proportion of infections that were symptomatic is estimated by dividing by the ratio of the IFR in the final column of Table 1 of Verity20 to the fully adjusted case fatality rate (CFR) in the penultimate column of that table.
Is there any way to get this in front of Boris – cough, cough, cough – Johnson right away?
You are happy that Boris has the Red Chinese bat virus. Pathetic.
Just hoping the UK can go back to work now.
TDS; BDS, obviously a progressively crippling pandemic.
The Chinese are very much afraid of the second wave, and for good reason.
Please elaborate on the Chinese fear. Is it based on health concerns or fear the truth may emerge?
Chinese county goes into coronavirus lockdown as country tries to get back to work amid fear of second wave
https://www.scmp.com/news/china/society/article/3078010/chinese-county-goes-coronavirus-lockdown-country-tries-get-back
It is based on the fact that you can’t really eradicate the virus and the severer the mitigation of spread measures the more you are just ensuring that the virus returns when you let up. Ideally there would be some balance that allows immunity to build up in the population without overwhelming health resources. My interpretation of the Chinese actions is that they tried to suppress information and ignore the disease, hoping it wouldn’t be a big problem. When it turned into a big problem, they took very extreme mitigation measures. Those measures did slow the spread way down, but are unlikely to have completely suppressed the virus. But they also realized they couldn’t take an extended economic hit, so now they are trying to get pack to normal while being hypervigilant for signs of re-emergence.
While it will be interesting to see why the difference, it looks like it only amounts to around 20% overall, if I am interpreting this right.
However, it would be nice if the author gave a conclusion statement which states clearly what he arrives at vs what Lewis had, as it isn’t totally clear to me from the tables and the text.
If the difference is only 20%, I don’t think that would significantly affect policy.
I’d be most interested in a similar analysis of the IMHE model.
From a Carnegie Mellon Math Prof calling the model interpretations misleading. Alarming https://medium.com/@wpegden/a-call-to-honesty-in-pandemic-modeling-5c156686a64b
C Michael Scott: From a Carnegie Mellon Math Prof calling the model interpretations misleading. Alarming https://medium.com/@wpegden/a-call-to-honesty-in-pandemic-modeling-5c156686a64b
Thanks for the link.
I interpret it as support for Trump’s desire to get all Americans back to work as soon as possible.
It can be considered “Just more modeling”. The virus will be with us for a long time.
The author is making an assumption that the strategy is to mitigate for a bit, and then just give up.
But mitigation, if it drives the number infected way down, can give an opportunity to then use focused mitigation wherever it pops up, without the whole society impacted by the full force of these efforts. That can continue for a year or more.
And, the whole strategy is predicated on the future development of a vaccine, or of a treatment effective enough that the case fatality rate will go way down.
Carnegie Mellon Math prof finds major problem with the assumptions promulgated by the models being presented. https://medium.com/@wpegden/a-call-to-honesty-in-pandemic-modeling-5c156686a64b
We have some guys here, who are confident that their modeling produces results that are useful. They need to step forward and help the jokers, who have been making serial bogus projections from the beginning.
Thanks. I noticed that study had not been reviewed and was hoping someone appropriate would take a close look.
Nic writes
“A study published two weeks ago by the COVID-19 Response Team from Imperial College (Ferguson20[1]) appears to be largely responsible for driving UK government policy actions. The study is not peer reviewed; indeed, it seems not to have been externally reviewed at all. ”
Some of his very polite peers have appeared on various media over the last week or two and the politest put down of Fergusons figures go along the lines of ;
‘this was an educated guess based on very limited information which urgently needs revisiting with the more complete data becoming available.’
Every death is regrettable but to provide context there are some 600,000 every year in the UK with most being in winter, some 140,000 annually being ‘avoidable’ and in the 2017 and 2014 flu seasons some 27000 and 48000 people respectively died.
Ironically, because people have been sheltering for some weeks and its been a mild winter, overall deaths in 2020 are likely to be down as many fewer will likely not die of flu, car accidents etc and presumably some of the ‘avoidable’ deaths will also not come to pass.
Previous years at this level of mortality have passed unnoticed and without shutting down the economy and reducing our freedoms, .so questions will need to be asked.
None of which is to deny the need to take proper precautions against this especially infectious illness that affects peoples health in very different ways
tonyb
Models are wrong if they use the wrong rates…. which are wrongly calculated by failing to consider the effect of increasing #tests on the apparent rate of increasing #cases (the apparent epidemic curve, which is a deliberate fake).
From a recent post by edimbukvarevic on the previous .. CoV discussion thread II:
“Dr. Richard Capek and other researchers have already shown that the number of test-positive individuals in relation to the number of tests performed remains constant in all countries studied so far, which speaks against an exponential spread („epidemic“) of the virus and merely indicates an exponential increase in the number of tests.”
So, if the graph of #cases/#tests is fairly flat (as shown), then the apparent increasing scary curve is just an artifact of the increasing #tests… and there is little actual spread. The models will be vastly wrong if they use spreading rates that are incorrectly calculated by failing to correct for the changing #tests. This bias effect of increasing #tests on the apparent increasing #cases shown (the epidemic curve that allegedly needs flattening, when it is actually already flat since the beginning) is very obvious. even to a freshman student of Statistics 101. and the failure to timely show this is ______.
sciencereview18: So, if the graph of #cases/#tests is fairly flat (as shown), then the apparent increasing scary curve is just an artifact of the increasing #tests… and there is little actual spread.
Alternatively, the virus has already spread much more than we know, and it spread at a higher rate two months ago than we were able to estimate.
And
The true case fatality rate is lower than previously estimated (a topic of discussion here and in the journals.)
matthewrmarler: Yes, good points. Now if we just knew the accuracy of the test, its expected rate of false-positives, we could compare that to the apparent rate, and make correction. What if the false-positives rate is 5% to 15% or about the same as the #cases/#tests? But, looks like there is no evaluation for the test accuracy. That omission is ________ .
sciencereview18: But, looks like there is no evaluation for the test accuracy.
That information is submitted by the test developers to the FDA when they apply for certification. It might be useful for the rest of us to know. That turned out to be a problem with an early CDC batch — it was not sufficiently accurate.
“Dr. Richard Capek and other researchers have already shown that the number of test-positive individuals in relation to the number of tests performed remains constant in all countries studied so far, which speaks against an exponential spread („epidemic“) of the virus and merely indicates an exponential increase in the number of tests.”
That is utter BS, the ratio of test-positive individuals in relation to the number of test performed is not even close to constant in all countries studied so far. Complete BS, look at the data not what Dr. Capek and other researchers are spewing. Look at US data from 3/26, 17%, to 4/1, 26%, to 4/4, 16%.
So much BS, that’s for spreading it!
Bob posted: “That is utter BS, the ratio of test-positive individuals in relation to the number of test performed is not even close to constant in all countries studied so far. Complete BS, look at the data not what Dr. Capek and other researchers are spewing. Look at US data from 3/26, 17%, to 4/1, 26%, to 4/4, 16%. ”
——
Hi Bob, thank you for your response, and for taking the time to check the numbers. Could you please check and post some more numbers? That will help. The percentage for positive cases is only approximately constant, within range of about 5% to 15% (another source said range was 10% to 20%), but anyway not an increasing trend that would indicate an increasing epidemic. So this is a very important analysis. I really appreciate your checking this. I hope more people will to this also. Thank you!
Also, I had posted a note earlier that it is a bit difficult to see (on the agencies’ websites) the matched data for number tests per day and the corresponding #positive cases reported for that given day’s tests, because the reported dates are offset by one – two weeks or more. So, if you are able to find the correctly matched dates, that will help the quality of the analysis results.
science review
As der Spiegel reports, tests are by no means accurate and testing is nowhere near as widespread as outsiders looking into Germany believe.
https://www.spiegel.de/international/germany/corona-challenge-germany-reaching-the-upper-limit-of-testing-capacity-a-4d75e7bd-dd0e-41e3-9f09-eb4364c43f2e
Add in the complication that they only certify a death as being because of CV when it was actually the cause of the death.
In most other countries, the UK included, WHO guidelines say CV mist be listed as a certifiable cause of death if present, even though the patient may have died WITH CV rather than OF CV.
So there are huge differences in the way that Countries do tests, assess results and count deaths. In Italy as you know the Health Authorities noted that ‘only’ some 12% of the deaths listed as those who died WITH the disease actually died OF it.
If you are interested I can send you a 2 year old science study on Italian flu deaths over most recent years. The numbers who died and the reasons for death are startlingly similar to the current Epidemic suggesting the 12% figure is correct and it is likely that common flu would have claimed a proportion of those anyway in 2020
tonyb
Frosty air will hit the west coast of North America. Far to spring in Washington state.
https://www.cpc.ncep.noaa.gov/products/stratosphere/strat_int/gif_files/gfs_hgt_trop_NA_f012.png
Even after a negative test and discharge from the hospital, patients die from lung damage.
It is too early to take any numbers for Covid-19 seriously. Numbers for two test-tube situations – the Diamond Princess and the Grand Princess – were just wildly different. I stopped bothering when of two Grand Princess passengers who tested positive three had died. It fits with today’s date, but these are real reports from mainstream media.
To Nic Lewis: Nic, could you please run your model again, using rates that are calculated to appropriately account for the bias in increasing #cases due to increasing #tests? That would help so much. Thank you.
Despite Beijing’s attempts to cover up the true scale of the outbreak in China, British scientists are now warning Downing Street that the CCP has probably downplayed the number of cases by a factor of 15 to 40. from https://www.telegraph.co.uk/politics/20 … ile-state/
Apologies if you can’t read the link, it’s normally paywalled but I can read it without paying, perhaps you can too.
It seems to me inconceivable that China has less deaths than the USA, Italy and Spain.
Fine with me if UK lies and trashes China. That way China doesn’t have to air freight 100’s of tons of PPE and the medical equipment. They can be like Trump and say they’re not that kind of people. “If they’re not nice to CHIna, we can put them down at the bottom of the list. EU come first!”
It’s conceivable because they made the right moves; the west made the wrong moves.
“China doesn’t have to air freight 100’s of tons of XDEFECTIVEX PPE and the medical equipment”
I don’t have a skull and crossbones on my keyboard.
https://www.bbc.com/news/world-europe-52092395
If the death rates were accurate, that is probably what matters. ‘Cases’ need defining: are they solely those ill enough to need hospital treatment, or anyone testing positive for CV (which absolutely does not matter too much if the massive increase in ‘cases’ are of not sick people).
If you are saying that 45 – 120,000 people died, that is a very serious accusation and one which has global implications.
Rtj1211
I have no idea whether the link I gave means just the case count is considered to be an underestimate. However this link seems to suggest
deaths are being underestimated ;
http://www.rfa.org/english/news/china/wuhan-deaths-03272020182846.html
Where does the 81% infection rate and 66% symptomatic rate come from???
The Diamond Princess was a worst case scenario – it was spreading unknown for weeks on a cruise ship whose demographics heavily skewed towards people in their 70’s and 80’s. Yet the infection rate on the Diamond Princess was only 19%. Also, even of those in their 70’s half were asymptomatic.
Why the obsession with the UK and Imperial College modelling?
Are you aware that this looks strange?
Two posts out of 3, and none on the modelling of any other country?
What about the covid19 modelling of Indonesia?
Or Turkey? Or the USA? Or Germany?
Imperial College has advised the government on its response to previous epidemics, including SARS, avian flu and swine flu. With ties to the World Health Organization and a team of 50 scientists, led by a prominent epidemiologist, Neil Ferguson, Imperial is treated as a sort of gold standard, its mathematical models feeding directly into government policies.
https://www.nytimes.com/2020/03/17/world/europe/coronavirus-imperial-college-johnson.html
Yes, the problem has been that Neil Ferguson has form in being alarmist in his predictions, with for example a suggestion a decade or so ago that 400,000 people in the UK would die of BSE. 175 did. The UK has a huge and diverse range of experts in this field who deserve as much attention as does Imperial.
As you know Prof Ferguson sharply reduced his forecasts once he got a bit more information he could do proper modelling on, but by then the damage was done with freedoms and the economy sacrificed when ironically we are on course for a relatively light winter deaths year as flu numbers are likely to be well down as will accidents due to the lockdown.
Locking people down has a profound effect, not the least on family members infecting each other whilst slowly going mad, losing their physical health and being worried about money and personal relationships..
People ‘get’ social distancing and with more testing and isolation for those who needed to be protected or quarantined, others could have gone about their lives.without the other unintended consequences which should have been obvious from the start if the govts had not been spooked.
tonyb
Hi Tony
Also the epidemiological Team during FMD 2001 was Roy Anderson, Neil Ferguson and Christyl Donnelly (biostatistician).
FMD2001 UK
There was a real outbreak; however the GIGO epidemiological modeling made the slaughter much worse. I’ve posted the Veterinarians ‘post audit ; Kitching et al at link below;
https://wattsupwiththat.com/2020/03/25/covid-19-updated-data-implies-that-uk-modelling-hugely-overestimates-the-expected-death-rates-from-infection/#comment-2947452
It’s the same Neil Ferguson (often as lead author) for the modeling team that is referenced extensively in the Kitching et al paper
Brent
Thanks for that very interesting link. But if YOU knew that about the authors and I knew that about the authors why are they given so much credence?
Perhaps we just have more experience of poor modelling through years of experience of climate models?
tonyb
Hi Tony,
Everyone has a different story to tell I guess.
In my case I first took a look at how one might model Climate in 97/98 timeframe. I was deeply shocked at what my assessment was telling me. My opinion was there was only the most remote chance that the GCMs could even be validated.
The reason I was shocked was that I identified with modeling activity. I’m a Canuck, and old/former petroleum downstreamer , a supply and refining guy. I spent a good part of my time in downstream very heavily involved in building and running downstream optimization models. And in such an activity, one takes verification and validation of models very seriously.
Initially this was just my own private opinion, however I followed others work closely thereafter including Steve McIntyre’s from 2003.
Despite being an old energy guy, I’ve other interests and I followed FMD2001 in real time as it happened. I was deeply suspicious of the Anderson, Ferguson, Donnelly efforts and sad to say that my suspicions were warranted.
Then I went back and looked at BSE-vCJD, and subsequently Sars, Avian Flu, Swine Flu Waves I and Wave II.
All of these were major Public Policy issues driven by “unvalidated” models. As is the Climate Change agenda.
I’ve posted supporting info for all these other outbreaks at link following: just scroll down
https://wattsupwiththat.com/2020/03/25/covid-19-updated-data-implies-that-uk-modelling-hugely-overestimates-the-expected-death-rates-from-infection/#comment-2948965
This is what Jerome Ravetz calls Post-Normal Science. Remember Ravetz appearing at WUWT after Climategate???
Here’s an indication of why politicians have favourite modelers IMO
Following the outbreak of SARS, one thing was certain: Professor Roy Anderson of Imperial College would soon be hitting the headines.
https://web.archive.org/web/20130922025814/http://www.warmwell.com/2may1pe.html
Warm Regards
brent
My understanding is that Ferguson and the Imperial Team find an over-high figure in order to test the results of subsequent mitigation actions.
