Part II: Is this “just a bad flu”? (deaths, ventilators, and estimates)
[NOTE: Part I can be found here.]
Flu (otherwise known as influenza) has been around far longer than COVID. Flu comes every year and it kills a lot of people.
So one might think that we know a great deal about flu; for example, that the number of flu deaths per season would be known if not precisely, then at least fairly well, because everyone who has a very serious case would be tested for it. But actually, flu deaths are always estimated, and there are good reasons for that:
First, states are not required to report individual flu illnesses or deaths among people older than 18 years of age to CDC. Second, influenza is infrequently listed on death certificates of people who die from flu-related complications. Third, many flu-related deaths occur one or two weeks after a person’s initial infection, either because the person may develop a secondary bacterial co-infection (such as bacterial pneumonia) or because influenza can aggravate an existing chronic illness (such as congestive heart failure or chronic obstructive pulmonary disease). Also, most people who die from flu-related complications are not tested for flu, or they seek medical care later in their illness when influenza can no longer be detected from respiratory samples. Sensitive influenza tests are only likely to detect influenza if performed within a week after onset of illness. In addition, some commonly used tests to diagnose influenza in clinical settings are not highly sensitive and can provide false negative results (i.e. they misdiagnose flu illness as not being flu.) For these reasons, many flu-related deaths may not be recorded on death certificates. These are some of the reasons that CDC and other public health agencies in the United States and other countries use statistical and mathematical models to estimate the annual number of flu-related deaths.
Flu deaths in children are slightly different though because these are nationally notifiable, which means that individual flu deaths must be reported to the Centers for Disease Control and Prevention. States report flu-related child deaths in the United States through the Influenza Associated Pediatric Mortality Surveillance System. However, even deaths in children may be underreported, for many of the same reasons listed above.
You may have noticed that there are some similar problems with COVID reporting, in particular the aggravation of existing chronic illnesses muddying the waters of cause of death.
All flus are far from equal in their lethality or their symptoms, as I wrote in Part I. But flus tend to have certain basics, and COVID-19 has some resemblances to these basics in terms of symptoms, especially in mild cases – and similarities in the manner in which people die and also the co-morbidities that often help lead to their deaths.
There is very real complexity and difficulty in trying to design a system that can tell us how many flu deaths we have. This isn’t an issue I’d ever thought about prior to the COVID-19 pandemic, and I would guess most of you hadn’t, either. However, I’ve thought about it a lot ever since COVID became a big big deal, because it’s clear that ascribing a death to COVID isn’t a simple matter either. The criteria can vary a great deal, and it’s also tempting to compare the COVID death rate to the flu death rate and try to draw conclusions. And yet both of those rates are hard to pin down.
I also have thought about this topic for personal reasons. Several people with whom I was very close have died (or in the case of one, nearly died) in ways similar to those reported with COVID-19, although their deaths were several years ago.
I’ll tell you the story of one of these friends who died. She was in her mid-60s and had a pre-existing condition but had been doing pretty well for years. Then she got what seemed like a mild flu.
I don’t think she was ever tested for flu; at least, not that I know about. She had some typical flu symptoms but nothing at all major, and was functioning quite well. The suddenly one afternoon, she became confused and was having trouble breathing. He husband immediately took her to the ER that was about three minutes from their home.
She had walked to the car, but by the time they got there three minutes later, she was unable to walk out of the car. That was the detail that seemed particularly vicious and terrifying to me. She was taken (by wheelchair) into the ER, and immediately put into an induced coma and placed on a ventilator. Doctors had determined that she was suffering from ARDS, something I’d never heard of prior to that:
Causes may include sepsis, pancreatitis, trauma, pneumonia, and aspiration. The underlying mechanism involves diffuse injury to cells which form the barrier of the microscopic air sacs of the lungs, surfactant dysfunction, activation of the immune system, and dysfunction of the body’s regulation of blood clotting. In effect, ARDS impairs the lungs’ ability to exchange oxygen and carbon dioxide…
The primary treatment involves mechanical ventilation together with treatments directed at the underlying cause. Ventilation strategies include using low volumes and low pressures. If oxygenation remains insufficient, lung recruitment maneuvers and neuromuscular blockers may be used. If this is insufficient, extracorporeal membrane oxygenation (ECMO) may be an option. The syndrome is associated with a death rate between 35 and 50%.
Globally, ARDS affects more than 3 million people a year.
