Coronavirus what’s going on with “numbers” and the “modeling”? Do we need a closer look and a do over of the “model” and the “numbers”?

[pattismith]

Yes, see table 2 in this study of the Diamond Princess outbreak. There were more older people on the ship than you find in the general population, so the Diamond Princess death rate of 1% is actually higher than the real world death rate.

Thank you, the Diamond Princess is a really interesting study indeed. Do you know how many people were in the boat?
On the other hand it's biaised, and they already pointed out :

"There were some limitations to our analysis. Cruise ship passengers may have a different health status to the general population of their home countries, due to health requirements to embark on a multi-week holiday, or differences related to socio-economic status or comborbities. "

it's not difficult to imagine that people undertaking that cruise at age sup to 80 years are probably more healthy than people of same ages in the general population.

 

[Hip]

Do you know how many people were in the boat?

Table 2 says 3711 people on the ship. They tested nearly everyone, and there were 301 symptomatic cases, and 318 asymptomatic cases in total.

it's not difficult to imagine that people undertaking that cruise at age sup to 80 years are probably more healthy than people of same ages in the general population.

Possibly, but cruise holidays are relaxing and laid back, so I imagine even those with health conditions would be capable of cruise trips.



What I found interesting in the data from table 2 of the study is that in younger people (under 50), there were very few asymptomatic cases; for these younger people, if they caught the virus, they usually showed definite symptoms.

But for the older people (50 and over) there were more asymptomatic cases than symptomatic. For example, in the 60s age range, there were 101 asymptomatic cases and 76 symptomatic cases.

I am not sure of the significance of this, but maybe it relates to a stronger and more active immune system in the younger people.

 

[pattismith]

Table 2 says 3711 people on the ship. They tested nearly everyone, and there were 301 symptomatic cases, and 318 asymptomatic cases in total.

What I found interesting in the data from table 2 of the study is that in younger people (under 50), there were very few asymptomatic cases; for these younger people, if they caught the virus, they usually showed definite symptoms.

But for the older people (50 and over) there were more asymptomatic cases than symptomatic. For example, in the 60s age range, there were 101 asymptomatic cases and 76 symptomatic cases.

I am not sure of the significance of this, but maybe it relates to a stronger and more active immune system in the younger people.

They said that they did 3,063 tests but didn't said if they tested several times the same person or if 3 063 tests meant 3 063 people tested among the 3 711 people on the ship, and they said they started to test older people.

So it's not possible to draw any conclusion about the proportion of asymptomatic infected people. Only serologies will be able to draw the full picture.
They may have tested all the old people (perhaps several times?), and less people under 50.....We just don't know.

 

[Hip]

They said that they did 3,063 tests but didn't said if they tested several times the same person or if 3 063 tests meant 3 063 people tested among the 3 711 people on the ship, and they said they started to test older people.

So it's not possible to draw any conclusion about the proportion of asymptomatic infected people. Only serologies will be able to draw the full picture.

Good point, I guess it would depend on the timing of those tests.

 

[Wishful]

I wonder if the lessons learned from forest fire prevention should be brought up in discussions about dealing with pandemics. For forests, it turned out to be a really bad idea, expensive to the environment in the long term. How much effort and resources should be spent to delay death for just a few more days/weeks/months, especially when the people are simply bed-bound and have nothing to do but wait for death? Resources are limited, so any used to delay death briefly isn't available for people who need medical help to continue on to a long productive life.

An interesting chart or list to see would be the average expected life expectancy of the fatalities if C19 hadn't ended their lives then. Including the quality of their remaining lives would be useful too.

 

[Hufsamor]

I suppose, in the end, the important number will be:
How many deaths comparing to a country's number of inhabitants.