In this case, he quickley came back saying the figures now showed the lock-down was working and the NHS would not be overwhelmed.
anng
as you may have seen in a parallel thread the figures were not remotely believable in the first place. Its a little like IPCC bragging that because of their warning actions 200 million lives have been saved and 10 degrees of warming averted. We might point out that would never have happened anyway but they will just look knowingly and say ‘Qh it won’t now we’ve taken action.’
We see this confusion continuing with like for like comparison over CV sadly missing
As der Spiegel reports tests are by no means accurate and testing is nowhere near as widespread as near as widespread as outsiders looking into Germany believe.
https://www.spiegel.de/international/germany/corona-challenge-germany-reaching-the-upper-limit-of-testing-capacity-a-4d75e7bd-dd0e-41e3-9f09-eb4364c43f2e
Add in the complication that they only certify a death as being because of CV when it was actually the cause of the death.
In many other countries the UK included ( I believe Italy and Spain do so as well) WHO guidelines say CV mist be listed as a certifiable cause of death if present, even though the patient may have died WITH CV rather than OF CV.
So there are huge differences in the way that Countries do tests, assess results and count deaths. In Italy as you know the Health Authorities noted that during the current pandemic, of the 100% noted as having died with CV ‘only’ some 12% of the deaths listed actually died OF it. They had sometimes very severe underlying health issues.
As Neil Ferguson noted about the UK some two thirds of those who died with it (to date) would have died of their existing health problems anyway in 2020. They would be highly susceptible to flu which ironically has been light this year due to social distancing-practiced by those most at risk since January.
Total of Covid19 AND flu deaths are likely to be less than during a bad flu year such as 2014/15 begging the question that should we do more to prevent those deaths or equally if we can cope with that level of deaths so frequently why did we need to shut down the economy and suspend liberties for this particular virus?
If you are interested I can post a 2 year old science study on Italian flu deaths over most recent years. The numbers who died and the reasons for death are startlingly similar to the current Epidemic suggesting the 12% figure is correct and it is likely that common flu would have claimed a proportion of those anyway in 2020
tonyb
In Australia there are 4 860 confirmed cases with 20 deaths thus far. With 4 million tests in a population of 25 odd million. A mortality rate of some 0.4% with an infection doubling time of about 11 days.
In the US there are 211 143 confirmed cases, 4 413 deaths and a doubling time of 7 days. This translates as 1.6 million infections by the end of the month and some 38 500 deaths.
There is immense variability globally – and don’t hold me to any of it. Ultimately it seems a matter of slowing the rate of infection thus buying time for vaccines and therapies. Two vaccines were cleared for animal trials in Australia yesterday. I noted the day before a US based recombinant antigen therapy. There are dozens of approaches globally. None of it is wasted effort. We need to be prepared for future viral spillovers.
There is – btw – a clear emissions paralel. A multi-gas and aerosol strategy – CFC’s, nitrous oxide, methane, black carbon and sulfate. Ongoing decreases in carbon intensity and increases in efficiency and productivity. Buying time for cost competitive technical innovations across sectors – energy, transport, industry, residential and agriculture and forestry.
China Concealed Extent of Virus Outbreak, U.S. Intelligence Says
https://www.bloomberg.com/news/articles/2020-04-01/china-concealed-extent-of-virus-outbreak-u-s-intelligence-says?srnd=premium
Models are useless if the inputs are useless. Nate Silver’s website has a good article on why CoV models are of limited use right now. There are simply too many things we don’t know yet, and any model will include far too many “educated guesses.” Perhaps worst of all, the models are giving us authoritative sounding but incorrect information. We would be better off with no information at all except our first principle understanding of how a virus spreads in a society. Then watch the real world and respond to what is actually happening instead of black box outputs.
https://fivethirtyeight.com/features/why-its-so-freaking-hard-to-make-a-good-covid-19-model/
It seems more and more likely that intimate contact in a family setting makes transmission more likely. I fear that our social distancing is forcing people into these intimate family settings more not less.
doug,
This doc from Cornell University Med Center NYC is very experienced in handling cv cases. He says that is all his hospital does now and he believes he has seen more cases than anybody else in the country, or something like that. I believe he gives some well-informed advice here about how to avoid infection. It’s long and all interesting, but I suggest watching at least the first 20 minutes and the rest if you are still interested. I hope the link works, if not he is Dr. David Price and can be found on vimeo.
wash your hands, don’t touch your face, keep a small social circle
80% of cases in CHina are family transmission.
thats why the infected were taken out of the home
Mosher that’s interesting. Do you have a link? I would like to share that but won’t based only on a comment on a blog.
How deadly is the coronavirus? It’s still far from clear
There is room for different interpretations of the data
https://www.spectator.co.uk/article/The-evidence-on-Covid-19-is-not-as-clear-as-we-think
Dramatic daily increase in fatalities in the UK.
https://www.worldometers.info/coronavirus/country/uk/
Very low temperature in the west of North America.
https://files.tinypic.pl/i/01001/atini46aodwb.png
The virus in the UK is unstoppable. Many young people will also die.
Evidence? Do you live here, in Washington State or somewhere else??
Bad weather forecast for UK. Influence of the low from the Norwegian Sea.
The weather forecast for the SE of England for the weekend is sunny, 20C with minimum night-time lows of 12C. It may be wrong, but the forecast the next 10 days is for things to warm up significantly where the outbreak is currently at its worst.
Covid19 is a test of countries’ ability to act collectively.
I agree. I’m in a state that is on lock down. I’ve been out of the house in the last few weeks only to pick up groceries outside of the store, keep an unavoidable doctor’s appointment and go for walks outside by myself. The auto traffic is nearly nonexistent. When someone approaches me while we are walking, we both move to the other side of the road to keep our distance. When picking up groceries I see people with masks, something that has never happened before.
The lockdown affects us in many ways. When watching movies, any time I watch actors get close or shake hands or hug, I notice how what they did is now a taboo in this environment. We interact with the grandkids only on FaceTime. Normally at this time of year I would be out on the golf course with friends complaining about playing golf in the cold. Now, we are texting with each other complaining about boredom and bemoaning the fact we can’t be outside playing golf in the cold.
I’ve been watching a financial TV channel this morning. In the last few minutes I learned that stock of JC Penny, one of the all time great old, old Department stores is trading at 34 cents and foot traffic at retailers in the US is down year to year 97%.
I watched a video of students on Spring Break congregating on a beach in Ft Lauderdale, Florida. If I would have seen that same video last year, I would have instantly thought about what a great time I had on that same beach nearly 60 years ago. Instead, this morning I thought what are those idiots thinking. The video was followed by an interview with a CEO of a company that developed technology to track movement of cell phones and put the tracking on a map to show movement over time. They showed the video of those students’ cell phones who were on that Florida beach as they left to go back home in the MidWest and East Coast. A great demonstration of how COVID19 affects millions of people in a very short time.
There is hope of acting collectively. It’s just that some catch on more quickly than others.
ceresco kid
I think the lockdowns are too rigid. People ‘get it’ and most behave as you say. Keeping people locked up-apart from the freedoms aspect-is bad for your physical, mental and financial health and also wrecks personal relationships.
There are some huge anomalies on where we are supposed to go. a crowded supermarket selling food, hardware and plants in that order is ok, but going to the wide open spaces of a garden centre 100 yards away which sells the same stuff but in the opposite order of importance is not allowed.
Similarly whilst not a golfer myself I walk past our local one and see the hundreds of acres and think surely golfers are better off there than walking on crowded streets. Our beach is 500 yards away and has a takeaway. it could be perfectly well open but isn’t allowed to
All three pursuits raise morale put money into the local economy and maintain jobs. all the activities must be safe of course but there are lots of sensible activities within say 5 miles which could similarly be offered.
tonyb
Poor COVID outcomes ( such as death ) correlate with diabetes & age.
Diabetes leads to ectopic fat such as fatty liver disease.
https://static-01.hindawi.com/articles/ije/volume-2012/983814/figures/983814.fig.001.jpg
Age is correlated with thymic involution.
The thymus gland, where T-cells go to mature, is peak at puberty but atrophies and fills with fat with age. Without mature T-cells, immune response, particularly to new pathogens, is compromised. There is evidence that thymic involution is part of ectopic fat. Like fatty liver disease, thymic involution may be fatty thymus disease. Evidence for this includes the fact that thymic involution can be reversed with human growth hormone and insulin sensitizing metformin:
https://www.youtube.com/watch?v=-ow_Tems3I0
The best news is this: one doesn’t need external human growth hormone or metformin. Strength training and fasting increase human growth hormone and fat loss and muscle growth increase insulin sensitivity.
To improve one’s chances against not only SARS-COVID-19 but indeed most causes of morbidity and mortality, lose fat and gain muscle. Eat for nutrient density, avoid energy dense foods and do resistance exercise.
I agree. Trainong, fasting, carbohydrates reduction, autophagy… The physician within.
Obesity accelerates thymic aging
I comes across as blaming, I think, but it’s important to know.
Nic, have you looked at the new Lancet study. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30243-7/fulltext They seem to be assuming too low a total population infection rate and they seemed to assume, if I read it right, that all age groups had similar infection rates, which also is not consistent with the real world experience. But their case fatality rates seem closer to yours, I believe.
Yes, I’ve seen that, thanks, kevin
From twitter comment:
“This is the @IMHE_UW model for #Covid_19, the new US standard. It was put out SIX days ago (post lockdown). It projects New York State will have 50,000 hospitalizations TODAY. Instead NYS has 12,000. Wrong by 4x in under a week. What on earth are we doing?
http://covid19.healthdata.org/projections
Let’s see if this link works:
https://twitter.com/AlexBerenson/status/1245416486879051778?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1245416486879051778&ref_url=https%3A%2F%2Ftheconservativetreehouse.com%2F2020%2F04%2F02%2Fapril-2nd-2020-presidential-politics-trump-administration-day-1169%2Fcomment-page-2%2F%23comments
Meanwhile, the subsurface temperature in the equatorial Pacific begins to decline.
http://www.bom.gov.au/cgi-bin/oceanography/wrap_ocean_analysis.pl?id=IDYOC007&year=2020&month=04
The global temperature will drop. The solar polar fields have reached their maxima and a new solar cycle has begun.
https://solen.info/solar/polarfields/polar.html
The virus will not stop until the population reaches herd immunity.
Perhaps Nic Lewis takes these model results a bit too serious. There are a lot of known unknowns so justifiable projections will be all over the map.
Models at this moment mainly serve to conceive scenarios that might inform policy makers about which measures might have which consequences.
The known parameter estimates for the virus are so far consistent with a possibly very bad outcome, severe enough to justify erring on the cautious side.
And so far the course of events isn’t credibly inconsistent with a very bad outcome.
The measures have to be balanced with the damage to the economy caused by the shutdown. Things constantly break down and have to be repaired and replaced. At some point the breakdowns may become systemic and cascade through the societies.
The breakdown of our meanwhile very complicated and fragile financial system would be a major disaster.
I personally doubt that it will possible to meaningfully suppress this virus at this point without possibly creating more damage in other places.
Policy wise this would be the worst of all possibilities. No matter what you do the result will be bad.
But the next 4 weeks may bring some clarity to the data and the availability of helpful medication so that decision making may have a sounder base and the new data hopefully vindicates the optimists.
krmmtoday: The known parameter estimates for the virus are so far consistent with a possibly very bad outcome, severe enough to justify erring on the cautious side.
And so far the course of events isn’t credibly inconsistent with a very bad outcome.
The measures have to be balanced with the damage to the economy caused by the shutdown. Things constantly break down and have to be repaired and replaced. At some point the breakdowns may become systemic and cascade through the societies.
The breakdown of our meanwhile very complicated and fragile financial system would be a major disaster.
that’s close to my view. I think some people are having trouble accepting that it is hard to grasp all the potentially bad outcomes, of which information at this time is frustratingly scant, in the many parts of our complex society.
In the US, about 2/3rds to 3/4ths of workers have kept working. The sooner everyone else can get back to work the better, as their work is valuable.
It seems to be hard to accept that, even if the death toll in the US is closer to 50,000 than 1.2 million, and even if it is true that a lot of the deaths were not accurately ascribed to COVID-19, and even if almost all the deaths occur in the elderly with multiple comorbidities, the situation is bad. You can’t go into N. Italy and say “Yeh, too bad about all those old people dying of COVID-19, but think of all the people who didn’t die in auto accidents”. It matters for evaluating demand for intensive care and the work load on the Nurses and Drs, but the situation is bad.
A 29-year-old man is in a Washington, D.C., intensive care unit recovering from coronavirus and he has a warning to young people and anyone who thinks they don’t need to abide by social distancing guidelines: “This can happen to you.”
Francis Wilson of Woodbridge, Virginia, was washing his hands often and taking other precautions as the potentially deadly virus spread. He didn’t think he was at much risk. But he got so sick that he was put unconscious for 10 days.
“I had no idea that the symptoms could get that bad for somebody young and healthy,” he said via video call Tuesday from his hospital bed at George Washington University Hospital.
https://www.nbcnewyork.com/news/coronavirus/this-can-happen-to-you-29-year-old-coronavirus-patient-shares-warning/2354408/?_osource=taboola-recirc
Another hopeful HCQ anecdote: https://www.thegatewaypundit.com/2020/04/this-is-the-beginning-of-the-end-of-the-pandemic-dr-stephen-smith-announces-hydroxy-choloroquine-study-that-is-game-changer-in-battle-against-coronavirus-video/
The Dr is too optimistic on the comorbidity effects, but they are reportedly real — healthy young have a relatively low incidence of extreme illness, not a zero incidence.
He doesn’t say anywhere that I could find that those patients were confirmed for cv. Same with Dr. Zelekof , another doc who appeared on Fox, who has claimed to treat 700 patients with similar results. Zelekof won’t say that any have been tested and comments ‘it takes too much time’. 90+% of the people tested with flu like symptoms do not test positive for cv.
Do Monfort: He doesn’t say anywhere that I could find that those patients were confirmed for cv. Same with Dr. Zelekof ,
I hope someone will review their records. I already expressed skepticism about Dr Zelekof’s claim.
Right. Those patients would have to be tested for cv antibodies to confirm, if they had ever been cv infected. My guess is that wouldn’t be definitive either, as they could have been infected, after they were treated. Anyway, other testing is underway that should render the claims of those two moot.
I have to recheck to see if I am understanding the time frame of the worldmeters cv reporting (based on GMT), but it looks to me like the most recent complete day reporting on deaths indicates a sizable decline day- to-day for N.Y.: 505 deaths on April 1 to 319 on April 2. With total U.S deaths also dropping from 1,049 to 968. I think I will have some drinks first. Getting tired of thinking about this mess.
PS: Fox shouldn’t have had those people on, unless they have been working with tested and confirmed cv cases. That is the first question they should have been asked in the interviews. Rudy Giuliani apparently was promoting Zelekof. I love Rudy, but I think he has become a loose cannon.
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This is the April 2 New York City Report for Deaths from COVID19. It shows of 1,397 deaths there were only 18 conclusively determined not to have underlying conditions. In 1,046 deaths they found underlying conditions with 333 cases pending.
As in other reports from various locations, males made up the majority of deaths.
https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-daily-data-summary-deaths.pdf
Reblogged this on I Didn't Ask To Be a Blog.