See that death rate? It’s brutal, absolutely brutal. You also might recognize the similarly of her story to that of the unfortunate COVID-19 victims who wind up on ventilators. The situation is even more puzzling with COVID-19, though, because it’s emerging that although COVID deaths may resemble those like hers, leading from flu to ARDS, COVID-19 might be different in important ways:
In a letter last week in the American Journal of Respiratory and Critical Care Medicine, researchers in Germany and Italy said their Covid-19 patients were unlike any others with acute respiratory distress. Their lungs are relatively elastic (“compliant”), a sign of health “in sharp contrast to expectations for severe ARDS.” Their low blood oxygen might result from things that ventilators don’t fix. Such patients need “the lowest possible [air pressure] and gentle ventilation,” they said, arguing against increasing the pressure even if blood oxygen levels remain low. “We need to be patient.”
I’m not a doctor and don’t have a deep understanding of this issue, but I’m aware that lower pressure is indicated in non-COVID ARDS as well:
Recent studies have shown that high tidal volumes can overstretch alveoli resulting in volutrauma (secondary lung injury). The ARDS Clinical Network, or ARDSNet, completed a clinical trial that showed improved mortality when people with ARDS were ventilated with a tidal volume of 6 ml/kg compared to the traditional 12 ml/kg. Low tidal volumes (Vt) may cause a permitted rise in blood carbon dioxide levels and collapse of alveoli because of their inherent tendency to increase shunting within the lung…
Low tidal volume ventilation was the primary independent variable associated with reduced mortality in the NIH-sponsored ARDSnet trial of tidal volume in ARDS.
More on ventilators and COVID:
To be “more nuanced about who we intubate,” as she suggests, starts with questioning the significance of oxygen saturation levels. Those levels often “look beyond awful,” said Scott Weingart, a critical care physician in New York and host of the “EMCrit” podcast. But many can speak in full sentences, don’t report shortness of breath, and have no signs of the heart or other organ abnormalities that hypoxia can cause.
“The patients in front of me are unlike any I’ve ever seen,” Kyle-Sidell told Medscape about those he cared for in a hard-hit Brooklyn hospital. “They looked a lot more like they had altitude sickness than pneumonia.”
We obviously have a lot to learn, and quickly. And not just about COVID, but about flu as well.
[NOTE: And now we also have people wondering whether some of the spike in flu deaths during late December and January may have been COVID-19 mislabeled as flu.]
Funny how this information just popped up.
Take a look a this at–https://www.nationalreview.com/news/u-s-diplomats-warned-about-safety-risks-in-wuhan-labs-studying-bats-two-years-before-coronavirus-outbreak/
Not exactly on topic, but relevant nonetheless–
Pelosi wielding–and not for the first time–her supposed Catholicism, and her fake “religiosity” as a hammer with which to bludgeon Trump.
The falsity and hypocrisy on display here is just nauseating.
See https://www.thegatewaypundit.com/2020/04/report-pelosi-calls-trump-handling-coronavirus-almost-sinful-house-not-session-may-4/#post-comments
Years ago, WHO doubled the number of AIDS cases in Africa by enlarging the definition. Whether this did anybody any good is a tough question. Unless we figure that AIDS gets more attention and funding than the local combination of various diseases and lousy nutrition known, in whatever local combination, as “chronic wasting disease”. For the ordinary first-worlder, knowing the difference is unlikely.
I have heard reports that the feds will reimburse hospitals for C19 expenses not covered by insurance. Given the confusion Neo explains, and the directives to list “died of” when the best you have is “died with”, and the justifiable righteousness of a hospital working itself to…in some cases literally…death with inadequate resources made up by inhuman demands on staff, we could have some slackness in coding.
The downstream result will be–there only being so many deaths to go around–fewer deaths from heart issues, neurological issues, pulmonary issues, etc.
Take away is that there will be sufficient mathematical confusion to fuel disputes affecting politics, funding, political liberty, and future research.
I think the biggest difference between Covid-19 and previous flu epidemics is that this time, one-third of the nation is suffering from the underlying condition known as TDS.
Snow. I suspect nobody takes Pelosi’s fake religiosity seriously at all. She obviously doesn’t. If she were a better hypocrite, she might have some chance at fooling some of the people. There are always those who find it politic to pretend to believe one or another impossibility, so there may be some nodding righteously along with her. But both she and they need to go to confession afterwards.
Some people appear to disagree with the CDC guidance about reporting deaths in which Covid-19 is a cause of death, but I haven’t noticed that anyone provided the guidance with which they disagree.
Here is the CDC page on which the “preliminary guidance” was issued on March 4 and the formal guidance was issued on April 2. Scroll down to the links to those pdfs.
https://www.cdc.gov/nchs/nvss/covid-19.htm
What is objectionable about that guidance?
I see no problem with it at all.
If I may offer an analogy, suppose the villain shoves you off a cliff and you die instantly upon impact with the earth’s surface after the fall. Isn’t the villain a cause of your death? The fall and resulting acceleration obviously play an important part, and it might be said that the instant deceleration upon impact is the immediate cause of death. But isn’t the villain’s shove at least an underlying condition and a cause of death?