I'm not too good at math, but I've tried to do some math here.
In Norway, we are 5,3 million people.
Each year at least 900 persons dies from the flue. (0,1 percent of the flue-cases)
I do believe this means 0,02% of the Norwegian population dies each year of the flue.
(Some years twice as many)
The worldometer shows deaths in each country according to 1 mil population.
And now it's too many 0000 for me, I'm a bit lost, but this would mean that when a country reach 200 deaths pr million inhabitant, it has lost as many people as to an ordinary flue?

https://www.worldometers.info/coronavirus/#countries

By the way: @percyval577 , I've been pondering my head of, why the number of deaths seems to be so low in Germany! I was very happy to read your explanation.
Are your schools and kindergartens open?

 

[pamojja]

I'm not too good at math, but I've tried to do some math here.
In Norway, we are 5,3 million people.
Each year at least 900 persons dies from the flue. (0,1 percent of the flue-cases)
I do believe this means 0,02% of the Norwegian population dies each year of the flue.
(Some years twice as many)
The worldometer shows deaths in each country according to 1 mil population.
And now it's too many 0000 for me, I'm a bit lost, but this would mean that when a country reach 200 deaths pr million inhabitant, it has lost as many people as to an ordinary flue? Not even Italy is there yet (or at least- not with the counted deaths)

I calculated it yesterday for all countries affected in this thread after 9 days of a first simpler calculation: https://forums.phoenixrising.me/thr...ou-feel-general-discussion.79429/post-2265682

Just did a quick and rough calculation.

Total populations: https://www.laenderdaten.de/bevoelkerung/einwohner.aspx
Flu and pneumonia mortality (2017) per 100000: https://www.worldlifeexpectancy.com/cause-of-death/influenza-pneumonia/by-country/
Covid-19 mortality: https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

For a fast calculation divided the yearly usual flu mortality into 4 = the 3 months this 'epidemic' exist. And compared it to the actual mortality from this alledgedly new virus:

The only epidemic till today seems to be happening in Italy. But if Italy just drew the bad luck this year, as the UK did in 2017 with 23.01 flu-deaths per 100000, then still nothing out of the ordinary. Soon we'll know.

15 pages of this thread and 9 days later:

This time I ordered the table in order of the first reported covid deaths. All countries with more than 999 postive tested included. Only exception are countries with yellow background. Calculated the average death-rate per 100 000 for all these countries at 24.45. With this average the second green column in percent from average was calculated. For the whole world the average death-rate for influenza/pneumonia would actually be 41.35 per 100 000. Almost double, therefore I marked only those results which exceeds 200% from normal.

What is remarkable till now is, that all those countries with excess pneumonia deaths have it in certain regions only! (in the table only added Italy without the regions of Lombaria and Emilia Romagna as example; https://www.bing.com/covid/ does break down the number in regions for countries mostly affected.)

While the vast majority of countries, including most without rigorous lockdowns (asterix on the right with gray background, accordinging to wikipedia, are far from any epidemic.


Here what week 12 (ending on 22th of March) looked like for Europe in respect to total excess mortality:

And that’s the comparison of all respiratory diseases (all pathogens) with the last 3 years for Germany (Robert Koch Institute) of this rather mild season:

 

[pattismith]

@Hip the only think we can conclude is the ability of older people to have asymptomatic covid. We can see that between 60 and 79 old, they had more asymptomatic infections than symptomatic. Between 80/89 it was 50/50% and people over 90 seem more susceptible to symptomatic infection.
It just means that the old age is not a fatality, if you are well cared, well feed, if you take good supplements for your immune system, you can hope for even unnoticed infection!

Yes.

Field Briefing: Diamond Princess COVID-19 Cases
View attachment 36642

 

[percyval577]

Are your schools and kindergartens open?

No, they are closed. Since two weeks they are now, I think.

Chancellor Merkel announced on Friday that the lockdown is been prolonged for now until April 20th. But I think there was already a discussion if this is going to be continued for schools and kindergartens, even a discussion about the whole thing has come up a bit two days ago.

The situation is of course still unclear.

 

[pattismith]

@pamojja
how do you interpret this table you posted?
I understand it's the deaths from pneumonia and flu, is it? Do you have explainations?

 

[pamojja]

Actually that was the only graphic not about mortality, but all acute repiratory diseases by all pathogens combined, up to 22nd of March. Therefore can't tell anything about excess mortality - as the graphics before that did - but the incidence of acute respiratory diseases this year, compared to the last 3 years.