Coronavirus Lessons From the Asteroid That Didn’t Hit Earth
https://www.wsj.com/articles/coronavirus-lessons-from-the-asteroid-that-didnt-hit-earth-11585780465
Benny Peiser & Andrew Montford: The Wall Street Journal 2 April 2020
Scary projections based on faulty data can put policy makers under pressure to adopt draconian measures.
London: The coronavirus pandemic has dramatically demonstrated the limits of scientific modeling to predict the future. The most consequential coronavirus model, produced by a team at Imperial College London,
https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf
tipped the British government, which had until then pursued a cautious strategy, into precipitate action, culminating in the lockdown under which we are all currently laboring.
With the Imperial team talking in terms of 250,000 to 510,000 deaths in the U.K. and social media aflame with demands for something to be done, Prime Minister Boris Johnson had no other option.
But last week, a team from Oxford University put forward an alternative model of how the pandemic might play out, suggesting a much less frightening future and a speedy end to the current nightmare.
How should the government know who is right? It is quite possible that both teams are wrong. Academic studies often suffer from a lack of quality control, as peer review is usually brief and cursory. In normal times this doesn’t matter much, but it’s different when studies find their way into the policy world. In the current emergency, it is vital to check that the epidemiological models have been correctly assembled and that there are no inadvertent mistakes.
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.
https://twitter.com/neil_ferguson/status/1241835454707699713
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.”
https://www.medrxiv.org/content/10.1101/2020.03.24.20042291v1.full.pdf
It isn’t only the U.K. that’s plagued by inscrutable models that describe very different futures. It’s a problem that governments around the world now face. Is there anything that can be done to make the predictions put in front of policy makers more reliable?
Peer review can’t bear reform, because there are simply too few people around with the expertise and time to do comprehensive reviews. It would be much simpler to require publicly funded academics to publish data and code as a matter of course; the possibility of competing teams checking their work might encourage development of the quality-control culture that seems lacking within the academy. It would also mean that in a crisis, when traditional academic peer review would move too slowly to be useful, a crowdsourced review process could take place.
In this way, the combined intellects of experts among the general public could be brought to bear on the problem, rapidly identifying errors and challenging assumptions. This sort of crowdsourced review would provide the manpower to take apart the abstruse models that are all too common in many academic fields. The authors of the Imperial model have argued that they don’t have time to explain to people how to get their 13-year-old computer code running. But getting computer code running is usually a problem that can be solved in a day or two when you throw enough brain power at it.
Calculations aren’t the only problem. Only a few weeks into the pandemic, we don’t have enough data to feed into the models. In particular, information about how many people are infected but remain asymptomatic is highly tentative. This means that there are a huge number of mathematical models that might explain what has happened so far, each extrapolating a very different future. New data can change predictions considerably.
Take an example from astronomy. On March 12, 1998, media around the world announced that a mile-wide asteroid was on a possible collision course with Earth in 2028. Only a day later, the global asteroid scare was over as additional observational data showed it would miss by 600,000 miles. While the initial calculations weren’t inaccurate, they were based on limited data and weren’t properly scrutinized, which made the announcement premature. A short delay while new information was collated was all it took to show that there was no risk at all.
After this scare, the international astronomical community agreed on a robust warning system based on the Torino Impact Hazard Scale, a tool for categorizing and communicating potential asteroid impact risks. Out of a scientific fiasco, a successful risk-communication tool was developed. It has since prevented many false alarms and taught the public to understand and live with the comparatively small risk of asteroid impacts. Covid-19 is no false alarm, but public health could benefit from a similar warning system, which would help governments and health officials communicate uncertainties and risks to the public.
When competing models are giving wildly different, and in some cases frightening, predictions, the pressure on governments to adopt a draconian approach can be overwhelming. But, as we are seeing, the costs of such measures are extraordinarily high. Nations cannot afford to lock down their economies every time a potentially devastating new virus emerges. Setting up an effective pandemic hazard scale would inform policy makers and the public, helping fend off media demands for “something to be done” until the right decisions can be made at the right time.
Messrs. Peiser and Montford are, respectively, director and deputy director of the Global Warming Policy Forum. https://www.thegwpf.com/
*
MG
It is questionable whether highly detailed modelling of covid19 spread and fatalities is appropriate when there are still such large uncertainties about the R0 infectivity, latency period, environmental survival of virion and the spectrum of illness and death from the virus. Better just test and measure quickly and intelligently, and respond likewise. The same could be said about climate modelling, considering the underlying uncertainties.
In the tuesday 3/31 briefing, Dr Birx talked about a University of Washington model that is getting updated daily to correct it to the facts on the ground, why aren’t we hearing a lot more about that model?
I’ve been looking at it for days.
https://covid19.healthdata.org/projections
Another amateur epidemiologist. They’re coming out of the woodwork. You only need to know algebra, right?
uh, if you don’t which branch of mathematics applies, may want to be careful. Since I do know epidemiology, I suspect Nic’s math skills are more than adequate to understand the modeling and research in this field. And if you were being sarcastic, I really don’t understand it given Nic’s obvious qualification.
But we don’t expect Appell to make sense. He lives way back in the woods, off grid.
Kevin – you missed the joke. My fault, I admit.
I’m sure I know more mathematics than you. Or Don M.
Here is a very recently produced Canadian model of the Province of Ontario. Will those of you qualified to critique models let me know if this is a good or bad model, and why?
https://www.medrxiv.org/content/10.1101/2020.03.24.20042705v1.full.pdf+html
This is a TOTAL RIOT – must read/listen. Sabine Hossenfelder and Tim Palmer singing about CoV
http://nautil.us/blog/its-the-end-of-the-world-and-this-physicist-feels-fine
Yes, I came across it from a link elsewhere. It is indeed very funny. I never knew Tim Palmer was into such things, nor indeed Sabine Hossenfelder.
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This is great news and testifies to the high effectiveness of real scientists.
As Dr. Mariola Fotin-Mleczek said on Thursday, SARS-CoV-2 coronavirus vaccine has been working since mid-January. The vaccine is intended to be innovative because it uses ribonucleic acid, which contains information about the structure of the protein on the surface of the virus.
https://tvnmeteo.tvn24.pl/informacje-pogoda/nauka,2191/koronawirus-sars-cov-2-nasza-szczepionka-wywoluje-odpowiednia-odpowiedz-u-zwierzat-to-nas-uskrzydla,318956,1,0.html?fbclid=IwAR149TPowu8w5T_l56h51t5p3xNMbsac5mpixEC7P64ZzwprNy2w3-aIxVo
This is great news and testifies to the high effectiveness of real scientists.
As Dr. Mariola Fotin-Mleczek said on Thursday, SARS-CoV-2 coronavirus vaccine has been working since mid-January. The vaccine is intended to be innovative because it uses ribonucleic acid, which contains information about the structure of the protein on the surface of the virus.
SARS-CoV-2 coronavirus. “Our vaccine elicits the right response in animals. It gives us wings.”
As Dr. Mariola Fotin-Mleczek said on Thursday, SARS-CoV-2 coronavirus vaccine has been working since mid-January. The vaccine is intended to be innovative because it uses ribonucleic acid, which contains information about the structure of the protein on the surface of the virus.
– We have been preparing it for animal testing since January, and at the same time, the production of this vaccine for human testing started two weeks ago.
It all began with an unexpected discovery. CureVacs founder, Dr. Ingmar Hoerr (a doctoral student at the time), discovered that when it was administered directly into tissue, the historically unstable biomolecule mRNA could be used as a therapeutic vaccine or agent after optimizationno complicated reformulations or molecular packaging needed.
We built CureVac from lifes building blocks
With a single discovery, CureVac opened the world up to the potential of mRNA to treat diseases and create vaccines. Officially founded in 2000, CureVac is the worlds first company to successfully harness mRNA for medical purposesbecause we saw opportunities where others saw obstacles. Today, were more than 400 passionate people strong, each one committed to using the clinical potential of our proprietary mRNA technology to provide tailored solutions for those with the greatest medical needs.
https://www.curevac.com/about-curevac#
Testing has been largely confined to those suspected of having the virus. Confirmed cases are thus real evidence of the spread of the virus and not an artifact of expanded testing. The number of new cases in the USA is on track to double over 7 days.
e.g. https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html
Models of real world system have many parameters for which there is inadequate quantification. Frequently – the best approach is to develop a robust conceptual model and do a Fermi estimate.
Climate models have another wrinkle in nonlinear equations at their core introducing sensitive dependence on initial conditions.
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John Oxford.- “Personally, I would say the best advice is to spend less time watching TV news which is sensational and not very good. Personally, I view this Covid outbreak as akin to a bad winter influenza epidemic. In this case we have had 8000 deaths this last year in the ‘at risk’ groups viz over 65% people with heart disease etc. I do not feel this current Covid will exceed this number. We are suffering from a media epidemic!” –
John Oxford. John Oxford is the UK’s top expert on influenza and Emeritus Professor of Virology at the University of London
Unless something changes in a dramatic manner, such as using mass prophylaxis with chloroquine, I don’t see how we can keep deaths anywhere near that low.
This is not an influenza virus. This is the SARS virus, viral pneumonia.
For those that are interested in clinical trials past, present, and future; clinicaltrials.gov is an informative site.
Is there spare hospital capacity in NYC?https://www.thegatewaypundit.com/2020/04/broken-models-cdc-doctors-screwed-bigly-usns-comfort-ny-harbor-sits-idle-3-patients-usns-mercy-la-15-patients/
Any word on the field hospitals set up in the Javits Convention Center or Central Park?
They apparently are streamlining the process to get patients on the ship. Hopefully there will be changes made quickly to eliminate the bureaucracy.
If the country doesn’t learn from the bottlenecks, glitches and inefficiencies during this crisis, shame on us. Numero Uno ought to be creating a secure health care manufacturing supply chain.
If covid19 is just a strain of flu, then why are hospitals in many countries running out of respirators and needing many more? Why didn’t they have enough from previous winters’ flu epidemics? Why is intensive care capacity needing to be increased? Why are temporary hospitals needing to be made? What are all the doctors and nurses complaining about? Why are ice rinks and refrigerated lorries being used as morgues? Can’t all the patients be sent home with a paracetamol?
Phil, you have asked this same question before.
The answer to your questions probably lie in discovery of how various hospitals coped with large flu epidemics and / or pneumonia vis the ventilator numbers.
One would assume that for exceptionally severe flu seasons past, then the ventilator shortage would have been similarly acute.
Hopefully you are also aware that ventilation carries it’s own risks and can cause death in already frail patients for a number of different reasons. Do you think these deaths would be reported as such Phil ? especially for cases with a supposed “co-morbidity of cv” as a notifiable disease ?
Maybe you can then write an essay on why the world doesn’t get to hear about those shortages and while you’re at it, why those high flu season mortality rates don’t make the headlines every day and why the world doesn’t get shutdown during those exceptional flu seasons too …
Good luck !
MG
mark
Yes, there are larger flu epidemics and yes the hospitals are overwhelmed and yes there are studies on this. A very good one which puts their current predicament into context concerns flu numbers in Italy 2013 to 2016 the numbers are huge
https://www.ijidonline.com/article/S1201-9712(19)30328-5/fulltext
“In the winter seasons from 2013/14 to 2016/17, an estimated average of 5,290,000 ILI cases occurred in Italy, corresponding to an incidence of 9%.
•
More than 68,000 deaths attributable to flu epidemics were estimated in the study period.
•
Italy showed a higher influenza attributable excess mortality compared to other European countries. especially in the elderly.
In recent years, Italy has been registering peaks in death rates, particularly among the elderly during the winter season. A mortality rate of 10.7 per 1,000 inhabitants was observed in the winter season 2014/2015 (more than 375,000 deaths in absolute terms), corresponding to an estimated 54,000 excess deaths (+9.1%) as compared to 2014 (
Signorelli and Odone, 2016 Signorelli C. Odone A.
Dramatic 2015 excess mortality in Italy: a 9.1% increase that needs to be explained.
Scand J Public Health. 2016; 44: 549-550
, representing the highest reported mortality rate since the Second World War in Italy ”
Does this all sound depressingly familiar? (but without the lock downs and economic catastrophe?) Modern science is able to keep increasingly frail very old people alive for much longer until a existing health problem-often numerous ones- or even a mild dose of flu can unfortunately tip them over the edge. A similar mild case of Covid 19 or of course a more severe dose of either virus will presumably precipitate their deaths faster and in greater numbers
tonyb
Ontario just released their assessment
http://s3.documentcloud.org/documents/6824779/COVID-19-Technical-Briefing-Friday-April-4-2020.pdf
https://www.cbc.ca/news/canada/toronto/ontario-covid-projections-1.5519575
Medical officials press conference here
I watched the entire presentations of the slides and the Premier’s response. I noted that the modelling exercise continued for 2 years, not the typical 3-6 months, to consider new waves. The atmosphere was serious but not hysterical, and reasonable doubts about the data and potential biases in it were mentioned. Better than I had expected.
Hi Andrew,
I just watched it too.
There were the usual deficiencies I thought. They estimated 100k deaths over the course of epidemic 18-24 months for do nothing case.. There was no discussion of “excess deaths”.
There was insufficient emphasis on wide spread antibody testing to get a much better idea of the infection rate, which IMO should be a high priority.
They focused almost entirely on social distancing measures
and claimed success for what we have already done. Seems they want to do more and certainly raised the prospect of having these type of measures in place for a very prolonged time.
I’m still quite dissatisfied
Ontario estimated do nothing deaths of 100K over course of pandemic scaled to UK Population of 67.8 million would equate to
468K deaths. They are basically following the Imperial College (Neil Ferguson) script
Ontario population about 14.5 million
How do we know how Ontario got its 100K deaths? I saw nothing in the explanation about how any of the numbers were estimated.
Hi Andrew,
Ferguson estimated 500K deaths for UK over course of pandemic
Ontario’s estimated 100K scaled to UK population equates to 468K.
For the purposes of this this sort of estimation that’s close enough to say they are singing from the same hymn sheet.
I see. That explains the do nothing scenario. What about the other numbers for the other scenarios?
It’s common knowledge that the US & UK are singing from Bill Gates’ boy Ferguson @ Imperial. Even the NYT wrote about that.
Question is, can anyone get their hands on the Ferguson “cv model” source code which according to the Prof himself consists of “13 year old code of undocumented C …”
https://judithcurry.com/2020/04/01/imperial-college-uk-covid-19-numbers-dont-seem-to-add-up/#comment-913030
https://twitter.com/neil_ferguson/status/1241835454707699713
MG
Hi Andrew,
Ferguson recently estimated 20K or fewer deaths in UK with Lockdown.