I recently looked at the CDC estimate for flu deaths this season. It was between 20some thousand and 60some thousand. That’s for a disease we’ve been tracking for generations.
Bloomberg, by the way, is reporting over 25,000 COVID-19 deaths since the first was reported on March 1. Over half are in New York and New Jersey, with Michigan and New Orleans leading the rest of the country with over 1,000 each and I believe about half the states have reported fewer than 200 deaths.
Mike
Interestingly, there seems to be a particularly uncivil and vicious battle between the ARDS camp and the kinda-like-HAPE camp, in terms of COVID-19. My lay person knowledge is not sufficient to fully get it, but if I understand correctly, the former has to do with mechanical function of breathing whereas the latter has to do with the capacity to oxygenate. Obviously these would be two completely different problems, with different treatments. Calling out to the medically inclined on this forum, what’s the story with the ideas and why would it present as something that is a troll magnet on otherwise civilized forums?
Bob. I saw Birx explain it. Died “with” is to be listed as died “of”. If you take your explanation, then any underlying cause can be chosen as the villain. A German epidemiologist wrote to Merkel making the same point. Many old folks who die of something will have a small cancer of some kind in them. That doesn’t mean it’s legit to call cancer the cause of death. Point is, that’s what’s happening with C19.
Point is, that’s what’s happening with C19.
Rubbish.
Art Deco:
To merely say “rubbish” by proclamation is hardly a way to convince anyone.
There are reasons the claim is made that deaths are being over-attributed to COVID when some cases are more gray. If you disagree – and there’s room for disagreement – and you want to convince anyone that you are correct, you need to deal with Dr. Birx’s statements as described here.
KyndyllG:
I think the reason is that people love to challenge the official line, and the oxygenation theory is anti the official line. So it attracts the rebels. And it may even be true, but most people (me included) don’t have the technical knowledge to have an informed opinion on the subject.
I wonder. A year from now, will those of us NOT residing in a few locations (NYC, NOLA, Detroit, some elder care hot spots, etc), will we be calling it the “Y2Kvirus”?
An overhyped disaster that came nowhere close to living up to its reputation?
JimNorCal;
Y2K simply didn’t happen. It was not a problem.
COVID-19 is happening, and is a problem. A lethal problem for some. I think that what happened to Boris Johnson, for example, illustrates that. It apparently came very close to killing him.
Whether it lived up to its hype is another story. The thing is, those who advocated the strictest measures will say that if not for those measures, it would have lived up to the projections. That can be argued one way or the other, but I don’t think it will ever be proven one way or the other.
Is this why no one seems to have taken the time to post a link to the actual official verbatim CDC guidance? No one reads it. Instead they rely on a news media report of what some official said.
Richard, read the CDC guidance and you may see that the viral infection is put on the death certificate when it is the villain that starts the chain of events that lead to death. That’s all the CDC is asking people to do–show the start and each condition that leads to the death.
There is nothing wrong with that.
It is not a matter of putting Covid-19 as a cause of death when it had nothing at all to do with causing the death.
I wish you all would take the time to read the guidance, think about it, and then reply if you find something wrong with it.
Bob:
It is not as simple as that, because quite a few people’s deaths are ascribed to COVID-19 who have never been tested for it. They have symptoms of it but have not been tested. I don’t have time to get the link for that, but I definitely recall one of the task force people saying that.
And yet, as I related, people can have symptoms of COVID-19 (such as my friend, who died years before the disease existed and therefore it was not an issue) and not have it.
That’s one of the problems.
Another is that if someone has a serious heart condition and dies with a COVID infection, technically the person might die of a heart attack, because ARDS or ARDS-like symptoms can put a huge strain on the heart. So, would the person have died of COVID if he or she didn’t have a serious heart condition? Maybe not. So what killed that person?
There are more gray areas, but I’ll leave it at that for now.
Bob:
Also, it would be helpful if you put a link to the CDC guidance to which you’re referring.
neo: “Y2K simply didn’t happen.”
As a software professional I assert that, obviously Y2K did happen and in fact there were some unwanted problems. If you were affected by the problems you were inconvenienced or worse. If you were the guy called in over a weekend to work your butt off to solve the problems you remember. Planes did not, however, fall out of the sky.
I’m guessing that for most of us, the government reaction to the virus will be far more momentous than the effects of the virus.
I think that this short 11 min YouTuber video helps to explain the “death with covid” and “death from covid” very well. It shows the incentive to ensure covid is listed, as well as input from a couple of doctors. And I believe it references the CDC advisory as well.
https://www.youtube.com/watch?v=Qk5ZIlB9e2w&
JimNorCal:
Yes, Y2K happened in terms of an event, mostly for programmers.
