WRT C19, I have been focusing on deaths, while continually raising the flag that there are going to be follow-on effects of those who have sustained lung, heart, kidney, or even neurological damage, which we can't yet measure, so we say little about. I predict it's going to be important, year over year. But i get why things that aren't easily measured get shoved to the back. I do it myself.
I have tended to dismiss number of cases as much of an indicator, because that is deeply related to how many tests we do. However, ICU census is not dependent on number of tests, and may be something worth noting at this point. We are better at treating this illness at present, so fewer people are dying, and that's a good thing. But ICU admissions are not a good thing, even if people are surviving who might not have a couple of months ago. We don't have a good apples-to-apples way of comparing that to Hong Kong Flu in 1957 or 1969, or at least, I don't know anything sensible about that.
I think deaths are still the key number. How many deaths we would have had if we hadn't done x, or y, or z is unknown. A few more? A lot more? We tend to follow our prejudices on such things. Yet I think we should at least keep in the back of our minds the idea that some of these ICU cases would have been deaths not long ago. The overall news continues to be generally good, though there are locations where things are bad right now.
Tom Bridgeland, I know you come by occasionally. Please weigh in.
11 comments:
I've been watching my county and another county in the state that has a similar population number and density. The test numbers are close -- the deaths are not. Seven in my county, 137 in the other. The difference seems to be in major industries and education levels, which are definitely related. Far more people in the county with the higher death numbers work in industries not compatible with working from home and that is, I think, directly related to the education level.
Also (but off topic), I've never seen (or heard) a 4th of July like this one in my community. It's always been better to stay at home here and watch from the driveway than to try to go to see a legal fireworks display -- rocket scientists and engineers are a dime a dozen around here and they like to show off a little. This year, it was two hours instead of one and there were, I'm guessing, 3-4 times the number of participants. Or the regular participants bought 3-4 times more fireworks. There are hills (the locals call them mountains) on two sides and the constant echoes of the booms were window-rattling in some neighborhoods. The full moon and distant lightning were beautiful too. Today on nextdoor.com, the few complainers were pretty much shut down with "Deal with it" comments.
"Britain recorded 65,000 more deaths than usual in the past three months as the coronavirus ravaged the country but numbers are now returning to normal, new data showed Tuesday.... By any measure, Britain has suffered the deadliest coronavirus outbreak in Europe."
https://medicalxpress.com/news/2020-06-excess-deaths-uk-figures.html
"Health Secretary Matt Hancock has said up to 80% of people who test positive for coronavirus in the UK don't have symptoms."
https://news.sky.com/story/coronavirus-up-to-80-of-covid-19-patients-have-no-symptoms-health-secretary-says-12004987
About one in 1500 of all U.K. citizens have died due to the pandemic.
285 thousand have tested positive, so that would mean about 1.5 million infected.
Of those infected, 44-65 thousand have died, for a fatality rate of about 3-4%.
Britain initially thought to allow the population to reach herd immunity, but the results would have been devastating, with hundreds of thousands dead and millions hospitalized. In any case, populations rarely achieve herd immunity. Rather, diseases will come and go in different areas. That's even assuming long term immunity is possible.
Asymptomatic carriers means that having lost control of the virus, it will be much harder to control going forward. Nevertheless, Britain has greatly reduced the spread. One further point, people will take action even if governments don't, but coordinated action early is much preferable to belated and stumbling steps.
http://www.zachriel.com/blog/DailyCovid-US-UK.png
US deaths/million population, as of 6 July 2020 - 402
UK deaths/million population, as of 6 July 2020 - 652
https://www.worldometers.info/coronavirus/#countries
Belgium has done worse than the UK. Spain and Italy are comparable. Sweden will move into that territory in a month or so. We don't know what the real numbers are in China, Russia, and Iran. Brazil and Mexico are both climbing rapidly.
The NYC metro area skews the American numbers somewhat - the shared air of public transportation (including taxis, Uber) plus semi-public shared air in elevators, apartment and office hallways - plus huge amounts of domestic and international travel leading up to the pandemic. How people from other regions think their governors would've dealt with that is a grim overlook on their part. Yet even if you take that out, the US still doesn't quite get down to the level of Canada in deaths per million. Cities are spreaders, and I still believe viral load is part of that problem.
At this point and perhaps forever, it is impossible to believe the numbers. We know they skewed them higher here in the US to slap Trump and EVERY death no matter what was the real cause was labeled as due to Coronavirus if it was present. Turns out that sucker is the flu virus and SARS *same thing* so false positive literally burst the limits of containment.
The scientists burned their credibility here like nowhere else in history. Every single utterance appeared gamed for publicity and to damage the ruling party. It did damage. I wouldn't believe a scientist now about ANYTHING he / she didn't have a valid Ph.D in and yeah, I get to decide if it's valid.
That issue about President Trump citing a drug regime that appeared to work and was hounded to death worldwide seems now to be truth all the time and so how many tens of thousands of those deaths will be due to the influence of pure political bile and animus against a man who simply spoke from the "BEST SCIENCE HE HAD AVAILABLE AT THE TIME?"
I thought the war between radiologists and nuclear medicine doctors was over-the-top. Maybe that was because they were in the family.
HMS Defiant, you speak in absolutes, but have no evidence to back up your claim that other causes of death are being attributed to COVID-19. Can you provide data showing this is true beyond "we know"? Asking as a scientist with a (maybe) valid PhD.
I agree with Doug on that. If one thinks we went overboard on believing scientists, we have gone much farther overboard not believing them. The claim is made often on conservative sites that the CoVid numbers are inflated, but the opposite is likely true at this point. Even though all infectious diseases are down because of people being home and having less contact, we still have thousands of excess deaths over previous years. Pneumonia in particular is much higher. I wrote about it in May and there was good discussion. The CoVid death stats are likely a lowball.
https://assistantvillageidiot.blogspot.com/2020/05/inflated-death-statistics.html
Good information is out there, and not all scientists concerned have soiled themselves.
Think of ER stays and deaths as "casualties"
A little late to the conversation, but...
Here in Illinois the situation is much improved. Raw numbers are way down, and IMO case severity is down too. We went from 3 full units, ICU, stepdown ICU and a critical care unit (where I usually work) all nearly full of little but Covid patients. Personally I have gone from caring for 5 covid patients a night at the peak, to one, two or occasionally zero.
We are now testing every patient admitted to the hospital, and there are several drive through testing centers in town, so there is no shortage of testing at all.
Case severity is down, due in part to our improved skills and in part to some drugs that appear to help. No longer seeing the rapid and scary descent from ambulatory and maintaining O2 levels to 'Oh hell he's on 12 liters of O2 and his O2 blood saturation is 70% and falling', all in the space of one shift. Have not seen that personally in weeks.
Anecdotally, in addition to the well-known elderly and co-morbidity patients, the patients who seem to suffer the worst are the beefy, muscular, physically active men. Not sure why this is, but they just seem to have a harder course. This is based on my personal observation of relatively few cases, so it could easily be a fluke.
Re the politics. Recently we are hearing a lot about the situation in Texas. I have a daughter there so follow the numbers fairly closely. Even now, with all the hype, TX numbers remain much lower than Illinois numbers at its peak. Yes, they are having a spike upwards. So far it is nowhere near what we saw in IL, NY or NJ and the other hard-hit states. It is, for now, politically-motivated hype.
Re recording deaths as covid deaths regardless of other factors. Well, maybe some of that happened. Docs have to put something in that box, and if the patient was admitted for covid, and died drowning in their own fluids, then I am fine with that.
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