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16 April 2020

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Mathias Alexander

Perhaps the Russian death rate is the real death rate and the other death rates have wrongly repoted causes of death in them.

Ulenspiegel

"COVID AND RUSSIA. Overall totals to today are 28K infected, 232 dead. This raises the question of why the death rate in Russia appears to be lower."

When the Russian with thousands of tourists in Tirol have only 28K infected with allegedly 700000 tests, then the Russian are either incompetent or simply lying. My bet is the last. The Russian numbers over the last 8 weeks do not make any sense.

"One theory is that the widespread Soviet-era tuberculosis vaccinations (BCG vaccine) may have had an effect "

That is no theory, it is not even a hypothesis. Try to understand how vaccination works. Then explain why a vaccine against a mycobacterium will work against a sneaky virus. There is a much higher chance that people after a common cough, often caused by a corona virus, have useful immune response.

Patrick Armstrong

Dear Till: As to BCG and COVID-19, address your comment to these guys : https://clinicaltrials.gov/ct2/show/NCT04327206

David Keating

No one has ever dies of Covid-19. The cause of death is usually heart failure ..... as to whether or not Covid-19 was a contributing factor is entirely subjective. If someone dies without having being tested or is found dead in their homes I doubt coroners or attending physicians first priority is to use up precious lab resources on confirming the cause of death when there is a lineup of severely ill patients in their emergency room awaiting tests. if it's politically expedient to either under report or over report Covid-19's contribution to the death toll all the better.

The only way of really determining the mortality rate of Covid-19 is with statistical analysis comparing the number of deaths during the epidemic with the time periods before and after the epidemic.

Obesity and age seem to be a factor as well and perhaps Russia doesn't have the numbers of obese and long lived people that we have in the west or perhaps that population hasn't been exposed in Russia for some reason.

rho

David Keating,

"The only way of really determining the mortality rate of Covid-19 is with statistical analysis comparing the number of deaths during the epidemic with the time periods before and after the epidemic."

There is a relatively fast-updating weekly time series with exactly this data from most Western European countries:

https://www.euromomo.eu/index.html

My interpretation is that this virus is slightly more deadly than a severe flu season, worse than the one we had in the winter of 2016/17 in Europe, but nowhere near severe enough as a threat that you would be justified to shutdown your economy because of it for weeks or even months.

And the country-by-country variations in mortality are huge. Sweden, UK, Belgium, the Netherlands, Italy, France, Switzerland and Spain are reporting excess mortality - but if you look at the graphs of Austria, Germany or Finland, you cannot even conclude that deaths from coronavirus are a serious health issue, especially not when you compare it with the flu seasons in the past winters.

Barbara Ann

rho

Thanks for the euromomo.eu link. Bear in mind that the recorded excess mortality data being, as you rightly say; "slightly more deadly than a severe flu season" reflects the effects of lockdowns in almost all of the countries included in the statistics. Without these the mortality recorded would have been much higher and may still be rising exponentially.

It will be interesting to see to what extent relaxations of the lockdown measures lead to secondary spikes in mortality over the coming weeks/months.

Seamus Padraig

Bear in mind that the recorded excess mortality data being, as you rightly say; "slightly more deadly than a severe flu season" reflects the effects of lockdowns in almost all of the countries included in the statistics. Without these the mortality recorded would have been much higher and may still be rising exponentially.
Unfortunately, because that's a hypothetical proposition, it also happens to be a non-falsiable proposition. There is no alternate universe out there where Britain adopted the Swedish approach and Sweden adopted the British approach so that we could contrast and compare and be sure.
It will be interesting to see to what extent relaxations of the lockdown measures lead to secondary spikes in mortality over the coming weeks/months.
In fact, that's been one of the arguments used by herd-immunity advocates against lockdowns: rather than strengthen the collective immune system, they keep it weak, so that when the lockdown is lifted, deaths will spike. And what about next winter when the virus returns? Are we going to lockdown Western civilization all over again? Herd-immunity advocates (such as Anders Tegnell, chief epidemiologist of Sweden) have therefore argued that it's better to take the hit up front, so that next time around it won't be as bad.