I’m talking about the rest of us. Nada except some minor inconvenience for some. The predictions were of catastrophe.
“That can be argued one way or the other, but I don’t think it will ever be proven one way or the other.”
I think we can say pretty conclusively that the Armageddon-like predictions at the start were nowhere near the truth.
The point of contention is how bad could it have gotten if we did nothing, or did substantially less, to mitigate the impact of the virus. The “If the rest of the country gets as bad as New York now” tracker now stands at 184,178 dead. That’s not going to happen but could it have been half that? A third?
Mike
MBunge – the politicians are in a no win, and a win-win, situation.
By no win, I mean that no matter what they do, someone will always find something wrong. The side of the aisle they occupy is irrelevant, it is just a sad truth. Because we can look back and see the right answers, doesn’t mean the right answers were there at the time.
As for win-win, like the weatherman standing there telling you there is a 35% chance of rain, he wins when it rains, and he wins when it doesn’t. The politicians can say that their actions saved lives, because we have no way to prove that they didn’t. The models, they were, and are, so egregiously wrong that they are near worthless. But, “had we done nothing, they would have been correct” is easy to say because we did something, and the numbers are lower.
It seems that ARDS is the big and predominant killer with COVID-19. I don’t know if that is as true with death by flu.
This MedCram video here has an excellent description of COVID caused ARDS and the modern ventilator developments that can be used to improve the rate of successful ventilator recoveries. Most of ventilator info is also in Neo’s Wikipedia article, but I think the MedCram material is more succinct and clear.
Cutting to the bottom line of that video, Dr. Seheult claims that the older standard ARDS ventilation has about a 40% death rate, whereas when all the newer techniques are employed, the death rate drops down to about 16%.
Doctor Seheult also has another video about the notion that something strange is happening with COVID patients that goes beyond typical ARDS. He specifically addresses the notion that the red blood cells or the hemoglobin is being damaged. His conclusion is that in his COVID patients, it is just standard ARDS, bad as that is.
“I’m guessing that for most of us…”
I agree. The long term consequences of the (IMO) unneccessary quarantine of the economy will be enormous. If we suffer a 2008 recession I will be grateful. A 1930s depression will be a deadly consequence. That is what is at risk.
Apparently New York City just added 3,700 “presumed” cases, retroactively. Any attempt at making sense of the case fatality rate is now null and void.
Paywall. https://www.nytimes.com/2020/04/14/nyregion/new-york-coronavirus-deaths.html?auth=login-email&login=email&smid=tw-nytimes&smtyp=cur
TommyJay:
One of the major causes of deaths from influenza is ARDS. See this, for example.
It’s the way H1N1 (a type of flu) tended to kill as well.
MBunge:
No, we cannot say it conclusively.
We can suspect it. We can think it. We can believe it very strongly. We cannot prove it. And plenty of people say otherwise, including some people who crunch numbers for a living. I read such an article recently. It was long, it was detailed, and I didn’t save the link. I don’t remember where it appeared.
Neo said:
“Bob:
Also, it would be helpful if you put a link to the CDC guidance to which you’re referring.”
I put a link to the CDC guidance in my first comment at 4:47.
Did you click it and then scroll down to the March 4 and April 2 guidance as I said? Apparently not.
I see the link in my comment. Is it visible to others?
Here are the two pdfs that you could find by scrolling down on the page at that link:
First, the one identified on that page as preliminary guidance.
https://www.cdc.gov/nchs/data/nvss/coronavirus/Alert-1-Guidance-for-Certifying-COVID-19-Deaths.pdf
Second, the one identified as the formal guidance on that page.
https://www.cdc.gov/nchs/data/nvss/vsrg/vsrg03-508.pdf
Can everyone see those links?
Bob, page 2, left column:
In cases where a definite diagnosis of COVID–19 cannot
be made, but it is suspected or likely (e.g., the circumstances
are compelling within a reasonable degree of certainty), it
is acceptable to report COVID–19 on a death certificate as
“probable” or “presumed.” In these instances, certifiers should
use their best clinical judgement in determining if a COVID–19
infection was likely. However, please note that testing for
COVID–19 should be conducted whenever possible.
NYC used this to add 3,700 “presumed” dead. Not tested positive, presumed. Now part of the official record of COVID-19 death toll.
Bob:
I very rarely read all the comments in a thread. It’s incredibly time-consuming. I do try to look at comments but ordinarily I only read some, and I reply to far fewer than I read.
In this thread, I had only seen your comment at 5:45 PM. The first sentence was, “Is this why no one seems to have taken the time to post a link to the actual official verbatim CDC guidance?” That is why I assumed you were bemoaning the lack of a link. Since you referenced the article, I said it would be helpful to post one. That’s how I missed your earlier comment and link.
