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We're #1! - BostonCard - 03-26-2020

Unfortunately we just overtook China and Italy for most diagnosed Covid-19 infections.  The good news, such as it is, is that we have fewer deaths than a number of other countries (China, Italy, Spain, Iran, and France), which means we probably have a larger share of our patients diagnosed.

BC


RE: We're #1! - martyup - 03-26-2020

Unless China is hiding cases, this is good news.  This means that this virus can be defeated with many fewer deaths than predicted by many "experts."  I find the China numbers suspect, however.


RE: We're #1! - Goose - 03-26-2020

(03-26-2020, 04:03 PM)BostonCard Wrote:  Unfortunately we just overtook China and Italy for most diagnosed Covid-19 infections.  The good news, such as it is, is that we have fewer deaths than a number of other countries (China, Italy, Spain, Iran, and France), which means we probably have a larger share of our patients diagnosed.

BC
And/or we are doing a better job of keeping people alive. Probably it is also sensitive to special cases, like the high relative Washington state mortality to cases ratio is still greatly affected by the nursing home numbers.


RE: We're #1! - 2006alum - 03-26-2020

Indeed, there's lots of evidence to think China's testing was highly imprecise, with errors in both directions:




Probably worth retweeting this again, because I think we're still susceptible to the ludic fallacy given how utterly noisy the data is, the inconsistency in tests, testing protocols, reporting standards, etc.:





RE: We're #1! - JustAnotherFan - 03-26-2020

(03-26-2020, 04:03 PM)BostonCard Wrote:  Unfortunately we just overtook China and Italy for most diagnosed Covid-19 infections.  The good news, such as it is, is that we have fewer deaths than a number of other countries (China, Italy, Spain, Iran, and France), which means we probably have a larger share of our patients diagnosed.

BC

Didn't China, Italy, Spain, and Iran (not sure about France) all vastly exceed their capacity to treat patients which drove up the death rate? If yes, then that would indicate that when the same happens in the US (already happening in NYC) then the fatality rate is going to increase.


RE: We're #1! - akiddoc - 03-26-2020

(03-26-2020, 05:18 PM)martyup Wrote:  Unless China is hiding cases, this is good news.  This means that this virus can be defeated with many fewer deaths than predicted by many "experts."  I find the China numbers suspect, however.

Many of our recently diagnosed are going to die. Don't get optimistic.
Our numbers are far from 100% accurate. Don't expect real accuracy from any country.


RE: We're #1! - martyup - 03-26-2020

(03-26-2020, 08:24 PM)akiddoc Wrote:  
(03-26-2020, 05:18 PM)martyup Wrote:  Unless China is hiding cases, this is good news.  This means that this virus can be defeated with many fewer deaths than predicted by many "experts."  I find the China numbers suspect, however.

Many of our recently diagnosed are going to die. Don't get optimistic.
Our numbers are far from 100% accurate. Don't expect real accuracy from any country.

True.  It appears that about 1.3% of the recently diagnosed will die.  That is tragic.  I'm only optimistic that the overall number of deaths will be less than most of the dire predictions.


RE: We're #1! - Mick - 03-27-2020

(03-26-2020, 05:18 PM)martyup Wrote:  Unless China is hiding cases, this is good news.  This means that this virus can be defeated with many fewer deaths than predicted by many "experts."  I find the China numbers suspect, however.

BC, what are the odds that China is hiding cases, do you suspect?


RE: We're #1! - Farm93 - 03-27-2020

(03-26-2020, 09:13 PM)martyup Wrote:  
(03-26-2020, 08:24 PM)akiddoc Wrote:  
(03-26-2020, 05:18 PM)martyup Wrote:  Unless China is hiding cases, this is good news.  This means that this virus can be defeated with many fewer deaths than predicted by many "experts."  I find the China numbers suspect, however.

Many of our recently diagnosed are going to die. Don't get optimistic.
Our numbers are far from 100% accurate. Don't expect real accuracy from any country.