David Keating

Rho

A typical seasonal flu infects upwards of 500 million people a year. Covid-19 has only been confirmed to have infected just over 2 million worldwide to date.

RO represents the infection rate of a virus. Any number over 1 is considered to spread exponentially. Seasonal influenza has an RO of 1.6 on average. Covid-19 has an RO of 3.

Every year 500 million get the flu on average. To date 2.2 million are confirmed to have Covid-19.

2% of influenza patients require hospitalization .... 20% of confirmed Covid-19 patients require hospitalization.

On average 0.1 % of flu patients die every year. To date 6.8% of confirmed Covid-19 patients have died worldwide according to this mornings numbers Johns Hopkins.

Our healthcare system accounts for influenza patients every year .... they don't account for covid-19 patients which is why we are panicking over ventilators and ICU beds.

You cannot compare this pandemic to influenza. It's only been in the wild for 4 months. We don't know what organs or systems it affects long term, we don't know for sure yet if we develop sufficient antibodies to achieve long term immunity ... this virus could be like the common cold in which you never achieve immunity and can't develop a vaccine for. We also don't know how well people recover from this virus .... SARs patients who survived were often disabled for life .... We just don't know yet

A virus with an RO over 1 left on it's own will infect between 30% and 70% of the population. Play around with your calculator for awhile .... this virus has the potential for serious carnage and we have no idea just what we are fighting yet.

Fred

David,

"Every year 500 million get the flu on average. "
We do not test 500 million people per year for flu, that number is based on a mathmatical model, just like the one that said 2 mililion Americans would did from the Wuhan virus.

"Our healthcare system accounts for influenza patients every year" Except for the people who don't seektreatment.
"SARs patients who survived were often disabled for life" You conveniently left out a number here, as if you wanted to emphasize "diabled for life" rather than point to an actual risk of disabilty from SARs infection, especially since this is yet another virus originating in China, and has been around close to 2 decades. Oh, and look, the conveniently available CDC information on SARs doesn't even mention "diability for life" on its fact sheet. I wonder why.
https://www.cdc.gov/sars/about/fs-sars.html

"we have no idea just what we are fighting yet."
Yes we do, we are fighting the Communist Chinese government and her agents on one hand and a virus that originated in their country on the other.

Patrick Armstrong

I think general comments on CIVID should be wheresoever else. Maybe a special open thread or something?

walrus

Fred,

The “herd immunity” people forget the fact that the herd, once it has its immunity, will be living in the ruins of what’s left of our civilisation. My rough maths are below.

According to the experts, doing nothing in the USA would result in 1-2 million deaths. The best guess CFR (the Lancet) is about 1.3%. That implies about 76 million total cases. Now assume just 20% require medical attention. Let’s say that’s 14 million people. Using Australia’s modelling as a rough guide the peak will be about five weeks in. You have about a million beds (AHA figures) but only 100,000 are ICU (SCCM figure). So at the peak you have maybe 4 - 5 million people wanting medical attention. Let’s now assume 25% need an ICU bed. So that’s at least a million and they need it for say three weeks. So that pretty much means ten patients for every ICU bed.

But wait, there’s more. Herd immunity requires something like 40% of the population to be immune. That’s about 120 million people, not the 76 million that I used.


Then of course you can try your own figures or simply take the australian uncontrolled spread numbers and multiply by 12 (25 million vs. 300 million) that gives you peak daily ICU demand of about 420,000 ICU cases.

Triage isn’t going to work with a ten to one patient to bed ratio. Not with an armed population. The health system will simply be overwhelmed. “Die in place?” most people won’t. Once there is no possibility of medical care then logistics chains freeze up. You are now in disaster movie territory. Bad disaster movies like “the road”.

At least with mitigation you preserve the systems that make America work. I believe Trump is right. We will bounce back faster and better than anyone thinks. Furthermore “globalization” is now a dirty word.

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