Now that I’ve read it, it conforms to what I’ve been saying about the difficulty of the situation in determining cause of death or even whether a person had COVID or not. For example, as I wrote in this comment addressed to you, some people die of COVID-like symptoms without ever having been diagnosed, and since influenza can cause the same symptoms and the same type of death (and is often not tested for either, for the reasons stated in the post), the situation can often be murky for that reason alone.
Also, of course, there is the fact that COVID-19 can be listed as a proximate or underlying cause of death; if there is COVID present (or presumed present) it is listed. As I wrote earlier, for example, if someone has a very bad heart and COVID problems that someone healthier would have survived relatively easily put a strain on the heart of the person who already has a bad heart condition, and precipitates a fatal heart attack in that person, is that person “really” a COVID death? There are plenty of people in nursing homes in really rough condition who are dying because COVID puts an extra strain on an already extremely-burdened system.
Here’s the relevant excerpt from the CDC document, for anyone who’d like to see. I would add that I suspect (although the doctors here can correct me if I’m wrong) that when a whole bunch of people are dying in an overburdened and stressed hospital, these guidelines may not be followed ultra-strictly:
Well, I don’t trust government, that is my bottom line. I don’t trust WHO, CDC, NIH, and people like Fauci and Birx. They all have an agenda, that agenda involves personal power, period. I remember Fauci declaring HIV would spread to heterosexuals. Didn’t happen, but sucked away billions in public health funding to the exclusion of real actual public health concerns. Unsafe male homosexual sex and intravenous drug addicts were the only ones in jeopardy.
Color me calloused, but the deaths of people willingly putting themselves in harm’s way does not make me sympathetic to their personal fate. They are victims of stupid ignorance of Darwinism. Don’t engage in stupid behaviors, don’t beg for my sympathy. FOAD.
Fauci and Birx are attention whores, sucking on the government teat, nothing more than that. DJT should kick their asses off to CNN. Useless grifters.
Regarding Y2K
In 1999 I was working while seated on an airliner and one of the flight attendants sat down next to me. “What are you working on?” she asked. I explained it was a project plan to correct a Y2K issue. “Oh!” She exclaimed. “I just saw a TV show about that. It’s going to be a huge disaster!” I asked her why she thought that. She repeated something that had been in the show. I explained to her how that issue would be resolved prior to December 31st. Then she remembered something else that the show had proclaimed and I gave a detailed explanation for how that would be resolved. And on, and on.
In the course of all her doomsday exclamations and my calm, detailed, specific refutations she also learned that I had been focusing the major part of my waking hours on this very topic for years, was in charge of several projects to resolve the issue at several different facilities and was also responsible for reporting progress to the Securities and Exchange Commission. I knew what the issue was, why it was and how it was being worked. I even explained some of the temporary work arounds that would be used if any of the hundreds of thousands of projects currently being worked failed to meet their targets by December 31st.
In other words, in an amazing coincidence this woman had learned about something the day before that had scared the heck out of her and by sheer happenstance had plopped herself down next to someone extremely well prepared to answer every question she had and explain how the program she had watched was incorrect. And that is what I did.
Yet I could see that with each calm, detailed refutation I provided she got more and more frustrated. Finally, after about 25 minutes she bolted up in her seat, shook her head at me angrily and said, “You just don’t get it!” And she left.
I thought about that exchange when I read Michael Crichton’s, “State of Fear” last month. Some people just want to be afraid.
“Yet I could see that with each calm, detailed refutation I provided she got more and more frustrated. Finally, after about 25 minutes she bolted up in her seat, shook her head at me angrily and said, “You just don’t get it!” And she left.
I thought about that exchange when I read Michael Crichton’s, “State of Fear” last month. Some people just want to be afraid.”
If I could get people who are very concerned about CAGW to have a good-faith discussion about the subject, the first thing I’d like to ask them is, “Just for the sake of this hypothetical, imagine that it’s a few years from now and all the experts announce that climate change isn’t actually turning out to be a problem; they’ve revised their models and discovered a lot of reassuring natural counter-balances to the release of carbon into the atmosphere. Really put yourself into that moment when you learn that it’s all going to be OK. What’s your emotional reaction? Are you–perhaps–disappointed instead of ecstatic?”
This video from the NYT is interesting regarding this issue. https://www.nytimes.com/video/us/100000007082510/coronavirus-treatment.html
Doctors seem baffled, but there is disagreement about deviating from accepted protocols.
*Ah Good old Charles Lieber and Harvard* Treason is only treason when it fails.
The Department of Justice announced today that the Chair of Harvard University’s Chemistry and Chemical Biology Department and two Chinese nationals have been charged in connection with aiding the People’s Republic of China.