Compare that with Ontario’s estimated 3-15K deaths with “public health measures”
UK has enough intensive care units for coronavirus, expert predicts
He said that expected increases in National Health Service capacity and ongoing restrictions to people’s movements make him “reasonably confident” the health service can cope when the predicted peak of the epidemic arrives in two or three weeks. UK deaths from the disease are now unlikely to exceed 20,000, he said, and could be much lower.
https://www.newscientist.com/article/2238578-uk-has-enough-intensive-care-units-for-coronavirus-expert-predicts/
No, a COVID Scientist Didn’t Walk Back His Prediction
https://www.nationalreview.com/corner/coronavirus-pandemic-neil-ferguson-did-not-walk-back-covid-19-predictions/
‘The virus isn’t going anywhere,’ says Ontario doctor
CBC March 22, 2020
Dr. Richard Schabas, the former chief medical officer of Ontario, says lockdown measures are ‘unsustainable.’
https://ca.news.yahoo.com/virus-isnt-going-anywhere-says-121720522.html
Andrew Roman | April 3, 2020 at 7:58 pm |
I see. That explains the do nothing scenario. What about the other numbers for the other scenarios?
*
As far as I understand it, Neil Ferguson, the chap at Imperial College, London, sponsored by UNICEF, WHO, Bill & Meilinda Gates Foundation with the BMGF having a permanent seat on the board …
… the chap to whom UK Gov cv policy has been outsourced to, predicted a UK “do nothing” cv mortality of 500k.
He is also credited with predicting the UK Gov’s hesitant, false start & since abandoned “herd immunity” paradigm to cause 250k deaths.
Ferguson also predicts 20k under the house arrest scenario while others at Imperial are reported as suggesting 5,700 deaths if the lockdown continues.
https://www.dailymail.co.uk/news/article-8164121/Professor-predicted-500-000-Britons-die-coronavirus-accused-having-patchy-record.html
https://www.washingtonexaminer.com/news/confusion-imperial-college-scientist-says-500k-coronavirus-death-projection-in-uk-remains-unchanged
MG
The beginning of 2020 brought us information about the novel coronavirus emerging in China. Rapid reseacommonly rch resulted in the characterization of the pathogen, which appeared to be a member of the SARS-like cluster, seen in bats. Despite the global and local efforts, the virus escaped the healthcare measures and rapidly spread in China and later globally, officially causing a pandemic and global crisis in March 2020. At present, different scenarios are being written to contain the virus, but the development of novel anticoronavirals for all highly pathogenic coronaviruses remains the major challenge. Here, we describe the antiviral activity of previously developed by us HTCC compound (N-(2-hydroxypropyl)-3-trimethylammonium chitosan chloride), which may be used as potential inhibitor of currently circulating highly pathogenic coronaviruses – SARS-CoV-2 and MERS-CoV.
https://www.biorxiv.org/content/10.1101/2020.03.29.014183v1?fbclid=IwAR1hnK36z4ykbgKTUy1-uI5PvYDV1DhiP9CFdYcc6sgioUMxfUCogjCLi9w
Don Monfort | April 6, 2020 at 3:56 am |
Oh, do you think that Fabrizio is a Russian bot, gobble? Fabrizio? How is that spelled in cyrillic? You think that the doc is fake, too? What’s his motivation? Is he a Trumptard trying to get even with cardiologists, for whatever? Maybe it’s Kushner. A lot of them are doctors. Right, gobble. Yeah that’s it. That’ll work. Call CNN.
Sorry you feel bullied, gobble. Get some counseling.
*
Good grief Don, name calling too ?
Reminds me of infant school …
Your talents know no bounds …
Don Monfort | April 2, 2020 at 10:53 pm | Reply
You forgot to mention the black helicopters. No worries. Your tinfoil hats are in the mail.
Don Monfort | April 2, 2020 at 11:07 pm |
The conspiracy theory filter is not working. Please get it fixed. We are running out of tinfoil hats.
Don Monfort | April 3, 2020 at 12:39 pm |
Run along. This isn’t the time or place for conspiracy theories.
Carry on Don, you are hilarious …
MG
“The epidemic began with a poignant example of potential life-saving information suppressed as a rumour. On 30 December, Li Wenliang, a young ophthalmologist in Wuhan, China, posted a message to colleagues that tried to call attention to a severe acute respiratory syndrome (SARS)-like illness that was brewing in his hospital. The Chinese government abruptly deleted the post, accusing Li of rumour-mongering. On 7 February, he died of COVID-19.
This is a complicated landscape that is not just a matter of debunking a piece of misinformation. This is about relationships between publics and politicians, a lack of trust in the motives of governing powers and fears among leaders that the truth would spark public disorder and dissent. Advice to “Keep calm and carry on” can have exactly the opposite effect in the context of a fatal, and evolving, new virus.” https://www.nature.com/articles/d41586-020-00920-w
https://www.youtube.com/watch?v=2eB_xCk5ABw
The news was suppressed under China’s 2016 fake news law. But by January 23rd large portions of Hubei Province were in lockdown. The numbers speak for themselves despite trumpanzee conspiracy theories.
https://www.worldometers.info/coronavirus/#countries
https://morningconsult.com/wp-content/uploads/2020/04/200402_Trump-Coronavirus-Approval_fullwidth-scaled.png
Yeah, he should fire Fauci, who told us on January 21, that the new Red Chinese Wuhan Wet Market Virus was in the spectrum of SARS and MERS. Around 800 deaths worldwide for each. He also said it was not a major threat and not to worry about it.
Even with that less than sound and prescient advice, little more than a week later Trump ordered ban on Red China Wuhan Bat Soup Virus importation. He was bombarded by every left loon in the country calling him a racist, xenophobe, fascist dictator etc. The standard reaction from the left to anything he does. So it’s no surprise that in these dire circumstances there isn’t universal acclimation for what he has accomplished.
When November rolls around, this will have been found to be way less disastrous than you disingenuous lefty alarmists hope it will be. Landslide! 4 more years.
More specifically, the World Health Organization attempted to quiet fears of a pandemic on Jan. 14 by repeating China’s claim that the coronavirus was not contagious. Besides the travel ban to and from China, January 31 was the same day he called the pandemic a national emergency. Now the Left is backpedaling, the Left didn’t have a clue then, and they are talking BS now.
https://twitter.com/WHO/status/1217043229427761152?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1217043229427761152&ref_url=https%3A%2F%2Fthewashingtonsentinel.com%2Fflashback-to-january-world-health-organization-tells-everyone-dont-worry-because-china-says-coronavirus-isnt-contagious%2F
Don’s comment is the usual trumpanzee tirade aimed at every stereotype in the conservative playbook.
Frankly – I gave Trump the benefit of the doubt. He even seemed preferable to Hillary. The hilarious aspect of that is how you could let it get to such a choice. But he has proved himself to be a complete idiot.
It is already dire in the USA. 278 037 cases with 20 to 30 thousand new cases daily currently. A doubling of cases in about 7 days. On track to 1.6 million cases and 38 500 deaths by the end of the month of April.
https://www.worldometers.info/coronavirus/country/us/
jg, November 3. Last laugh is ours. I think I’ll go to youtube and watch the videos of the crying lefties November 2016. That never fails to make me happy as a clam.
“The epidemic began with a poignant example of potential life-saving information suppressed as a rumour. On 30 December, Li Wenliang, a young ophthalmologist in Wuhan, China, posted a message to colleagues that tried to call attention to a severe acute respiratory syndrome (SARS)-like illness that was brewing in his hospital. The Chinese government abruptly deleted the post, accusing Li of rumour-mongering. On 7 February, he died of COVID-19.’
Ah, western fairytale, where leakers and whistleblowers are protected and held in the highest esteem. As long as they’re Chinese.
Captain Crozier
C.I.A. “Ukraine” whistleblower
It was not his job to warn anybody. He was not trying to warn the general public. He was trying to warn fellow medical students. Nothing was being covered up. He was mad when he found out his postings had been put out on social media.
He could have set off a city-wide panic, and possibly actually sent infected persons scurrying across China. That is why they leave it to people who specialize in something other than ophthalmology.
Shi Zhengli was on her way back to Wuhan the same day, December 30, because officials who knew what they were doing called her back to help identify what was then an unknown, SARS-like virus.
On December 30 nobody had died. They did not know what they had. They were remaining calm, making deliberative steps to identify, and quickly figured out what they had.
The Chines government apologized to his family. Has Trump or Trump Jr. ever apologized to the Ukraine whistleblower?
The quote comes from a very reputable source. We can contrast that with JCH’s confabulations. The point – however – was the rapidity of Chinese responses. In contrast to the US.
https://en.wikipedia.org/wiki/Li_Wenliang
Social distancing and lockdowns – btw – are stop gap measures intended to prevent overburden of medical facilities.
“Scientists in China sequenced the virus’s genome and made it available on Jan. 10, just a month after the Dec. 8 report of the first case of pneumonia from an unknown virus in Wuhan.”
https://www.statnews.com/2020/01/24/dna-sleuths-read-coronavirus-genome-tracing-origins-and-mutations/
So the pneumonia was detected in early Dec, and the RNA already sequenced by Jan 10.
The earliest case detected was on 17 November, weeks before authorities acknowledged the new virus, says Chinese media. https://www.scmp.com/news/china/society/article/3074991/coronavirus-chinas-first-confirmed-covid-19-case-traced-back This roughly aligns with Dr. Andrew Rambaut of the University of Edinburgh, an expert on viral evolution. “Applying ballpark rates of viral evolution, Rambaut estimates that the Adam (or Eve) virus from which all others are descended first appeared no earlier than Oct. 30, 2019, and no later than Nov. 29.” From the first link.
“Li Wenliang, a young ophthalmologist in Wuhan, China, posted a message to colleagues that tried to call attention to a severe acute respiratory syndrome (SARS)-like illness that was brewing in his hospital.”
When looking at pneumonia deaths, there’s nothing really remarkable about COVID-19 pneumonia that uniquely discriminates the ability for its detection over that of any other ARDS pneumonia. So why were any Chinese doctors or scientists looking for a unique cause of pneumonia infections in Wuhan hospitals to begin with?
“ARDS is a common pathology that we see in the intensive care unit, so it’s not new to anyone who practices critical care,” Tarabichi said. “We manage ARDS in the intensive care unit all the time.” Dr. Yasir Tarabichi, a pulmonary, sleep, and critical care physician at MetroHealth.
Pneumonia is one of the leading causes of death, it’s very common. Doctors in the west who describe COVID-19 pneumonia infection describe it as not looking any more unique than flu pneumonia. “I think in terms of the basics – inflammation, [ARDS], the need to go to the ICU in a proportion of patients – it’s very similar to other viruses we know about,” Cleveland Clinic lung pathologist Dr. Sajay Mukhopadhyay said. This is why certain NYC officials described delay in recognizing how hard the COVID-19 pandemic had hit NYC.
To the point.
Explain WHY Chinese officials were looking for a particular type of pneumonia case in China, caused by a unique virus with a lethal profile, yet being virtually indistinguishable from any other deadly pneumonia; when considering no deaths (as you state) occurred before Dec 30, yet the RNA for it being sequenced by Jan 10? The answer; they were looking for a known virus, already sequenced, that had escaped into the population. Otherwise, what would alerted officials to be looking deeper into what is demonstrably an unremarkable, plentiful form of death within a population of 19 million, where such deaths occur every single day.
No nation can afford to screen every pneumonia death among millions, looking for that unique virus; unless they either suspect it’s already out there to be found; or many are dying and it’s obvious something new is on the scene, but the latter is not the case here.
I suspect they were routinely testing for the usual suspects in order to tailor treatment regimes.
“I suspect they were routinely testing for the usual suspects in order to tailor treatment regimes.”
You know you’re really reaching with that argument.
Funny, our two favorite crotchety cantankerous know-it-alls clashing on details of one incident in the the well-documented history replete with perfidy of the Red China Thugocracy, with both finding a way to praise said Thugocracy and denigrate the MAGA United States. Bitter vociferous contentious enemies, but on the same low moral plane, when it comes to beloved Red China Thugocracy.
Routine pathology tests for lung infections is no stretch at all.
e.g. https://www.uofmhealth.org/health-library/hw254137
“However, influenza virus testing can inform clinical management when the results may influence clinical decisions such as whether to initiate antiviral treatment, perform other diagnostic testing, or to implement infection prevention and control measures for influenza.” CDC
As for little Donnie’s aggressive, pejorative empty vessel rattling… He can tell someone who gives a ….
Moderation seems a crap shoot. Let’s try this from above.
Don’s comment is the usual trumpanzee tirade aimed at every stereotype in the conservative playbook.
Frankly – I gave Trump the benefit of the doubt. He even seemed preferable to Hillary. The hilarious aspect of that is how you could let it get to such a choice. But he has proved himself to be a complete ,.. fill in the blank.
It is already dire in the USA. 278 037 cases with 20 to 30 thousand new cases daily currently. A doubling of cases in about 7 days. On track to 1.6 million cases and 38 500 deaths by the end of the month of April.
https://www.worldometers.info/coronavirus/country/us/
And perhaps I should try this again.
Routine pathology tests for lung infections is no stretch at all.
e.g. https://www.uofmhealth.org/health-library/hw254137
“However, influenza virus testing can inform clinical management when the results may influence clinical decisions such as whether to initiate antiviral treatment, perform other diagnostic testing, or to implement infection prevention and control measures for influenza.” CDC
You nailed it alright, Robert. I can’t imagine why NYC doctors had such a hard time recognizing what they were dealing with, when all they had to do is google viral pneumonia infection treatments, as you did.
Does the testimony here reveal it being really scary, in the beginning? https://apnews.com/6b9d9bf2f753ba7944c4dac379b3c5bb
Now imagine that this virus was yet an unknown quantity, discovered in NYC; what would Como have said instead? He probably wouldn’t have even known it existed until the virus expressed itself like pandemics do; the first viral pneumonia cases would be treated with the normal treatment regimens, and when these don’t work, the red flag goes up, discovery begins.
Yet stated here: “New York leaders sought to calm jittery nerves Monday after the city recorded its first confirmed case of the new coronavirus, saying the disease — while dangerous — is a manageable threat.”
Are the Chinese are more serious and dependable? JCH thinks so.
My comment also went to moderation, bobbie. Maybe the two will meet up there and you will be taught a lesson you won’t forget.
PS:Please stop the hillbilly type feuding with JCH. He can’t defend himself.
Pathology tests – junglebunkum – are far from a stretch despite your idiosyncratic and convoluted story line. The genome was sequenced and data released globally by the 10th of January. It’s likely NYC doctors had that information. I simply suggested that there are standard tests for all the likely suspects. You seem to be still in the dark ages.
D*n
I would estimate 2 out of 3 of my comments go into moderation. The trouble is the 2 that go missing are of such brilliance and insight they would change the world. The Nobel prize recedes
tonyb
Robert, are you channeling from your book of hydrology philosophy here? You can lead a horse to water, but you can’t make it drink. And after all, consider the science, the human body is mostly made up of water, and that you’re an expert hydrologist, what else need one know?
I shared the fact that the COVID-19 virus genome was sequenced by the Chinese, and they released this data to the world Jan 10, our facts align. The Chinese officials did the genome sequencing for this unknown, undeadly virus within a month after the Dec. 8 report of the first case of pneumonia from an unknown virus in Wuhan.
There are many possibilities for the chain of events surrounding this virus, I’m surely suspicious, I acknowledge my framing can’t be proven: but it comes from demonstrable examples of Chinese behavior. Caveat emptor.