 

[pattismith]

Actually that was the only graphic not about mortality, but all acute repiratory diseases by all pathogens combined, up to 22nd of March. Therefore can't tell anything about excess mortality - as the graphics before that did - but the incidence of acute respiratory diseases this year, compared to the last 3 years.

do you have some personal opinion about that graphic I mean?

 

[Wally]

This 3/29/2020 article from the Washington Post discusses some of the things learned three+ months out from the start of the virus. See, https://www.washingtonpost.com/heal...a-b148-e4ce3fbd85b5_story.html?outputType=amp

Three months into this pandemic, scientists are coming to understand the novel coronavirus. They know, for example, that as horrible as this virus is, it is not the worst, most apocalyptic virus imaginable. Covid-19, the disease caused by the virus, is not as contagious as measles, and although it is very dangerous, it is not as likely to kill an infected person as, say, Ebola.

But there is one critically important, calamitous feature of SARS-CoV-2: the novelty. When it jumped from an animal host into the human population sometime late last year, no one had immunity to it. That is one reason the new coronavirus is not comparable to a harsh strain of the flu going around. . .

At the genetic level, the new virus is not terribly different from the SARS virus that emerged in China in 2002 — which is why the new one has the derivative name SARS-CoV-2. SARS killed nearly 1 in 10 patients.

But people with SARS infections did not shed the virus until they were already quite sick, and victims were typically hospitalized. SARS was snuffed out after causing about 8,000 infections and 774 deaths worldwide.

That successful fight may have led to some complacency; researchers say funding for SARS research dried up in recent years.

“We thought we cured it. We thought the virus disappeared. Well, the virus didn’t disappear, did it?” said Michael Buchmeier, a UC Irvine virologist who has studied coronaviruses for three decades.

 

[pamojja]

do you have some personal opinion about that graphic I mean?

Less acute respiratory diseases this year than last year, and combined with the mortality data from the last 3 years, by far the least mortality too. But these numbers still might change. Or remain that way.

At this point no reason to fear this virus, but rather the economic implications of hugely increased mortality from the measures taken against. Which other then the final impact by the virus, by now have become a certainty:

https://drmalcolmkendrick.org/2020/03/29/a-health-economic-perspective-on-covid-19/

 

[pattismith]

Less acute respiratory diseases this year than last year, and combined with the mortality data from the last 3 years, by far the least mortality too. But these numbers still might change. Or remain that way.

The curve seems less acute his year, could it be the health measures imposed to fight the covid that induce a lowering of respiratory diseases in general, assuming less contagious agents like influenza will probably be less prevalent this year?

 

[Wishful]

Dr. Kendrick's article was just what I was expecting. There are methods for deciding whether medical intervention is--or is not--financially worthwhile for society, and the governments are ignoring them. After all, they're spending taxpayer's money, not their's.

 

[pattismith]

Actually that was the only graphic not about mortality, but all acute repiratory diseases by all pathogens combined, up to 22nd of March. Therefore can't tell anything about excess mortality - as the graphics before that did - but the incidence of acute respiratory diseases this year, compared to the last 3 years.

Dr Raoult Team noticed something similar in South France!
Here a blue print published online two days ago from IHU Marseille


Decreased mortality associated with respiratory viral infections between December 2019 and March 2020 compared to previous year, South east France


Author list: Audrey GIRAUD-GATINEAU1,2,3 § , Philippe COLSON1,4 §, Marie-Thérèse

JIMENO5, Christine ZANDOTTI1, Laetitia NINOVE1,6, Céline BOSCHI1,4, Jean-

Christophe LAGIER1,4, Bernard LA SCOLA1,4, Hervé CHAUDET1,2,3, Didier

RAOULT1,4*

...

The University Hospital Institute Méditerranée Infection performs real-time

surveillance of all infections diagnosed in public hospitals of Marseille, Southeastern France

3;4. This includes the count of the deaths associated with any diagnosed infection. Here, we

compared the mortality associated with diagnoses of respiratory viruses during colder months

overlapping 2018-2019 and 2019-2020.