Dr. Charles Lieber, 60, Chair of the Department of Chemistry and Chemical Biology at Harvard University, was arrested this morning and charged by criminal complaint with one count of making a materially false, fictitious and fraudulent statement. Lieber will appear this afternoon before Magistrate Judge Marianne B. Bowler in federal court in Boston, Massachusetts.
Yanqing Ye, 29, a Chinese national, was charged in an indictment today with one count each of visa fraud, making false statements, acting as an agent of a foreign government and conspiracy. Ye is currently in China.
Zaosong Zheng, 30, a Chinese national, was arrested on Dec. 10, 2019, at Boston’s Logan International Airport and charged by criminal complaint with attempting to smuggle 21 vials of biological research to China. On Jan. 21, 2020, Zheng was indicted on one count of smuggling goods from the United States and one count of making false, fictitious or fraudulent statements. He has been detained since Dec. 30, 2019.
Dr. Charles Lieber
According to court documents, since 2008, Dr. Lieber who has served as the Principal Investigator of the Lieber Research Group at Harvard University, which specialized in the area of nanoscience, has received more than $15,000,000 in grant funding from the National Institutes of Health (NIH) and Department of Defense (DOD). These grants require the disclosure of significant foreign financial conflicts of interest, including financial support from foreign governments or foreign entities. Unbeknownst to Harvard University beginning in 2011, Lieber became a “Strategic Scientist” at Wuhan University of Technology (WUT) in China and was a contractual participant in China’s Thousand Talents Plan from in or about 2012 to 2017. China’s Thousand Talents Plan is one of the most prominent Chinese Talent recruit plans that are designed to attract, recruit, and cultivate high-level scientific talent in furtherance of China’s scientific development, economic prosperity and national security. These talent programs seek to lure Chinese overseas talent and foreign experts to bring their knowledge and experience to China and reward individuals for stealing proprietary information. Under the terms of Lieber’s three-year Thousand Talents contract, WUT paid Lieber $50,000 USD per month, living expenses of up to 1,000,000 Chinese Yuan (approximately $158,000 USD at the time) and awarded him more than $1.5 million to establish a research lab at WUT. In return, Lieber was obligated to work for WUT “not less than nine months a year” by “declaring international cooperation projects, cultivating young teachers and Ph.D. students, organizing international conference[s], applying for patents and publishing articles in the name of” WUT.
As one of the doctors in the military ER I was working at in Japan many decades ago said, “when you write up a death certificate, you can always (pretty truthfully) list the cause of death as “heart failure.””
Then, of course, there is the quote attributed to Stalin, about how, “it doesn’t matter who votes, what matters is who counts the votes.”
You would hope that those writing out death certificates, and keeping the tally of Chinese Coronavirus deaths would all be singing off the same sheet of music, and would play it straight.
But I suspect that–beside the normal possible errors and confusion–there may possibly be some level of hanky-panky, of manipulation going on with some tabulations, especially in view of the various theories, reputations, and even the prospect of future funding involved.
It all depends on what you attribute the “primary cause of death” to, how you define those possible causes, and which of those possible causes of death you will consider; which one–of perhaps several possible causes of death–you fill in as “primary” and which “secondary.”
Then, how you present that data.
See this at https://www.thegatewaypundit.com/2020/04/new-york-adds-presumed-coronavirus-cases-death-toll-3700-new-deaths-added-today-revised-count/
Morning update: In terms of the parameters I’ve been examining for the past weeks, no real change. Active cases had shown a small decrease each of the last 3 days, but yesterday jumped up again. Serious cases continues a linear increase. My new analysis of (active-recovered) shows a plateau and is much more consistent with public statements. I’m also tracking data from CT, NC, and NH. Both NC and NH show a plateau in active minus recovered. A friend in NH who is connected into the NH health system, yesterday verified my NH analysis. This gives a bit more confidence in that way of looking at the data.
If someone else has another source of data they are tracking over the past month, let me know what that data shows. I think it’s now obvious that worldometers is just reporting cumulative numbers of active cases. It will eventually go down, but fails to take into account that 97% of those people from two weeks ago are no longer active cases.
Its a bad COLD… coronavirus cause about 15% of colds… not flu
sigh… beating my head against the wall would have more impact…
I think it’s now obvious that worldometers is just reporting cumulative numbers of active cases. It will eventually go down, but fails to take into account that 97% of those people from two weeks ago are no longer active cases.
which is why cumulative numbers in this analysis are WRONG to use
it can only have one outcome of maximizing the bad…
and the longer it goes, the harder it is to show the good..
if you have a cumulative number of 1 million, how long do the numbers have to drop a day from 1000 less to 5000 less a day to even dent the cumulative… after all, even when it drops, if it doesn’t drop to zero its still adding to the cumulative
The medRxiv study and another preliminary study recently published in Research Gate came to similar conclusions: there seemed to be a correlation between countries that require BCG vaccines and a reduced spread and severity of COVID-19 cases. For example, Portugal — which has required BCG vaccines for infants — has over 16,000 cases of COVID-19 but only 535 deaths whereas neighboring Spain has over 169,000 cases and over 17,000 deaths.