But speaking of idiosyncratic; what is it exactly that you’re arguing about here, it’s not about the COVID-19 disease, not really; are you defending China’s benevolence, their transparency, that their efforts were altruistic from the start? Are you expressing outrage for the lack of trust many have for what you see as unappreciated Chinese goodwill, like JCH is? There’s only one breed of horse drinking from the corrupt, virulent laced Kool-Aid pond that you point to; it’s not surprising why so many on the Left wobble around in a chronic politically intoxicated state, seething.
jungletrunks: But speaking of idiosyncratic; what is it exactly that you’re arguing about here, it’s not about the COVID-19 disease, not really;
I enjoyed your little interchange with RIE. He does not usually do “exactly”.
tonyb: The trouble is the 2 that go missing are of such brilliance and insight they would change the world.
I commiserate. But my “disappeareds” have been short comments on false positive and false negative rates. No great loss.
matthewrmarler said: “I commiserate. But my “disappeareds” have been short comments on false positive and false negative rates. No great loss.”
———-
sure, “no great loss”…. merely crucial.
https://www.sciencemediacentre.org/expert-comment-on-different-types-of-testing-for-covid-19/
At this website, Dr James Gill, Locum GP & Honorary Clinical Lecturer, Warwick Medical School, said:
““PCR testing – as used by the CDC and WHO initially – is very labour intensive, and has several points along the path of doing a single test where errors may occur – which may lead to headline issues of a false positive, the test showing evidence of the virus when it’s not actually there, or a false negative, suggesting someone doesn’t have the virus when in fact they do.”
““During the course of the outbreak, the PCR testing has been refined from the initial testing procedures and with the addition of greater automation to reduce errors. As such, we now have an 80-85% specificity – i.e. the chance the test is detecting the virus.”
If the error percentage for false positive test results is about 15%, then that approximately matches the percentage of positive test results being reported …. that is, nearly all results could be false positives (could be flu instead of covid). There should be a reliable evaluation for the test accuracy conducted and published. That seems to be missing.
sciencereview18, I was referring to my lost comments as no great loss.
More on testing from the San Diego Union Tribune: 12:22 PM APRIL 4
California has tested 126,700 people for COVID-19
By Jennifer Van Grove
Citing a “new day” in testing capabilities, Gov. Gavin Newsom said Saturday that the state of California has now tested 126,700 individuals for the novel coronavirus, with around 13,000 people waiting for results.
The governor, speaking during a noon press briefing, also promised at least a five-fold increase in daily tests over the next few weeks, and noted that a task force has been formed to expedite the state’s testing capabilities.
This story is developing.
Now worldometers is displaying a count of 12, 639, so only 10% have the virus so far.
As to false positive and false negative rates in general, estimates of those are submitted to the FDA when the testing company submits its tests for approval. You’ll recall that the first test kits submitted by the CDC had error rates that were too high.
sciencereview18: If the error percentage for false positive test results is about 15%, then that approximately matches the percentage of positive test results being reported …. that is, nearly all results could be false positives (could be flu instead of covid). There should be a reliable evaluation for the test accuracy conducted and published.
Indeed. If the true prevalence is low, like the 10% reported for CA, then the Positive Predictive Value of a test with a 15% false positive rate is really low, about 2%. Meaning, only about 1% of the identified positives are true positives. PPV and NPV explained here:https://en.wikipedia.org/wiki/Positive_and_negative_predictive_values
Computations involve Bayes’Theorem, and make assumptions (you can experiment with different values for these) about representativeness of samples.
Junglebunkum
It is numbers and not ideology.
https://www.worldometers.info/coronavirus/country/us/
And MM
Claiming that there are routine tests for influenza or pneumonia is exactly true. Just as there is now for Covid19.
“The fractionally dimensioned space occupied by the trajectories of the solutions of these nonlinear equations became known as the Lorenz attractor (figure 1), which suggests that nonlinear systems, such as the atmosphere, may exhibit regime-like structures that are, although fully deterministic, subject to abrupt and seemingly random change.” Slingo and Palmer 2011
As indeed is that the mechanistic universe is fully deterministic if seemingly random. Despite your habitual piffling antipathy.
matthewrmarler, I can appreciate your sentiment about RIE, “He does not usually do “exactly”.
RIE, about what you “exactly” mean; the implication of your recent post is the opposite of what you conclude, you state: “It is numbers and not ideology”. Actually you’re communicating that your focus is indeed “ideology”, and not numbers. You ignore that the US is behind Europe in per capita cases of COVID-19, both in case totals, and death totals. Take out outliers, NY and Italy, and the US is way lower. Aren’t relevant population comps a better apples-to-apples metric? While there are no perfect comps, comparing the US to say, Belgium, is more than a little ridiculous; or any individual country in Europe.
tony,
I will ask Trump to send you a Noble Prize. I hear they are mailing some of them out to good honest people, even ferriners, when they start mailing out the Trump checks. I will try to get you a modest check, also.
Don “But it’s only JCH that he manages to mudwrestle into submission.”
True; yet he makes allowances in attempts to win the overarching ideological war, which takes precedent over quibbling familial battles.
Right,jg.
They squabble like pullets, but at the same time manage to team up when it comes to propagating Red China propaganda. People on a low moral plane can do that without suffering even a slight twinge of conscience.
Junglebunkums original comment was that Chinese doctors couldn’t distinguish pneumonia from Covif19. Donnie’s odd proclivities involve a whole lot of political posturing, deceptive argumentation, ineffectual schoolboy derision and blaming Chinese ‘wet markets’ for all spillover viruses.
The difference between Donnies moderated comments and mine is that mine usually appear. While even those he manages to post commonly disappear. It’s a waste of everyone’s time – especially mine. In trying to distill any substance from this nonsense.
It was the cases and deaths per million population column I had in mind. With the US mortality rate being three times the world average. And 34,196 new cases yesterday with another 1,331 deaths. What it
seems to be is the result of too little too late. Something they seem to blame on everyone but Trump. I can only pray that things rapidly improve from what is a dire situation.
https://www.worldometers.info/coronavirus/#countries
And all they can do is misrepresent my politics – which are classic liberal free market such as the USA was founded on but has since forgotten. Frankly I consider JCH, junglebunkem and poor little Donnie to be all a bit slow on the uptake.
The spam filter is going crazy, e.g. most of tonyb’s comments land in spam.
Lots landing in moderation also. If a comment gets flagged and it mostly insults another commenter, I don’t approve it.
It is not a problem Judith. These threads are a bit mad. 😊
junglebunkums original contention was that Chinese doctors couldn’t tell the difference between pneumonia and covid19.
But it was precisely per capita columns I had in mind. US fatalities three times the world average. With 34,986 new cases and 1,331 deaths yesterday. It seems a case of too little too late – which they blame on everyone but Trump. Trumpanzees are all a bit slow on the uptake.
All I can do is pray for a turnabout soon. And all they can do is misrepresent my politics. Which are classic liberal free market such as the USA was founded on but has since forgotten.
You are a trip, bobbie. The NY City area with nearby parts of NJ are the problem. NY and NJ accounted for 830 of the 1,331 deaths. Together they accounted for 15, 528 of the 34,196 new cases. They are going to continue to pile up bodies in a very ugly disproportional way.
It’s a Cuomo-De Blasio problem. They run that show and they and their citizens are doing something very wrong. POTUS Trump is giving them everything he can to support them. Those are the facts and any rational intelligent person with no ax to grind would get it.
You are intelligent enough to get it, but you are either blinded by hate, or you get it and you are shamefully dishonest.
Another comment to moderation, for no apparent reason. I was relatively kind to this character. Going to take a break from this foolishness.
Look bob, NY and NJ reported 830 of the 1,331 fatalities. Are you with me so far, bob? 15,528 of the 34,196 new cases. I don’t know if you been to the US, bob, but the areas of NY and NJ that we are talking about make up a very small part of a big country with a lot of people. The leaders and the citizens of that area are not doing what they need to do, bob. Trump is giving them everything he can and they are failing to take care of themselves.
You are probably smart enough to get this, but you are driven by animus. End of story.
I am light years ahead of you Donnie. Nothing new there.
New York and New will hopefully peak this week.
https://watertechbyrie.files.wordpress.com/2020/04/new-york-new-jersey.png
“There will be a lot of death,” Mr. Trump said at the White House, where he and other American officials depicted some parts of the United States as climbing toward the peaks of their crises, while warning that new hot spots were emerging in Pennsylvania, Colorado and Washington, D.C. – https://www.nytimes.com/2020/04/04/world/coronavirus-live-news-updates.html
But he is all over the place and half the country is wide open.
umm, US fatalities running 3x world average??? where do you get that?
https://www.realclearpolitics.com/coronavirus/ shows the fatality rate running well below much of the world as a percentage of confirmed cases, and the per-capita confirmed cases is #10
Robert: “junglebunkums original contention was that Chinese doctors couldn’t tell the difference between pneumonia and covid19.”
That’s not what I said. I described how COVID-19 “pneumonia”, and flu “pneumonia” present identically at a hospital. This came from US doctors, I named a few who described it this way. Most deaths coming from COVID-19 are caused by the complications from pneumonia.
Before COVID-19 was sequenced and understood, it presented like a flu. I won’t repeat the framing of my suspicions; but here’s what the CDC says about testing for flu in the US:
“Will my health care provider test me for flu if I have flu-like symptoms?
Not necessarily. Most people with flu symptoms are not tested because the test results usually do not change how you are treated. Your health care provider may diagnose you with flu based on your symptoms and their clinical judgment or they may choose to use an influenza diagnostic test. During an outbreak of respiratory illness, testing for flu can help determine if flu viruses are the cause of the outbreak. Flu testing can also be helpful for some people with suspected flu who are pregnant or have a weakened immune system, and for whom a diagnosis of flu can help their doctor make decisions about their care.”
While I didn’t get into any detailed discussion about testing, between how China does it versus how the US does it; I do make a presumption that China’s healthcare system isn’t as sophisticated as western nations, that they’re not, in general, going to be as efficient as the CDC, for example; after all, they’re a developing nation, right? It’s this same reason why they aren’t held to clean air standards, why they’re given a free pass on CO2.
I have already acknowledged that my suspicions about China can’t be proven, but the speed of discovery from the known genesis of the disease doesn’t add-up to me. It doesn’t help that China is a closed society, they are not transparent about much of anything. The fact that the Chinese didn’t allow CDC experts in to test, myriad other assorted tidbits of information, including how WHO soft-pedaled the nature of the disease until the end of January. China’s role in facilitating WHO’s Director-General Tedros Adhanom into that position. How China manipulates the UN in general, i.e. yesterdays headline: “China joins UN Human Rights Council”, it’s quite astonishing; but not more astonishing than how people like you and JCH are so willing to carry their water, why China’s word is golden to you guys is beyond comprehension, ideology is a good guess.
China is a propaganda machine. Besides my suspicions surrounding the genesis of COVID-19, I don’t have any trust in the stats coming out of China for new cases, or deaths either. It’s factual that China is a closed society.
Don addressed your per capita garbage, no need to go there again.
you actually believe the ‘world average’ numbers?
that requires you to believe that there are no new cases in china for the last month, that Iran only has a thousand or so deaths, and that countries that put you in jail for saying ‘coronavirus’ actually have zero cases.
world population numbers are questionable to begin with (given that many countries self-report and get more aid given to them for the rulers to abscond with the larger their population), and the deaths due to the Wu Flu are also questionable.
You don’t believe the numbers based on jingoism, want to downplay the impact of the virus in the US as a New York problem and invent conspiracy theories. 🤣
The good news is that new US cases are down to 18,874 with 7,286 in New York. Down from 34,196 and 11,299 respectively the day before.
You are not very bright, bobbie. Those are partial day numbers. That’s all the time I have to help you today, bobbie. I am light years ahead of you, bobbie.
The good news is that the numbers are holding and not exponentially increasing. You are about as dullard as it gets Donnie.
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Regarding the claim that there is NO increasing epidemic…. because the apparent increasing epidemic (the scary graph of increasing #cases per day) is merely a result of the increasing #tests per day….. while a correct graph of the data shows that the percentage #cases /#tests has been fairly constant all along, indicating no increasing spread…..
I hope that lots of people are obtaining the data to graph this percentage #cases/#tests per day so can check the above claim of ….. NO increasing epidemic. If you do obtain data, please be aware that CDC’s reported dates have recently been adjusted, so that it is now difficult to match the #tests made on a given day to the corresponding #positive cases identified from that day’s tests. And you do need to match the dates correctly in order to do the correct analysis to see the trend (fairly constant, not increasing) in the percentage #cases/#tests.
Here are the quotes from the CDC website, regarding the adjusted dates for #Tests and also adjusted dates for #Cases reported ….. the combined adjustment for both resulting in offsetting/separating the dates (that need to be matched) by one or two weeks or more.
For #Tests — “Note: As of March 12, the dates associated with the specimens tested by CDC Labs have been updated to reflect the date the specimen was received by CDC, instead of when they were collected from the patient. Use of the specimen received date better reflects when specimens became available for testing by the CDC Labs.” “… the lag in time between when specimens are accessioned, testing is performed, and results are reported. Range extended from 4 days to 7 days on March 26.”
For #Positive Cases — “Date is calculated as illness onset date if known. If not, an estimated illness onset date was calculated using specimen collection date.
Note: On March 24, CDC updated the data included in this figure to include estimated illness onset date.”
So please be careful to match the dates correctly in order to show the percentage correctly. For a given day, you need to know the #tests made on a that day and the corresponding #positive cases identified from that day’s tests.
Hat tip to nickels
…. who was the first one I noticed (last week) to point out that the percentage #cases / #tests was fairly constant… in that he/she posted the data from Colorado website on an earlier thread here. Nickels also commented that the data was shortly afterwards taken off the website.
It would help to have graphs of #cases/#tests from each state …. volunteers welcome! Good homework assignment for Statistics classes.
Here are the two webpages from CDC, per my post a few minutes ago:
https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/testing-in-us.html
https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html
Here is the earlier quote from the swiss website, which was first posted by
edimbukvarevic, whose full post did show the graph:
edimbukvarevic | April 1, 2020 at 11:59 am | Reply
“Dr. Richard Capek and other researchers have already shown that the number of test-positive individuals in relation to the number of tests performed remains constant in all countries studied so far, which speaks against an exponential spread („epidemic“) of the virus and merely indicates an exponential increase in the number of tests.”
———————
(leave out all spaces):
s w p r s . o r g / a-swiss-doctor-on-covid-19 /
Here is a quote from the April 2 report near the end of this document:
USA: “Biophysicist Felix Scholkmann has visualized the fact that in the US (as in the rest of the world), it is not the number of „infected“ people that is increasing exponentially, but the number of tests. The number of „infected“ people in relation to the number of tests remains basically constant (oscillating between 10 and 20%), which speaks against a current viral epidemic.”
What is the difference between influenza virus and SARS virus? The influenza virus causes bacterial complications, the SARS virus kills itself.
Sorry.
What is the difference between influenza virus and SARS virus? The influenza virus causes bacterial complications, the SARS virus kills on one’s own.
One of the things that has alarmed me about the UK statistical reporting is that people who should know how they work (public health officials etc.) appear not to know with claims of underreporting of covid19 deaths being repeated in the media when they are a very common feature in any influenza season since things are only official when they are officially recorded. Even the figures in the PHE official annual deaths from influenza report change for each previously published year as more information is discovered.