......... Between week 47 of 2018 and week 11 of 2019, 72 patients

died after being diagnosed with a respiratory virus (Table 1). They represented 0.16% of the

43,909 patients hospitalized during this period and 6.9% of the 1,042 who died. Deaths

occurred in 38 of the patients diagnosed with Influenza A virus (1.7%), which was the

respiratory virus associated with the highest number of deaths. In addition, deaths occurred in

19 of the patients diagnosed with rhinoviruses (1.8%), and in 13 of those diagnosed with

respiratory syncytial virus (RSV) (1.1%). Respiratory samples had not been tested for

coronaviruses and parainfluenza viruses in routine clinical practice, but all those tested

retrospectively from dead patients were negative. In comparison, during the same period of

3 winter 2019-2020 (between week 47 of 2019 and week 11 of 2020), 44 patients died after

being diagnosed with a common respiratory virus. They represented 0.11% of the 52,624

patients hospitalized during this period and 5.6% of the 985 who died. They included 6 of the

patients diagnosed with influenza A virus (0.4%), 2 of those diagnosed with influenza B virus

(0.2%), 7 of those diagnosed with RSV (0.7%), and 4, 2 and 1 of those diagnosed with human

coronavirus-HKU1 (1.7%), NL63 (1.2%) and OC43 (1.0%), respectively (Table 1).

Additionally, we tested since the 29th of January 13,089 patients for SARS-CoV-2 using a

reverse transcription-PCR assay 5, and diagnosed 1,416 infections (11%). Of these infected

patients, 11 (0.8%) died; 8 were 82 year-old and 5 were men.

Overall, 55 patients died after being diagnosed with a respiratory virus during colder months of 2019-2020 so far, versus 72 the year before.

The proportion of respiratory virus-associated deaths among hospitalized

patients was thus significantly lower in 2019-2020 than in 2018-2019 (105 per 100,000

people vs 164 per 100,000 people; p= 0.007, Yates-corrected chi-square test). This proportion

among patients who died of any cause at hospital was also lower, although not significantly;

Hence, we observed 39% less deaths associated with common respiratory viruses

during colder months of 2019-2020 compared to 2018-2019. This was essentially due to

significant decreases of influenza A virus (-84%; p<10-3) and RSV (-46%; p=0.055)-

associated deaths, and was not compensated so far by SARS-CoV-2-related deaths. Excess

mortality associated with influenza virus infections is estimated to be 5.9 per 100,000 people

worldwide and 5.3 per 100,000 people in Europe 6. In comparison, mean mortality associated

with SARS-CoV-2 infections is estimated to be 0.3 per 100,000 people worldwide and 2.2 per

100,000 people in Western Europe (https://www.mediterranee-infection.com/covid-19/).

These data and our findings allow putting into perspective the death burden of SARS-CoV-2

infections….

 

[andyguitar]

Thats very interesting @pattismith

 

[Mouse girl]

One thing to bear in mind is that in the US for instance, our numbers will be off due to many people not having the finances to go to the hospital or seek care. I don't know the process of figuring out who died of what if they person wasn't tested while they were alive. For many people who know that they may not get a vent and might die, they might choose to not put their families members in financial ruin by raking up hundreds of thousands if not more in hospital bills. I can't even imagine what the cost of being in the ICU for weeks on a vent. This illness will absolutely cripple families due to medical bills for those lucky enough to go to the hospital or get care. We are the richest country in the world and yet, our hospitals are like third world hospitals where it's starting to peak with nurses and doctors not having proper masks or gowns etc. Sadly, I don't think most people's attitude will even change about the right to health care in this country. I would imagine lots of health care workers will leave health care after this ends because they are just being treated as if their lives don't matter.

 

[Hip]

Diamond Princess death count has now gone up to 11. And the latest figure for the total number infected is 696. Ref: 1

So that's a death rate of 1.6%. But as mentioned earlier, there were lots of older people on the ship, so the real world death rate will be lower.