Similarly, Ireland, with 9,655 cases and only 334 deaths, requires the BCG vaccination, whereas the U.K. with 89,554 cases and 11,346 deaths no longer does. Based on these numbers, Ireland has a fatality rate 3.5% whereas the U.K. has a fatality rate of 12.7%. Of course, there are big population number differences across these countries, along with other variables that could affect death and infection rates.
These preliminary studies are “very flawed,” because many factors such as differences in wealth and testing ability, can affect the outcomes Levy told Live Science. But the authors are “doing the best they can in a very difficult situation.” While there’s no direct evidence that BCG vaccines will reduce people’s risk of developing COVID-19, “I’m enthusiastic about the hypotheses,” Levy said.
It’s difficult to draw firm conclusions, but there’s enough scientific evidence to prompt clinical trials, and his team is looking into starting one in the U.S, he said. Clinical trials analyzing the protective effects of the vaccine against COVID-19 are already underway in other countries, including Australia and the Netherlands.
Even in coronavirus hot spots in Europe and the US, there’s greater chance of being killed in a car accident than being harmed by COVID-19, according to research published last week by Stanford scientist John Ioannidis.
“The risk of dying from coronavirus for a person under 65 years old is equivalent to the risk of dying driving a distance of nine to 415 miles by car each day during the COVID-19 fatality season,” he concluded.
Yet many of those under-65s have had their lives pulled apart, including loss of 195 million jobs around the world this quarter, according to the International Labour Organisation.
[snip]
“The likelihood of someone dying from coronavirus is much lower than we initially thought,” Ioannidis told Greek media this week, forecasting that “the mortality rate will be slightly — but not spectacularly — higher than the seasonal flu.”
Indeed, almost 80 per cent of the population of Gangelt, a German town highly exposed to COVID-19, was recently tested to see if they had had the virus. About 15 per cent had, without any symptoms, implying an infection death rate of 0.37 per cent — about four times as bad as seasonal flu but much lower than figures of 1 per cent to 3 per cent first feared.
[snip]
“I am much more concerned about the consequences of blind shutdowns and the possible destruction of a (Greek) economy where 25 per cent of the GDP is based on tourism,” Ioannidis said.
[snip]
“Another month of mass isolation will cost the West at least the equivalent of a million deaths in terms of reduced quality of life,” says Paul Frijters, a professor of economics at London School of Economics using his index of wellbeing.
[snip]
We urgently need randomised testing to see how widespread the coronavirus already is. The Prime Minister has said COVID-19 is akin to a one-in-100-year event. It’s unlikely that’s true of the virus, but it’s looking true of damage caused by hysteria.
Physicsguy, and anyone else keeping score at home: I am using Worldometers daily death count for one of the set of statistics I’m maintaining and watching on my own, and those are not cumulative.Yesterday’s spike in US fatalities notwithstanding, general trends in all of the nations I’m monitoring show stability/decline. Other data I’m tracking are coming directly from jurisdictions. One is NYC itself, which has has detailed data updated frequently.
I don’t care about case count – no jurisdiction anywhere has done the sort of widespread testing of the population that would be necessary to get a reasonably accurate count of cases of a virus that spreads as easily as a cold and doesn’t usually cause serious symptoms. And now, weeks to months into it, they’d have to do both PCR and serology testing to get an accurate picture of the population. Moreover, each jurisdiction has set its own bar for the likelihood of getting tested. Since case count is horribly incomplete and inconsistent across jurisdictions, it’s practically useless.
I also ignore active case count, which is even more useless. Not only is it based on case count, which I dismiss for the reasons noted above, if jurisdictions aren’t even testing people who are actually sick right now, they certainly don’t have the bandwidth to be formally confirming the status of people who got better.
We are watching daily death counts, as it seems to us that case counts, either cumulative or daily, aren’t much use. And even daily death counts are suspect coming out of New York, for instance, because of changes in reporting standards.
Here in NC, anecdotally, from reading the area news reports, the largest problems are in the nursing homes and assisted living facilities.
Circling back to my comments a few minutes ago, I just ran across a study posted today at medrxiv in which they ran PCR tests on all 408 residents of a Boston homeless shelter and got 147 positive (36%). Most of the positives did not have symptoms. The most commonly reported symptom for positives was coughing, reported by 7.5%. Meanwhile, 8.4% of those who tested negative reported coughing. Seriously, that’s what it says.
As it was a PCR test, which only detects current or very recently recovered infections, this does not address how many of these people were infected and have since recovered. It was done in late March, in response to a cluster earlier in the month.