True.  It appears that about 1.3% of the recently diagnosed will die.  That is tragic.  I'm only optimistic that the overall number of deaths will be less than most of the dire predictions.
Sadly, NYC will start getting fatalities at a higher rate now that the system is beyond capacity. 

China is not the appropriate reference point, as their government can easily maintain two sets of data.   One for internal use and one for global propaganda.  My personal reference points remain Korea and Japan.    They both have populations in very large and very densely populated cities, and both have managed COVID-19 without significant stress to their systems.   To some degree the same is true for almost every other country that neighbors China.  SARS taught their governments AND their citizens to treat pandemics with great caution from day #1. 

Europe and the USA just didn't experience the SARS lessons, so they have done too little too late for different reasons.   

POTUS-45 failed to use the long established USA playbook, but it doesn't seem like American citizens would have followed the playbook anyway.  I am really worried about the impact of those Florida Springbreakers.   They may, in time, prove to be our Atalanta game.

https://time.com/5809848/game-zero-soccer-game-italy/


RE: We're #1! - burger - 03-27-2020

(03-27-2020, 05:14 AM)Mick Wrote:  
(03-26-2020, 05:18 PM)martyup Wrote:  Unless China is hiding cases, this is good news.  This means that this virus can be defeated with many fewer deaths than predicted by many "experts."  I find the China numbers suspect, however.

BC, what are the odds that China is hiding cases, do you suspect?

Until I see some actual evidence taht China is lying, as far as I'm concerned, any claim that China is hiding cases is a BS conspiracy theory, and people need to drop this.  Does anyone have evidence that things are bad in China, and they are covering it up?  Actual news reports suggest the opposite.  They have closed many of their temporary hospitals.  They have let people move again and go back to work in some cities. 

Here are some actual news reports on the subject:

https://www.theguardian.com/world/2020/mar/23/wuhan-eases-coronavirus-lockdown-as-restrictions-intensify-outside-china
https://www.reuters.com/article/us-health-coronavirus-china-retail/as-chinas-coronavirus-outbreak-eases-a-wary-return-to-shops-for-consumers-idUSKBN21447W

This article suggests that China is maybe moving too quickly, which wouldn't surprise me since Trump isn't the only leader who may prioritize economic growth over stopping the virus.  The article does not suggest that China is lying about its caseload, only that they may be moving too fast and that there are possibly undetected/asymptomatic cases.  https://www.nytimes.com/2020/03/24/world/asia/china-coronavirus-lockdown-hubei.html

That later article is somewhat terrifying because it implies that even months of prison-like lockdown will not be enough to eliminate the virus.  But maybe China can keep it manageable by testing and contact tracing.


RE: We're #1! - 2006alum - 03-27-2020

Some other bad news about China is that fighting this virus appears to be a two steps forward, one step back kind of battle:





RE: We're #1! - BostonCard - 03-27-2020

(03-27-2020, 05:14 AM)Mick Wrote:  
(03-26-2020, 05:18 PM)martyup Wrote:  Unless China is hiding cases, this is good news.  This means that this virus can be defeated with many fewer deaths than predicted by many "experts."  I find the China numbers suspect, however.

BC, what are the odds that China is hiding cases, do you suspect?

Yes, I think the probability that China is hiding cases is virtually 100%, especially if reports that local political officials are being told they will be punished if cases arise are true.  If you incentivize someone to hide cases, that's what they will do.

On the other hand, it is also clear that China is relaxing its lockdown.  They have emptied the special coronavirus hospitals. So, the totality of the data does point to a waning epidemic. The number of cases is almost certainly higher than reported, but it also clearly has gone down from the peak.

BC


RE: We're #1! - terry - 03-27-2020

(03-26-2020, 09:13 PM)martyup Wrote:  It appears that about 1.3% of the recently diagnosed will die.  That is tragic.  I'm only optimistic that the overall number of deaths will be less than most of the dire predictions.

I think it's very likely that deaths will be less than the most dire predictions because the worst-case predictions assumed business as usual with no mitigation measures. "Stay at home" orders, social distancing, etc. should help reduce deaths.