This hardly encourages anyone to believe government, experts or media actually know what they are doing or talking about. The bottom line is we are experiencing a covid19 epidemic with an under resourced NHS, with massive shortages of manpower, relevant equipment, and relevant leadership in Government. On top of that our media seems to be totally unable to understand reporting responsibility as if this is the first time an influenza epidemic has ever occurred. It’s absurd.
Weather lass
Having experience of a number of countries it has been obvious for decades that the great and the good ruling us are nowhere near as great or as good-or as clever-as they believe themselves to be.
The right people for the job are not often in position, as politicians and those who know their way round the system scramble over them. It was ever thus as we can see back to Roman times. Common sense and strategic thinking also seems to be ditched for ideologies
Fortunately there are some very good people-the jurist who gave their opinion last week on the world at one last week was brilliant
As regards the covid 19 epidemic-the figures simply don’t show up as being as yet, anywhere near as bad as our frequent flu epidemics, when for example some 27000 died in 2014 and there were in total some 47000 ‘excess winter mortality in that year.
tonyb
In the Infectious Diseases Clinic of Clinical Hospital No. 1 in Lublin, an innovative method of treating coronavirus-infected patients is being tested, which aims to prevent the development of respiratory failure. The treatment uses drugs that are used in rheumatology and hematology. Their implementation is carried out at the second – third stage of infection.
The drug blocks the mechanisms of inflammatory reactions
– This is not strictly an antiviral treatment, but we are trying to turn off the inflammatory response that is responsible for serious complications. By blocking the receptor of one of interleukins – a substance secreted by our immune system, we do not get to the so-called cytokine storm, which results in respiratory failure – said dr hab. Krzysztof Tomasiewicz.
There’s been a lot of talk about Fergusson’s model, which is understandable as it is the one which massive policy decisions have been based, in the UK at least. As Willis Eschenbach has pointed out recently, the data suggests that using masks is probably more effective than complete lockdowns – https://wattsupwiththat.com/2020/04/01/do-lockdowns-work/ . Also, while the need to keep the curves below the health system capacities is key, I think the decision makers have lost sight of the bigger picture in their panic to minimise the death rate (most of whom would likely have died from this or next year’s seasonal flu – co-morbidities are key), i.e. the long term economic and human cost a complete shutdown will have on society, more poverty, suicide, disease, and in turn much less tax revenue to spend on healthcare etc. I would much prefer to see a focused lockdown of the elderly and at risk, but allow younger age people who can go back to work do so with masks where possible (except in critical zones like New York where a complete lockdown is probably advisable for the next few weeks. I do wish that our politicians were listening to other experts in the field, such as Israeli ebola model expert Dr. Dan Yamin who suggests that complete shutdowns are likely just delaying the inevitable. This interview with him is a week old now but still worth reading: https://www.haaretz.com/israel-news/.premium.MAGAZINE-israeli-expert-trump-is-right-about-covid-19-who-is-wrong-1.8691031
tony,
I suggest that you would find informative Dr. David Price on call with his family and friends explaining how the virus is transmitted and how to protect ones self and family. He claims very likely with justification that he has handled more cv cases than anyone in US. He works at Cornell University Hospital NYC. First 20 minutes is most interesting:
Don … Thanks for the great video. And love your sense of humor.
My friend is a nurse at Evergreen Health in Kirkland, WA. She sent me this from her circle of medical people. It gives some interesting info.
“I am an ER MD in New Orleans. Class of 98. Every one of my colleagues have now seen several hundred Covid 19 patients and this is what I think I know.
Clinical course is predictable.
2-11 days after exposure (day 5 on average) flu like symptoms start. Common are fever, headache, dry cough, myalgias(back pain), nausea without vomiting, abdominal discomfort with some diarrhea, loss of smell, anorexia, fatigue.
Day 5 of symptoms- increased SOB, and bilateral viral pneumonia from direct viral damage to lung parenchyma.
Day 10- Cytokine storm leading to acute ARDS and multiorgan failure. You can literally watch it happen in a matter of hours.
81% mild symptoms, 14% severe symptoms requiring hospitalization, 5% critical.
Patient presentation is varied. Patients are coming in hypoxic (even 75%) without dyspnea. I have seen Covid patients present with encephalopathy, renal failure from dehydration, DKA. I have seen the bilateral interstitial pneumonia on the xray of the asymptomatic shoulder dislocation or on the CT’s of the (respiratory) asymptomatic polytrauma patient. Essentially if they are in my ER, they have it. Seen three positive flu swabs in 2 weeks and all three had Covid 19 as well. Somehow this ***** has told all other disease processes to get out of town.
China reported 15% cardiac involvement. I have seen covid 19 patients present with myocarditis, pericarditis, new onset CHF and new onset atrial fibrillation. I still order a troponin, but no cardiologist will treat no matter what the number in a suspected Covid 19 patient. Even our non covid 19 STEMIs at all of our facilities are getting TPA in the ED and rescue PCI at 60 minutes only if TPA fails.
Diagnostic
CXR- bilateral interstitial pneumonia (anecdotally starts most often in the RLL so bilateral on CXR is not required). The hypoxia does not correlate with the CXR findings. Their lungs do not sound bad. Keep your stethoscope in your pocket and evaluate with your eyes and pulse ox.
Labs- WBC low, Lymphocytes low, platelets lower then their normal, Procalcitonin normal in 95%
CRP and Ferritin elevated most often. CPK, D-Dimer, LDH, Alk Phos/AST/ALT commonly elevated.
Notice D-Dimer- I would be very careful about CT PE these patients for their hypoxia. The patients receiving IV contrast are going into renal failure and on the vent sooner.
Basically, if you have a bilateral pneumonia with normal to low WBC, lymphopenia, normal procalcitonin, elevated CRP and ferritin- you have covid-19 and do not need a nasal swab to tell you that.
A ratio of absolute neutrophil count to absolute lymphocyte count greater than 3.5 may be the highest predictor of poor outcome. the UK is automatically intubating these patients for expected outcomes regardless of their clinical presentation.
An elevated Interleukin-6 (IL6) is an indicator of their cytokine storm. If this is elevated watch these patients closely with both eyes.
Other factors that appear to be predictive of poor outcomes are thrombocytopenia and LFTs 5x upper limit of normal.
Disposition
I had never discharged multifocal pneumonia before. Now I personally do it 12-15 times a shift. 2 weeks ago we were admitting anyone who needed supplemental oxygen. Now we are discharging with oxygen if the patient is comfortable and oxygenating above 92% on nasal cannula. We have contracted with a company that sends a paramedic to their home twice daily to check on them and record a pulse ox. We know many of these patients will bounce back but if it saves a bed for a day we have accomplished something. Obviously we are fearful some won’t make it back.
We are a small community hospital. Our 22 bed ICU and now a 4 bed Endoscopy suite are all Covid 19. All of these patients are intubated except one. 75% of our floor beds have been cohorted into covid 19 wards and are full. We are averaging 4 rescue intubations a day on the floor. We now have 9 vented patients in our ER transferred down from the floor after intubation.
Luckily we are part of a larger hospital group. Our main teaching hospital repurposed space to open 50 new Covid 19 ICU beds this past Sunday so these numbers are with significant decompression. Today those 50 beds are full. They are opening 30 more by Friday. But even with the “lockdown”, our AI models are expecting a 200-400% increase in covid 19 patients by 4/4/2020.
Treatment
Supportive
worldwide 86% of covid 19 patients that go on a vent die. Seattle reporting 70%. Our hospital has had 5 deaths and one patient who was extubated. Extubation happens on day 10 per the Chinese and day 11 per Seattle.
Plaquenil which has weak ACE2 blockade doesn’t appear to be a savior of any kind in our patient population. Theoretically, it may have some prophylactic properties but so far it is difficult to see the benefit to our hospitalized patients, but we are using it and the studies will tell. With Plaquenil’s potential QT prolongation and liver toxic effects (both particularly problematic in covid 19 patients), I am not longer selectively prescribing this medication as I stated on a previous post.
We are also using Azithromycin, but are intermittently running out of IV.
Do not give these patient’s standard sepsis fluid resuscitation. Be very judicious with the fluids as it hastens their respiratory decompensation. Outside the DKA and renal failure dehydration, leave them dry.
Proning vented patients significantly helps oxygenation. Even self proning the ones on nasal cannula helps.
Vent settings- Usual ARDS stuff, low volume, permissive hypercapnia, etc. Except for Peep of 5 will not do. Start at 14 and you may go up to 25 if needed.
Do not use Bipap- it does not work well and is a significant exposure risk with high levels of aerosolized virus to you and your staff. Even after a cough or sneeze this virus can aerosolize up to 3 hours.
The same goes for nebulizer treatments. Use MDI. you can give 8-10 puffs at one time of an albuterol MDI. Use only if wheezing which isn’t often with covid 19. If you have to give a nebulizer must be in a negative pressure room; and if you can, instruct the patient on how to start it after you leave the room.
Do not use steroids, it makes this worse. Push out to your urgent cares to stop their usual practice of steroid shots for their URI/bronchitis.
We are currently out of Versed, Fentanyl, and intermittently Propofol. Get the dosing of Precedex and Nimbex back in your heads.
One of my colleagues who is a 31 yo old female who graduated residency last may with no health problems and normal BMI is out with the symptoms and an SaO2 of 92%. She will be the first of many.
I PPE best I have. I do wear a MaxAir PAPR the entire shift. I do not take it off to eat or drink during the shift. I undress in the garage and go straight to the shower. My wife and kids fled to her parents outside Hattiesburg. The stress and exposure at work coupled with the isolation at home is trying. But everyone is going through something right now. Everyone is scared; patients and employees. But we are the leaders of that emergency room. Be nice to your nurses and staff. Show by example how to tackle this crisis head on. Good luck to us all.”
Bill Fabrizio | April 5, 2020 at 11:49 am |
Good post.
This is disappointing. Plaquenil which has weak ACE2 blockade doesn’t appear to be a savior of any kind in our patient population. Theoretically, it may have some prophylactic properties but so far it is difficult to see the benefit to our hospitalized patients, but we are using it and the studies will tell.
Thanks, Bill. But no laughing out loud. You should know that, Fabrizio:
https://www.youtube.com/watch?v=pXO6AVTJGoc
I find this report disturbing by the New Orleans, MD. “I have seen covid 19 patients present with myocarditis, pericarditis, new onset CHF and new onset atrial fibrillation. I still order a troponin, but no cardiologist will treat no matter what the number in a suspected Covid 19 patient. Even our non covid 19 STEMIs at all of our facilities are getting TPA in the ED and rescue PCI at 60 minutes only if TPA fails.”
It looks like the cardiologists have decided to sit this one out. Gone fishing.
Need some state intervention there.
The more I think about it the more disturbing. I wonder if this seeming lack of interest in treating cv heart patients is a widespread phenomenon. Are other comorbidities being ignored. This could be very significantly adding to the death rate.
As of this moment, the NYC Metro Area (NY, NJ) alone, with over 133,000 COVID19 cases, has more than any country in the world. Several highly populated countries, apparently not yet affected, continue to report surprisingly low deaths, while China, professing to be passed the worst, continues to report deaths in the single digits.
ceresco kid
I believe NYC accounts for half of all US cases/deaths. Which should be teaching us some ;lessons
tonyb
tony
Yes, that’s right. There are so many “mysteries” to me, and we probably won’t have insights into them for months. Many highly populated countries still haven’t had a surge in cases or deaths. Pakistan and Russia come to mind. Some large states in the US haven’t been hit yet to any significance.
I just looked at the daily cases and deaths in France. Huge spikes. Then by reading the footnotes you find out the previous reports have included only hospitalized patients, leaving out nursing homes, etc. In future reports these numbers will reflect actual situation on the ground. Are there similar idiosyncrasies in the reporting from other countries?
We really don’t know level of testing, reporting etc, in a lot of countries so it’s difficult to assess reality versus just looking at the data available to us.
I think a large key to the differences isn’t the size of the state/country or the population, but a combination of population density and mass transit.
the hard surfaces of modern mas transit is tailor made to let the virus survive for lengthy times and have lots of people touch it.
Countries around China are conditioned to respond to a new virus showing up out of China because it happens every couple of years, and they are used to ignoring China’s statements on the matter.
The rest of the world believed China’s statements (especially when backed by the WHO) and expected this to be just another routine china virus scare. The US actually took it more seriously than the rest of the west, but still drastically under-estimated what the impact was going to be.
While Trump was blocking travel from Whuhan, Italy was having ‘hug a chinese person events and Pelosi and DeBlasio were encourging people to visit chinatown
Ceresco and David
Population density, plus style of living-tactile intergenerational- small apartments, limited outside space plus smoking habits, existing ailments, age of demographic. etc etc all have an impact.
I remarked before about how Jews are wildly over represented in deaths in the UK and that crowded London -which is unlike the rest of the UK- represent some half the deaths of the whole country and Italy and china fulfil much of the profile mentioned in my first 2 lines.
My concern is that if we turn everyone ‘italian’ by herding us all together in a small space with the rest of the family, will the virus spread internally accordingly?
tonyb
https://i.imgur.com/R2dmIfR.png
https://i.imgur.com/m0Oep1b.png
tony,
I posted above wrong place video that you might find useful. I will put it here also:
D*n
Many thanks for that. It seems to be about an hour long so I have watched half now and will watch the other half later this evening
tonyb
tony,
You might also be interested in another front line pulmonologist doc’s very informative almost daily updates, since we have a lot of time on our hands:
Thought I had posted the latest update #49, Try again:
weird, it’s all on youtube
One way to cause a country to appear to have very few cases is to conduct very few tests. Conversely, if NYC is engaging in widespread testing it will find a huge number of cases compared to all of India, for example.
What we need to know is what % of the population in a particular geographic area or nation has been tested, and the rate of infection among those tested. But if the number of tests is small relative to the population sampling bias becomes a large issue, and the entire set of numbers from that country or area becomes unreliable or even meaningless.
exactly, and there isn’t any place where there has been enough testing to eliminate this sampling bias.
If someone develops a finger-prick test for the antibodies, we may have the ability to really do mass testing to find out how many people have had it, but as Dr Birx said in today’s briefing, the current antibody test requires drawing a vial of blood and sending it to a lab. The lab time is probably better spent on other tests, there’s no way that they can do enough testing to get reasonable coverage of antibody tests.
How deadly is the coronavirus? It’s still far from clear
There is room for different interpretations of the data
Early evidence from Iceland, a country with a very strong organisation for wide testing within the population, suggests that as many as 50 per cent of infections are almost completely asymptomatic. Most of the rest are relatively minor. In fact, Iceland’s figures, 648 cases and two attributed deaths, give a death rate of 0.3 per cent. As population testing becomes more widespread elsewhere in the world, we will find a greater and greater proportion of cases where infections have already occurred and caused only mild effects. In fact, as time goes on, this will become generally truer too, because most infections tend to decrease in virulence as an epidemic progresses.
https://www.spectator.co.uk/article/The-evidence-on-Covid-19-is-not-as-clear-as-we-think
Iceland is allowing everyone in the country to be tested for the coronavirus. The government says it spent years perfecting its approach.