How many cases like the 100+ positives in this homeless shelter with no symptoms are not in case counts? Almost none of them are. The only way to get this information would be to run PCR and antibody tests on entire populations. I suspect once that’s finally done, the picture will change considerably.
Kate and Kyndyll,
I’m going to keep tracking active cases, but won’t report on it. I’m going to concentrate on active minus recovered especially now that I have some confimation of its validity from NH. I haven’t dealt with death stats as so many others are doing that, but decided to concentrate on precursor stats.
Check out the most recent update from Willis on death stats on WUWT. Apparently, the IMHE model just updated their prediction on Sweden deaths to an even high level, and the data show that is is very unlikely they will even come close to that. As a reminder, Sweden has very minimal restrictions. Also there’s a report from Israel that shows no matter what a country does the virus is following the same course. We are being fed a load of crap, and destroying the economy and lives in the process.
We stay relatively calm about flu despite its obvious ability to kill us because it’s been around long enough that we feel we have a grasp of the risks and the costs of various ways to combat it. A new virus doesn’t give us that luxury, particularly if its arrival on our shores is preceded by scary reports from overloaded hospitals in China and Italy. Now that we can see the curve flattening, we’re starting to be able to think things through better. I don’t think we’ll really calm down, though, until we get more confidence in treatments and, ultimately, in a vaccine.
“We are being fed a load of crap, and destroying the economy and lives in the process.” Amen to that! I must stay around home; I’m 71. There is little to no validity to rules requiring people under 65 without health problems to stay home. We have seen and heard of some awful cases among healthy under-65s, but for the most part, those are anomalies, and they are surviving, thanks be to God. Treatment protocols are improving daily. Hand-washing and face masks in public places are good recommendations; destroying lives, not.
Meanwhile, in Raleigh, NC, which has a Democrat mayor and a Democrat governor, a woman was arrested at a small protest downtown in front of the legislative building. She was charged with violating the governor’s executive order, and told that protesting is not an essential activity. Our First Amendment rights have been suspended by order of the governor.
Regarding face masks in public places, at some point, logic has to be addressed. Either this virus is so contagious that it can be routinely transmitted in open air … in which case a vast number of people have been exposed and obviously did not die or get terribly ill, which thereby reduces the IFR to trivial levels. OR, the virus has a high fatality rate, which means that comparatively few people have caught it, in turn indicating that it is not routinely transmitted by a passing breath.
In the absence of mountains of bodies and “overwhelmed” medical facilities, you just cannot have it both ways.
(Just this weekend I got a first-hand report from a medical worker in a major metro area who is being paid to show up a specified number of days per week and stand there – there are no patients.)
Physicsguy, I am following the figures for Snohomish County, WA where I live.
Here’s the cumulative cases chart:
https://www.snohd.org/ImageRepository/Document?documentID=3526
Here’s the daily number of new cases:
https://www.snohd.org/ImageRepository/Document?documentID=3487
This chart I find most interesting.
https://www.snohd.org/ImageRepository/Document?documentID=3550
It shows the status of Covid-19 cases. Shows the number recovered, status unknown (cases they don’t know the resolution of with certainty), quarantined, hospitalized, and deaths. The numbers all seem headed in the right direction. I would say that by May 1st, we will be close to being able to track and quarantine infected individuals accurately. Now, if we can just ramp up the testing, we could begin opening up in steps in May. Yeah, I’m a cockeyed optimist.
You might be interested in perusing the entire site:
https://www.snohd.org/499/COVID-19-Case-Count-Info
J.J.
But what will King Jay decide? He does have to consult with Commissar Brown and Commissar Newsom (Governors of WA, OR, and CA).
om, J.J.,
Yes our WA leaders finally have their dream of uniting with California (they remind me of Sally Field years ago ‘you like me, you really like me!’).
I suspect we are nearing the point where in many areas people are going to stop following these insane restrictions especially in areas with little impact.
I’ve talked to many people who supported this at first but are changing their opinions.
om & Griffin, I don’t know what it’s like in your respective areas, but when I go out, (groceries, doctor appointments, food pick ups, etc.) it doesn’t seem to me that the auto traffic is much less than it was before this began. I don’t know where all the people are going, but they’re not sitting at home.
The medical facilities that are treating things other than Covid are pretty quiet, though. It’s obvious that a lot of people are avoiding routine medical care. My bride and I have to get treatment, so we go. They meet you at the door and take your temp, give you a mask if you don’t have one, and Purell is everywhere. The doctors treating routine stuff seem pretty relaxed. So, there’s that.
I hope public pressure on Jay and his fellow West Coasters will mount. We’ll see. IMO, testing is the key. The new saliva test seems to be the answer if they can just ramp it up fast enough.