RE: We're #1! - Farm93 - 03-27-2020

(03-27-2020, 08:10 AM)2006alum Wrote:  Some other bad news about China is that fighting this virus appears to be a two steps forward, one step back kind of battle:



It will be interesting to see how this plays out in Europe and the USA.  I honestly can't imagine there would be a film I would go see a week or two after domestic case growth stopped.  

Movie theaters, restaurants, bars, hotels, cruise ships, airlines and sports leagues will have a tough time even after governments issue all clear orders.


RE: We're #1! - OutsiderFan - 03-27-2020

I use Occam's Razor on China numbers.

The U.S. already has more cases than China. That tells me China numbers are phony baloney.

China has what, 4x the U.S. population?  And, China - though it did enact tougher restrictions than the U.S. has or ever will and mobilized nationally - was asleep at the wheel for what, 6 weeks before really acting at all?  

If Italy says it has 10x its reported cases, China probably has 20x.

The ONE mitigating factor that must be the devil's advocate position is China, like other Asian countries made mask wearing mandatory.

Oh, and speaking of masks... I was chatting with someone from India on Skype this morning. She told me police are hitting people with batons if they aren't wearing masks when outside, and then telling them to pull their shirts up over their mouth and nose if they don't have one. India is terrified of a big outbreak for obvious reasons, but we all in the U.S. should be wearing masks too!


RE: We're #1! - burger - 03-27-2020

(03-27-2020, 11:01 AM)OutsiderFan Wrote:  I use Occam's Razor on China numbers.

The U.S. already has more cases than China. That tells me China numbers are phony baloney.

China has what, 4x the U.S. population?  And, China - though it did enact tougher restrictions than the U.S. has or ever will and mobilized nationally - was asleep at the wheel for what, 6 weeks before really acting at all?  

If Italy says it has 10x its reported cases, China probably has 20x.

The ONE mitigating factor that must be the devil's advocate position is China, like other Asian countries made mask wearing mandatory.

Sorry, but this is silly, and you are making things up with zero evidence.  Occam's razor does not allow you to make things up.

China did wait weeks to start responding.  But they started with probably a single case.  Exponential growth is surprisingly slow at first, and it may have been several weeks before they even had a detectable number.  Meanwhile, the China death rate reported is roughly in line with what other countries have reported, and the characteristics of their deaths are similar to those from other countries in terms of age, comorbidities, etc.

No doubt the China numbers are underrported due to lack of testing, but almost every country's numbers are underestimated for the same reason.

If you're going to accuse China of making things up, show me some evidence.  There are too many conspiracy theories around this virus as it is.  I'd like to think that a community of Stanford alums can be more evidence-based than the public at large.

Quote:Oh, and speaking of masks... I was chatting with someone from India on Skype this morning. She told me police are hitting people with batons if they aren't wearing masks when outside, and then telling them to pull their shirts up over their mouth and nose if they don't have one. India is terrified of a big outbreak for obvious reasons, but we all in the U.S. should be wearing masks too!

We went to the grocery store yesterday, and maybe 5-10% of people were wearing any kind of mask (including us--we made our own).  Increasing that number could go a long way towards decreasing the rate of spread.


RE: We're #1! - M T - 03-27-2020

REMINDER:  CFR is a proportion, based on the disease's progress in the various infected individuals.  If you infect 1000 or 100 80 year-olds, the proportion that die is going to be the same (given the same medical care).   The number of deaths will be differ of course.

CFR is also age dependent.  In terms of age of population & the expected CFR per age decade, I will remind you these are the CFRs for various countries, based on the countries' demographics & the age-based CFR's (not Infection Fatality Rate, but based on confirmed cases) out of this study
China: 1.22%, India 0.73%, Italy 2.47%, South Korea 1.71%, Spain 2.16%, UK 1.96%, US 1.73%.
(Personally, I think that study has low numbers, but is getting toward the right ballpark.)