Iceland, an island country home to about 364,000 people, has taken a different approach to the coronavirus than many other countries.
The government allows testing for anyone who wants it. Iceland is also working to identify people who have the virus quickly so it can isolate them.
The country has not gone on lockdown during the pandemic.
https://www.businessinsider.com/iceland-coronavirus-pandemic-approach-could-help-other-countries-2020-4
Why Iceland might be the key to understanding coronavirus
The island country is providing large-scale COVID-19 testing for its citizens, which is made easier by its small population, but they’re crucially offering tests to people who aren’t exhibiting symptoms. That differs most other countries, who are saving their limited supply for people most clearly in need.
https://news.yahoo.com/why-iceland-might-key-understanding-162800806.html
What’s the Status of COVID-19 in Iceland?
https://www.icelandreview.com/ask-ir/whats-the-status-of-covid-19-in-iceland/
COVID-19 in Iceland
A prediction model for the number of individuals diagnosed with COVID-19 and the corresponding burden on the health care system.
2020-04-02
https://covid.hi.is/english/
Most of the UK testing has been in hospitals, where there is a high concentration of patients susceptible to the effects of any infection. As anyone who has worked with sick people will know, any testing regime that is based only in hospitals will over-estimate the virulence of an infection. Also, we’re only dealing with those Covid-19 cases that have made people sick enough or worried enough to get tested. There will be many more unaware that they have the virus, with either no symptoms, or mild ones.
That’s why, when Britain had 590 diagnosed cases, Sir Patrick Vallance, the government’s chief scientific adviser, suggested that the real figure was probably between 5,000 and 10,000 cases, ten to 20 times higher. If he’s right, the headline death rate due to this virus is likely to be ten to 20 times lower, say 0.25 per cent to 0.5 per cent. That puts the Covid-19 mortality rate in the range associated with infections like flu.
https://www.spectator.co.uk/article/The-evidence-on-Covid-19-is-not-as-clear-as-we-think
How deadly is the coronavirus?
That is why random sampling is important. John Ioannidis, a Stanford epidemiologist who is famous for debunking bad research, has been pushing for it. He told me that random sampling is needed and could be done with a couple of thousand tests. When I told him that I previously worked in the polling industry, he put it in terms that resonated with me. He said, “Random representative testing is like polling. We run thousands of opinion polls in this country. We should similarly get a representative sample of the population and get them tested. It is just so easy.”
A recent television interview with Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and member of the White House Coronavirus Task Force, underscores the need. After estimating that 100,000 to 200,000 Americans could die of the coronavirus, he said that projections are a “moving target” and that models are “only as good and as accurate as your assumptions.” But how good are models if the data is insufficient?
Ioannidis warned of a potential evidence fiasco in a recent op-ed for Stat. He wrote, “The data collected so far on how many people are infected and how the epidemic is evolving are utterly unreliable. Given the limited testing to date, some deaths and probably the vast majority of infections due to SARS-CoV-2 are being missed.”
Eran Bendavid and Jay Bhattacharya, also professors at Stanford, echoed that concern in The Wall Street Journal, writing, “The true fatality rate is the portion of those infected who die, not the deaths from identified positive cases.” They speculate that due to how infectious the coronavirus appears to be, and because tens of thousands of people traveled from Wuhan to America in December, millions of Americans could have been infected.
Random sampling will tell us what percentage of the population has the coronavirus and its lethality. Only testing the very sick skews mortality rates and leaves us in the dark about how many Americans are unknowingly walking around asymptomatic or with mild symptoms. Looking at other countries’ data also has its challenges; age structures, climate differences, quality of health care systems and testing all vary.
https://thehill.com/opinion/healthcare/491021-how-deadly-is-the-coronavirus
“After estimating that 100,000 to 200,000 Americans could die of the coronavirus, he said that projections are a “moving target” and that models are “only as good and as accurate as your assumptions.”
yes, like our friend Ferguson whose estimates range from 500,000 to 5000 within a week or so. If he was a climate scientist modeller he would no doubt be suggesting a catastrophe with an estimated range of warming between 1 and 100degrees Centigrade
tonyb”
Hi Tony,
I’m not a catastrophist by nature.
It may be a little overly cruel to say that Ferguson is the Michael E Mann of epidemiology, however I would never blindly trust his modeling since I saw what happened with FMD modeling way back in 2001
In fairness his 500K estimate was over the course of the pandemic for a do nothing case. However that’s not how it was perceived by the public. That was intended to soften up the public for the lockdown.
Al Gore and the IPCC got a Nobel. One wonders If Imperial College and Neil will get one as well (perish the thought)
For example, certain types of zinc lozenges can stop a cold dead in its
tracks, and everything we know so far suggests that zinc offers strong protection against the
coronavirus too. Elderberry is very effective against the flu, and it’s probably just as effective
against the coronavirus.
Pingback: Die COVID-19-Zahlen des Imperial College scheinen nicht aufzugehen – EIKE – Europäisches Institut für Klima & Energie
President of the Polish Society of Cardiology and Director of the Warsaw Course on Cardiovascvular Interventions, prof. Adam Witkowski, draws attention to the dangers of the heart associated with the coronavirus pandemic not only to cardiological patients, but also to young and healthy people.
Many factors contribute to the severe course of coronavirus infection. On the one hand, in most cases, patients who suffer from cardiovascular disease are elderly people, therefore they have worse functioning of the immune system, which is able to fight infections, but it is also caused by the fact that the virus itself can attack heart cells. – explains prof. Witkowski. – because the receptors through which the virus enters the lung cells – ACE2 receptors – are also found in the cells of the heart muscle, as well as in the cells of the kidneys or vascular endothelium. SARS-Cov-2 virus can also damage myocardial cells by causing so-called cytokine storm caused by a corrupted T-helper lymphocyte response to infection.
https://i.imgur.com/3FZhvKJ.png
https://i.imgur.com/D6yGAwn.png
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Pingback: Die COVID-19-Zahlen des Imperial College scheinen nicht aufzugehen - BAYERN online
Richard Horton, editor of Lancet, says UK (like all other western countries) “wasted February” rather than preparing for coronavirus. Did he/his journal made specific recommendations at beginning of Feb, which, if followed, would have helped? Wld someone check his past tweets?
https://twitter.com/ClimateAudit/status/1245702259683602432
The end of January thru to February 1st must have been an intense period of internal reflection for Horton
https://twitter.com/richardjwadland/status/1245704398224994304
“The case against Horton is straightforward: much of what he says, perhaps half, may simply be untrue.”
Yet he carries on regardless.
https://twitter.com/clim8resistance/status/1245707784928321538
Lancet editor Richard Horton urges medical licensing body not to punish doctors in Extinction Rebellion protests
The Lancet is one of the most respected medical journals in the world.
So when its editor, Richard Horton, endorsed nonviolent protests to address a climate emergency, it generated attention far and wide.
Horton’s videotaped statement is available on the website of Doctors for Extinction Rebellion, which is a collective of medical professionals who’ve participated in civil disobedience.
They’ve done this because they see climate change as “an impending public health catastrophe”.
“The climate emergency that we’re facing today is the most important existential crisis facing the human species,” Horton said. “And since medicine is all about protecting and strengthening the human species, it should be absolutely foundational to the practice of what we do every single day.
https://www.straight.com/life/1317926/video-lancet-editor-richard-horton-urges-medical-licensing-body-not-punish-doctors
Lancet Editor: Protesting Climate Change Is a Doctor’s Duty
The editor-in-chief of one of the world’s most prestigious medical journals, The Lancet, is encouraging all health professionals to engage in nonviolent social protest to address climate change in the face of government inaction.
https://nonprofitquarterly.org/lancet-editor-protesting-climate-change-is-a-doctors-duty/
Doctors for Extinction Rebellion is a Doctors collective who, appreciating that Climate change is an impending public health catastrophe, have decided to undertake Civil Disobedience with Extinction Rebellion.
We have carefully considered our position. As a highly respected group of professionals, publicly backing and acting with a group which commits to breaking the law may seem like an unusual move, but we believe that the severity of the crisis is so great that such a decision is justified.
https://www.doctorsforxr.com/
Hmmm, has the virus since January mutated into a more deadly and spreadable form? Or, have the January soothing epidemiology experts like Fauci and Horton mutated into doomsday preaching mindless alarmists to make up for their previous ineptitude? See the next issue of Horton’s Lancet and the next daily White House briefing on COVID-19, featuring nominal M.D., but government bureaucrat first, little Tony Fauci, for a shameless display of more reputation salvaging mutating.
“The disease is way more severe than anybody could actually imagine,” Grayver said. “I cry. I think that’s ok to actually say, the fact that I do allow myself to, at a certain point, feel what this actually means.”
She said that if others could see what she has to witness on a daily basis, people would take the quarantine much more seriously, and no one would ever leave their home.
https://www.nbcnewyork.com/news/coronavirus/you-can-smell-fear-you-can-smell-death-doctor-describes-covid-19-hospital-hell/2359507/
Recommendations of management in SARS-CoV-2 infection of the Polish Association of Epidemiologists and Infectiologists
Authors: Robert Flisiak, Andrzej Horban, Jerzy Jaroszewicz, Dorota Kozielewicz, Małgorzata Pawłowska, Miłosz Parczewski, Anna Piekarska, Krzysztof Tomasiewicz, Dorota Zarębska-Michaluk
Article type: Special article
Received: March 30, 2020.
Accepted: March 31, 2020.
Published online: March 31, 2020.
ISSN: 1897-9483
https://www.researchgate.net/publication/340318173_Recommendations_of_management_in_SARS-CoV-2_infection_of_the_Polish_Association_of_Epidemiologists_and_Infectiologists
In tobacco, but also other plants, and even yeast or cell lines, you can produce vaccines so-called subunit. Such vaccines usually contain one or more virus proteins – most of them are structural proteins, i.e. those that form a virus envelope. What makes them different from attenuated vaccines?
– These particles externally resemble a given virus and cause almost the same immune response as a natural virus. They do not contain genetic material of the virus. Therefore, there is no risk in their case of neither the virus multiplying nor the return of the virus to its virulent form and disease symptoms – the expert explains.
https://www.defenseone.com/technology/2020/03/breaking-weve-got-vaccine-says-pentagon-funded-company/163739/
One way to study the spread of covid19 and whether isolation and other measures are succeeding in limiting its spread, is to look at the increase or decrease in the number of daily deaths from the virus.
The daily deaths from the virus are – in the view of many – a more reliable metric than detected cases, since the latter depends simply on who has and has not been tested, and that is limited and variable. However deaths are a metric that lags 3-4 weeks behind the spread of infection.
Mathematically there are 3 ways you can look at the daily death rate from covid19 in different countries. You can look at the number, the rate of change or slope, or you can look at the acceleration – does the increase or decrease get faster or slower? Does the plotted curve curve upward or downward?
Mathematically this can be expressed in a second order polynomial – the simplest way of expressing a line that is straight or curved. The equation is:
y = a x^2 + b x + c
How does y change with x, or how do daily death numbers change per day? a is the square or quadratic term that gives the curvature of the slope, if it’s positive the curve is upward and vice versa. b is the linear slope component and c just a number.
Here’s a graph of the quadratic term a of daily mortality, for several countries for the last two weeks. Each daily number of deaths was a 3-day average, and the polynomial was fitted to the 7 days (all 3-averaged) up to that date:
https://i.imgur.com/PsuLWOD.png
Here’s the source of the daily mortality numbers as a 3-day rolling average:
https://ourworldindata.org/coronavirus
Remember, these curves are not daily number of deaths, nor are they the slope or linear change with time of daily mortality. They are the “derivative” or the curvature, and indication of if the rate of change is accelerating or decelerating.
Start with the easy one to see, the blue curve for Italy with big amplitude waves. Death rate is – mercifully – decreasing in that country and that is reflected in the bigger area under the oscillating curve that is in the negative region than in the positive. It seems in Italy there was initially fast growth – in Lombardy and the north, which then levelled off, but then further acceleration – the next excursion above the line – reflected new spread in the south of Italy.
That waviness of the curve is present in all countries in the graph. This may reflect the multiple local outbreaks that comprise the covid19 situation in every country. Different outbreaks may be behind the separate waves of acceleration and deceleration of the death rate.
Clustered in the middle and close to zero, and hard to see, are several north European countries – Germany, Belgium and The Netherlands. They seem to follow a similar wave. Curiously their waves match those of Iran, even though Iran is much further developed in its epidemic and deaths are steadily declining.
Spain has a wave that is almost opposite to that of Italy, although like Italy, the good news is that the most recent quadratic is negative and the rate of daily deaths is curving down. The countries with ongoing and accelerating spread appear to be the UK, USA and France.
Note that the quadratic numbers are normalised to the population of each country.
430,000 People Have Traveled From China to U.S. Since Coronavirus Surfaced
Sieve lockdown. Still is.
Science clash: Imperial vs Oxford, and the sex smear that created rival Covid-19 studies
Rivalry began two decades ago when leading lights of Imperial College and Oxford University worked together
Eight years later, Prof Ferguson, then an adviser to the Government and the World Health Organisation, sounded the alarm over swine flu, warning that it could cost up to four million lives globally and floating a study on the anti-viral benefits of closing all UK schools. In the end, schools mostly stayed open and the worldwide death toll was 18,500.
https://www.telegraph.co.uk/news/2020/04/04/science-clash-imperial-vs-oxford-sex-smear-created-rival-covid/
Oxford scientist wins the battle for her reputation
NINE months ago, Dr Sunetra Gupta, a talented scientist and award-winning novelist, was falsely accused of having a relationship with a professor to gain a senior academic post at Oxford University.
Today, her accuser, Prof Roy Anderson (left), one of Britain’s most distinguished scientists, makes a public apology, and Dr Gupta speaks to NATASHA LODER for the first time about her fight to restore her reputation.
Dr Gupta tells how she battled to win a retraction from Prof Anderson because “nobody should be allowed to get away with this. I felt there was no other choice”
https://web.archive.org/web/20030717235217/http://www.warmwell.com/andersonstories.htm
UK FMD Epidemic 2001
WHAT HAS HAPPENED TO OUR INSTITUTIONS?
Roger Windsor’s talk, read on his behalf, to the Central Veterinary Society.
The College and the profession should have refused to act when the direction of the campaign was taken over by politicians, and the Chief Scientist. The CVO stated that he was in control the whole time, but the public perception was that the Chief Scientist and his side-kicks Prof. Roy Anderson and Sir John Krebs had taken over. They decided that killing all animals on neighbouring farms and all animals within three kilometres of an outbreak was the only way to stop the disease, in time for a June General Election. Why anyone should listen to Anderson, a proven liar who was forced to resign his chair at Oxford is beyond me? (Ref for this statement is an article in Private Eye last year) Did he offer the politicians a quick fix ? His mathematical model indicated that a two km kill would be adequate. However, MAFF decided to follow EU advice and stuck to 3 km which more than doubled the number of animals that were killed. Roy Anderson should be called, not the Professor of Epidemiology, but the Professor of Extermination at Imperial College, London. I understand that he subsequently revised his model and came to the conclusion that the virus travelled no more than 500 metres. Too many animals (probably five million) were killed in the name of elections and mathematics. Alan Richardson considers that this was the largest animal experiment ever carried out, and that it was done without a Home Office licence !
https://web.archive.org/web/20041019141754/http://www.warmwell.com/nov11windsor.html
The Swine Flu Panic of 2009
Swine flu kept the world in suspense for almost a year. A massive vaccination campaign was mounted to put a stop to the anticipated pandemic. But, as it turned out, it was a relatively harmless strain of the flu virus. How, and why, did the world overreact? A reconstruction. By SPIEGEL staff.