Higher or lower actual measured rates may be due to worse/better care.  Surveillance & isolation won't impact the rate (except as lack of those measures may lead to worse care).  Widespread testing may lower the measured rates  IF there were a significant ratio of asymptomatic cases found that are then added to the denominator.  Conversely, lack of testing may increase the measured rates, if symptomatic cases are not confirmed by testing.

New York and L.A. County have indicated they will not test (some) cases that are expected to be COVID-19.  Those jurisdiction's numbers should be considered incomplete & thus wrong.  Someone in China might point to their numbers and say they are lying.

As for Chinese stats, I expect that, as in any chaotic circumstance, there were deaths early on from COVID-19 that were not counted.  But, by late January, their numbers are probably more accurate than Santa Clara County's.   Imagine if our grocery stores required a temperature check before you could enter.  if you have a fever, you were taken to a fever clinic, where you were tested.  If the test is positive, you are taken from the clinic to the hospital.  So, from the time you tried to buy groceries, you had no contact with family (nor did you in the hospital).  You had no chance to slip out of the system.  They offered monetary rewards for turning people in.  I've seen a video of police forcing their way into an apartment of an elderly man who was suspected of being sick.  I've seen a video of a group of allegedly sick people tied together by rope being led down the street.  I've seen a video of a family being told that their door would be chained shut to keep them isolated (had they been sick, they would have been hospitalized, so I believe this family was simply exposed), and if a fire broke out, they were to call for someone to come unchain them.  I've seen a video of what happened when someone with a fever tried to run a roadblock.  (I do NOT know that these videos are typical events.  I can imagine some of these scenarios happening in the US.)

I would not want to live in such an authoritarian state.  But, I think China had the power to institute strict controls that resulted in tighter rein on the spread of COVID-19.  The politicians didn't have to worry about an election, or where campaign financing would come from.  Could they be lying about their numbers? Sure.  But they've been posting their daily numbers since February 13, which have been self consistent. Researchers have apparently gained access to case data from the hospitals and published studies based on those numbers.


RE: We're #1! - 2006alum - 03-27-2020

(03-27-2020, 12:27 PM)M T Wrote:  New York and L.A. County have indicated they will not test (some) cases that are expected to be COVID-19.  Those jurisdiction's numbers should be considered incomplete & thus wrong.  Someone in China might point to their numbers and say they are lying.

Are there any places beyond East Asia (and maybe Germany?) where "anyone who wants a test can get tested"? My impression is that France, Italy, Spain, and the UK are not able to test everyone who suspects or is suspected of having the virus. And I've yet to hear of anywhere in the U.S. that is.

If that's true, should we just assume that just about every "jurisdiction's numbers should be considered incomplete & thus wrong"? (Except, perhaps, the NBA)


RE: We're #1! - pefloresjr - 03-27-2020

I think that as China is opening up again, many workplaces and even stores are doing temperature checks before you can come in.  If you have a temp. you don't get in.  You aren't necessarily grabbed and taken to a clinic but I think you are referred to a clinic.  That is the message I got from a friend in Beijing.  Doing that on a widespread basis could help to slow the growth of subsequent waves if it caught enough cases soon enough.  I don't know if that will work in reality but China seems much more prepared to do this both culturally and practically.  

Cheers,
Pete F.


RE: We're #1! - oldalum - 03-27-2020

(03-27-2020, 12:27 PM)M T Wrote:  New York and L.A. County have indicated they will not test (some) cases that are expected to be COVID-19.  

Yes, not all likely infected patients are being tested. Here in Santa Clara County, my daughter had a high-risk exposure (60 minutes 2 feet away from another student who became symptomatic later that day and tested positive) and was put in 14-day quarantine within our house as a result. Her physician checked with the Dept. of Public Health and was told she would not be tested if she became symptomatic because she would be presumed infected. Presumably she would not be counted in the official totals if she became symptomatic, unless she needed hospitalization (fortunately, she just ended the 14 days asymptomatic). On the other hand, they said if my wife or I became symptomatic, we'd get tested.