This agreement could explain why Professor Roy Anderson, one key scientific advisor to the British government, declared the swine flu a pandemic on May 1. What he neglected to say was that GSK was paying him an annual salary of more than €130,000 ($177,000).
https://www.spiegel.de/international/world/reconstruction-of-a-mass-hysteria-the-swine-flu-panic-of-2009-a-682613.html
Following the outbreak of SARS, one thing was certain: Professor Roy Anderson of Imperial College would soon be hitting the headines.
https://web.archive.org/web/20130922025814/http://www.warmwell.com/2may1pe.html
Special report: The simulations driving the world’s response to COVID-19
How epidemiologists rushed to model the coronavirus pandemic
https://www.nature.com/articles/d41586-020-01003-6
Coronavirus professor Neil Ferguson says lockdown may ease next month if people stick to strict social distancing rules
https://www.dailymail.co.uk/news/article-8187041/Coronavirus-professor-Neil-Ferguson-says-lockdown-ease-month.html
Welcome as this news may be, it is a problem for Ferguson who is at best an technical advisor to be making statements about Public Policy which is rightfully a Political Decision
He is also covering his own back as he can say that because of his modelling, disaster was averted, but if people hadn’t complied half a million would be dead. The fact that his numbers were nonsensical in the first place would be swept aside which would also suit the government who paniced at his original report
tonyb
Can we really trust chief scientific officers? – The Times del 11/01/2010 , di Ross Clark
Can we really trust chief scientific officers?
The Times del 11/01/2010 , articolo di Ross Clark
I have an idea how officials could try to get rid of 60 million unwanted doses of swine flu vaccine: put them on eBay with the words “will exchange for a very large pile of grit”.
http://www.agenziafarmaco.gov.it/aifaminesi/201001/articolo_20100111_115257211.htm
Ferguson almost shut down the world wrt Swine Flu earlier. Some of us haven’t forgotten his earlier “projections”
Hi Tony,
Agree that he is covering his back.
Sometimes one has to laugh or one would lose one’s sanity.
At least he hasn’t recommended a 3km cull around infected premises yet !!
brent
Don’t give him ideas. But it would work wouldn’t it?
tonyb
This allowed the researchers to draw two conclusions: “A high viral load in the throat at the very onset of symptoms suggests that individuals with COVID-19 are infectious very early on, potentially before they are even
aware of being ill,” explains Colonel PD Dr. Roman Wölfel, Director of the Bundeswehr Institute of Microbiology and one of the study’s first authors. “At the same time, the infectiousness of COVID-19 patients appears to be linked to viral load in the throat and lungs. In hospitals with limited bed capacity and the resultant pressure to expedite patient discharge, this is an important factor when it comes to deciding the earliest point at which a patient can be safely discharged.” Based on these data, the study’s authors suggest that COVID-19 patients with less than 100,000 viral RNA copies in their sputum sample on day 10 of symptoms could be discharged into home-based isolation.
The researchers’ work also suggests that SARS-CoV-2 replicates in the gastrointestinal tract. However, the researchers were unable to isolate any infectious virus from patients’ stool samples. None of the blood and urine samples tested positive for the virus. Serum samples were also tested for antibodies against SARS-CoV-2. Half of the patients tested had developed antibodies by day 7 following symptom onset; antibodies were detected in all patients after two weeks. The onset of antibody production coincided with a gradual decrease in viral load.
https://www.eurekalert.org/pub_releases/2020-04/c-ub-cvf040320.php
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Mathematically there are 3 ways you can look at the daily death rate from covid19 in different countries. You can look at the number, the rate of change or slope, or you can look at the acceleration – does the increase or decrease get faster or slower? Does the plotted curve curve upward or downward?
This can be expressed in a second order polynomial – the simplest way of expressing a line that is straight or curved. The equation is:
y = a x^2 + b x + c
How does y change with x, or how do daily death numbers change per day? a is the square or quadratic term that gives the curvature of the slope, if it’s positive the curve is upward and vice versa. b is the linear slope component and c just a number.
Yes OK a polynomial is an imperfect representation of what is a log or exponential process, but over a one-week period it is a fair approximation to measure acceleration.
Here’s a graph of the quadratic term a of daily mortality, for several countries for the last two weeks. Each daily number of deaths was a 3-day average, and the polynomial was fitted to the 7 days (all 3-averaged) up to that date:
https://i.imgur.com/PsuLWOD.png
Here’s the source of the daily mortality numbers as a 3-day rolling average:
https://ourworldindata.org/coronavirus
Remember, these curves are not daily number of deaths, nor are they the slope or linear change with time of daily mortality. They are the “derivative” or the curvature, and indication of if the rate of change is accelerating or decelerating.
Start with the easy one to see, the blue curve for Italy with big amplitude waves. Death rate is – mercifully – decreasing in that country and that is reflected in the bigger area under the oscillating curve that is in the negative region than in the positive. It seems in Italy there was initially fast growth – in Lombardy and the north, which then levelled off, but then further acceleration – the next excursion above the line – reflected new spread in the south of Italy.
That waviness of the curve is present in all countries in the graph. This may reflect the multiple local outbreaks that comprise the covid19 situation in every country. Different outbreaks may be behind the separate waves of acceleration and deceleration of the death rate.
Clustered in the middle and close to zero, and hard to see, are several north European countries – Germany, Belgium and The Netherlands. They seem to follow a similar wave. Curiously their waves match those of Iran, even though Iran is much further developed in its epidemic and deaths are steadily declining.
Spain has a wave that is almost opposite to that of Italy, although like Italy, the good news is that the most recent quadratic is negative and the rate of daily deaths is curving down. The countries with ongoing and accelerating spread appear to be the UK, USA and France.
Note that the quadratic numbers are normalised to the population of each country.
In India one Muslim sect (Tablighi Jamaat) disobeyed national secular directives about (international) mass gatherings and (self)isolation:
Rate of doubling of COVID-19 cases is 4.1 days; without Jamaat incident it would have been 7.4, says government https://www.thehindu.com/news/national/rate-of-doubling-of-covid-19-cases-is-41-days-without-jamaat-incident-it-would-have-been-74-says-government/article31262700.ece
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The Open Letter from Professor Sucharit Bhakdi to Chancellor Angela Merkel is now available in German, English, French, Spanish, Russian, Turkish, Dutch and Estonian, other languages will follow.
https://swprs.org/open-letter-from-professor-sucharit-bhakdi-to-german-chancellor-dr-angela-merkel/
A leaked confidential strategy paper of the German government shows that the German government, in conjunction with the media and some scientists, is apparently following a „shock strategy“ to make people afraid of a „worst case scenario“. The general population – for whom the virus is largely harmless – should be warned against „painful suffocation“; likewise, children playing in playgrounds could cause the „painful death“ of their parents.
https://fragdenstaat.de/blog/2020/04/01/strategiepapier-des-innenministeriums-corona-szenarien/
Several German law firms are preparing lawsuits against the measures and regulations that have been issued. A specialist in medical law writes in a press release: „The measures taken by the federal and state governments are blatantly unconstitutional and violate a multitude of basic rights of citizens in Germany to an unprecedented extent. This applies to all corona regulations of the 16 federal states. In particular, these measures are not justified by the Infection Protection Act, which was revised in no time at all just a few days ago. () Because the available figures and statistics show that corona infection is harmless in more than 95% of the population and therefore does not represent a serious danger to the general public.“
http://beatebahner.de/lib.medien/aktualisierte%20Pressemitteilung.pdf
The German historian René Schlott writes about the „Rendezvous with the police state„: „Buying a book, sitting on a park bench, meeting up with friends – that is now forbidden, is controlled and denounced. The democratic safeguards seem to be blown. Where and how will it end?“
https://www.spiegel.de/politik/deutschland/corona-krise-und-buergerrechte-rendezvous-mit-dem-polizeistaat-a-68611322-f4d4-453f-aba5-5ec5a49ae329
“The initial results are excellent so that the admissions in the intensive care unit have been reduced, with shortened hospital stays and radiological and clinical responses that I would dare to define as spectacular. We believe that COVID therapy for pneumonia is corticosteroid therapy at the onset of pneumonia at the stage that we consider mild, particularly in febrile patients from the first week and with analytical abnormalities. Initiating anti-inflammatory therapy prior to the development of severe pneumonia, covering the period of time in which the patient can worsen corticosteroid therapy”
“The OMS made a contraindicated mistake in the use of corticosteroids in patients with COVID infection 19. In this way, this therapy is postponed until a very serious situation in which the therapy is much less effective. Soon we will have data on all this and we will disseminate it but we will disseminate this information inviting you to try this treatment on the patients that I anticipate. Infection Does Not Kill Them Kills The Inflammatory Reaction To Macrophage Activated Infection”
” What we propose and are carrying out with the excellent initial results, ” he continues, “ is to start corticotherapy on the sixth day of the onset of symptoms, keeping it until day 12 so that this inflammatory phase is prevented, that is, the patient who is developing Small infiltrates in chest radiography are at risk of evolving into a distress without our being able to predict which patients will have this evolution or which patients will evolve favorably.
https://www.elperiodicodeaqui.com/epda-noticias/el-hospital-doctor-peset-de-valencia-aplica–con-mucho-exito–en-pacientes-con-coronavirus-una-terapia-antiinflamatoria-con-corticoides/207638
COVID-19 in Proportion?
The British project „In Proportion“ tracks mortality „with“ Covid19 in comparison to influenza mortality and all-cause mortality, which in Great Britain is still in the normal range or below and is currently decreasing.
This part is very important:
“Is the cure worse than the disease?
To deal with the threat of COVID-19 the UK Government has ordered unprecedented shut-downs and quarantines, and many support this in the spirit of “better safe than sorry”. However, this overlooks the fact that shutdowns and quarantines also kill. The economic, social and health costs will almost certainly include:
-Earlier deaths for cancer sufferers due to diagnosis and treatment delays
-Business failures leading to more business failures
-Job losses leading to poor health, social problems and suicides
-Fewer taxpayers available to fund an increasing need for social benefits
-Reduced funding for the NHS and the rest of the public sector
-Lost educational opportunities and disruption to exams and graduations
-Inflation as Government “prints” and “borrows” more, while tax revenues fall
-Pension values reduced by stock-market crashes
-Reduced life expectancy for people moving deeper into poverty”
The link:
http://inproportion2.talkigy.com/
10 countries account for 91% (62,565) of the total global deaths (69,042) in the 206 countries/entities with COVID19 cases.
10 countries account for 91% (62,565) of the total global deaths (69,042) in the 206 countries/entities with COVID19 cases
Obviously a targeted bio weapon then …
It probably follows the air traffic and ability to afford it.
No, it mostly follows testing and ability/will to use it. Take Japan for example:
“Japan was one of the first countries outside of China hit by the coronavirus and now it’s one of the least-affected among developed nations. That’s puzzling health experts.
Unlike China’s draconian isolation measures, the mass quarantine in much of Europe and big U.S. cities ordering people to shelter in place, Japan has imposed no lockdown. While there have been disruptions caused by school closures, life continues as normal for much of the population. Tokyo rush-hour trains are still packed and restaurants remain open.”
“Japanese officials say they’re confident in their testing regimen. “We don’t see a need to use all of our testing capacity, just because we have it,” health ministry official Yasuyuki Sahara said at a briefing Tuesday. “Neither do we think it’s necessary to test people just because they’re worried.””
https://www.japantimes.co.jp/news/2020/03/20/national/coronavirus-explosion-expected-japan/
So edimbuk, sounds like you are from former yugoslavia, maybe Montenegro? So what’s your solution? Testing? But Japan as you say, isn’t doing it,
not being funny but don’t the Japanese wear masks all the time anyway…?
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A general principle of passive antibody therapy is that it is more effective when used for prophylaxis than for treatment of disease. When used for therapy, antibody is most effective when administered shortly after the onset of symptoms. The reason for temporal variation in efficacy is not well understood but could reflect that passive antibody works by neutralizing the initial inoculum, which is likely to be much smaller than that of established disease (5). Another explanation is that antibody works by modifying the inflammatory response, which is also more easily achieved during the initial immune response, a stage that may be asymptomatic (6). As an example, passive antibody therapy for pneumococcal pneumonia was most effective when administered shortly after the onset of symptoms, and there was no benefit if antibody administration was delayed past the third day of disease (7).
https://www.jci.org/articles/view/138003
Imperial’s Neil Ferguson: “We don’t have a clear exit strategy”
https://ftalphaville.ft.com/2020/04/04/1586015208000/Imperial-s-Neil-Ferguson—We-don-t-have-a-clear-exit-strategy-/
UK coronavirus deaths could reach 7,000 to 20,000: Ferguson
“We don’t have the ability right now to measure how many people have been infected, that will come with antibody tests, and so we are making statistical estimates of that and those are subject to a certain degree of uncertainty.
“We think it could be anywhere between about 7,000 or so up to a little over 20,000.”
https://www.thetelegram.com/news/world/uk-coronavirus-deaths-could-reach-7000-to-20000-ferguson-433941/
When will the UK lockdown end? The four potential exit strategies
https://www.telegraph.co.uk/news/2020/04/07/when-lockdown-end-uk-exit-strategy-what-options/
Revealed: Coronavirus exit strategy of mass testing and contact tracing
Government adviser sets out path forward for Britain once case numbers begin to fall
https://www.telegraph.co.uk/news/2020/04/05/revealed-coronavirus-exit-strategy-mass-testing-contact-tracing/
Nic, have you seen the materials released by the state of Minnesota in regard to its model. They are here https://mn.gov/covid19/data/modeling.jsp, with links at the bottom of that page to a powerpoint containing mitigation scenarios, a technical paper which includes at least some of the formulas, and other material. The model appears to be better constructed than the IMHE one, for example, although suffering the same issues with regard to inadequate data to make good assumptions on some key parameters.
Very interesting to note, however, that in the scenario modeling on different mitigation of spread strategies, the outcomes in terms of death are basically the same. So why use a general shutdown when a targeted one performs as well. it also appears that almost all deaths are due to the dreaded “overwhelm hospital resources” situation, which is unlikely due to the ability to quickly create “ICU” beds in general wards.
In any event be very interested in your analysis of the model. Thanks.
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Six questions that Neil Ferguson should be asked
https://www.spectator.co.uk/article/six-questions-that-neil-ferguson-should-be-asked
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Perhaps second rate mathematician should leave medicine to qualified doctors.
Neil Ferguson should loose his job and face charges for being a lying alarmist. A long stay in jail will help him gain a sense of proportion. The fake pandemic hoax fed of his unrealistic modelling causing massive loss (financial but mainly human suffering).
The trouble is that the govt will have to support him otherwise it is an admittance they didn’t take wider advice and so took the wrong course of action
tonyb
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