22 Jun 20
@sh76 saidIf you look at the page on the world-o-meters site below [1] they give an estimate for the IFR of 1.4% for New York City. They explain their reasoning in some detail. You need to divide deaths/(deaths + recoveries) otherwise you'll get a low figure for a CFR. Incidentally, for the US as a whole. We have 2,356,655 cases, 122,247 deaths and 979,790 recovered at the time I wrote this post [2]. This gives 1,102,037 resolved cases.
Granted deaths are a lagging indicator and so it's not truly apples to apples, but today's deaths-to-cases ratio would imply a CFR of 1.1%
If we calculate the CFR based on all cases so far we get:
CFR = 122,247/ 2,356,655 = 5.19%
and if we calculate the CFR based on resolved cases we get:
CFR = 122,247/1,102,037 = 11.09%
If we assume an IFR of 1% then there are 10 unidentified cases for every identified one. If we assume an IFR of 0.5% then there are 20 unidentified cases for every identified one.
You can't compare daily deaths to daily cases for the same day. That simply won't work. The world-o-meters page gives a calculation that estimates the lag between deaths and cases, it came out at 12 to 13 days. So to start with you'd need to compare daily deaths today with daily cases from just under a fortnight ago. This won't work because some people die more quickly than others and you'd need to take into account contributions from different daily cases. Worse still you're at the mercy of the reporting schedule, they don't report people who've died that day, they report people who've have been confirmed to have died of covid-19 and haven't yet been reported as having died. The NHS England figures for a given day come in a spread sheet with a breakdown of when they actually died, and there's a few on the actual reporting day, the bulk the day before that and then it sort of tails off backwards in time, with the odd person who'd died a month ago.
To do the type of calculation you're trying to do you need to get a time series of cumulative cases, deaths and recoveries, by date of occurrence and not date of report, and calculate the cumulative CFR and see how and if it changes with time.
Note that the IFR given by world-o-meters assumes no treatment beyond ventilation. Since they've found that dexamethasone reduces deaths in ventilated patients by 1/3 and going with an IFR of 0.94% for the US, you can expect that to be 0.61% from now on and the CFR should drop to about 8%.
[1] https://www.worldometers.info/coronavirus/coronavirus-death-rate/
[2] https://www.worldometers.info/coronavirus/#countries
22 Jun 20
@deepthought said===If we assume an IFR of 1% then there are 10 unidentified cases for every identified one. If we assume an IFR of 0.5% then there are 20 unidentified cases for every identified one.===
If you look at the page on the world-o-meters site below [1] they give an estimate for the IFR of 1.4% for New York City. They explain their reasoning in some detail. You need to divide deaths/(deaths + recoveries) otherwise you'll get a low figure for a CFR. Incidentally, for the US as a whole. We have 2,356,655 cases, 122,247 deaths and 979,790 recovered at the time ...[text shortened]... s.info/coronavirus/coronavirus-death-rate/
[2] https://www.worldometers.info/coronavirus/#countries
It's impossible to know precisely, but it varies so widely between time and place that CFR is a terrible proxy for IFR. Like I said, in early March in NY, the ratio between cases and positive tests was probably 1,000 to 1 or higher. The infection was spreading like wildfire, but if you wanted to get tested on February 25, you had to prove that you'd been to China or Iran in the last 14 days AND had a fever and cough.
"Recovered"s are also completely meaningless. The only way to get this data is hospital discharges or negative tests. Most people who get COVID aren't in hospitals and don't bother getting follow-up tests. Scores of my relatives and friends got COVID and NONE of them got follow-up tests. They just got better and went on with their lives. We were in lockdown anyway, so there was no need to get a negative test to go "back" to anywhere anyway. I chuckled pretty hard when my county was still showing zero recoveries around March 22 when I personally knew scores of people who had recovered, including 3 brothers-in-law and their whole families.
As I said before, I understand the limitations of comparing cases and deaths on any given date, but given those limitations, you need to come up with some sort of proxy if you're going to bother at all.
If you want instead to use cases and deaths 14 days apart, that's fine.
Dexamethasone is one treatment. It's not the only one being used. Remdesivir, Avigan and other antivirals are being used. Blood thinners are being used for people with cardiovascular issues. Monoclonal antibodies like Tocilizumab are being used. Convalescent plasma is being used. Corticosteroids and other anti-inflammatories are being used. Other small measures like laying patients are their stomachs do small things on the margins.
Not all of these things have been proven in RCTs yet (there hasn't been enough time), but some of them are definitely helping.
While there's a certain antiseptic appeal of using the ratio of a single treatment based on a single RCT to mathematically estimate the effect on IFR, that is not a holistic summary of the actual state of affairs.
22 Jun 20
@sh76 saidDoesn't that justify considering the possibility that SARS2 started here in the USA? Why else would so many people have already had it? Most of them didn't even know they had it until they were tested. This could have been happening prior to the Wuhan outbreak.
"A state-funded study at Wake Forest Baptist Health shows nearly 10 percent of people tested in North Carolina have antibodies to the coronavirus."
https://www.wral.com/coronavirus/antibody-study-shows-more-people-infected-with-coronavirus-in-nc-than-numbers-show/19150903/
NC's population is ~10.5 million, implying about 1.05 million infections.
With ~ 1,269 deaths repo ...[text shortened]... ator), and I'm optimistic that the COVID IFR will settle in at less than .5% as the summer moves on.
Why are so few people talking about this possibility?
22 Jun 20
@metal-brain saidThere were hundreds of flights between Wuhan and the US in November-January and hundreds more between Europe and the US after the virus had gone to Europe.
Doesn't that justify considering the possibility that SARS2 started here in the USA? Why else would so many people have already had it? Most of them didn't even know they had it until they were tested. This could have been happening prior to the Wuhan outbreak.
Why are so few people talking about this possibility?
There is no evidence of any cases in the US prior to December.
22 Jun 20
@sh76 saidRead this:
There were hundreds of flights between Wuhan and the US in November-January and hundreds more between Europe and the US after the virus had gone to Europe.
There is no evidence of any cases in the US prior to December.
https://www.globalresearch.ca/tracing-evolution-migration-sars-cov-2/5710648
"There is no evidence of any cases in the US prior to December."
There was no testing to find evidence. This makes your pointing to a lack of evidence irrelevant. There is anecdotal evidence of it from respected science journals. I'll try to find them and post them again.
@sh76
https://www.sciencemag.org/news/2020/01/wuhan-seafood-market-may-not-be-source-novel-virus-spreading-globally
Scroll down and read where is says "Where Did the Virus Come From?" on the link below:
https://science.sciencemag.org/content/367/6477/492.full
There is no evidence SARS2 originated in Wuhan or even China.
https://www.redhotpawn.com/forum/science/origins-of-covid-19.184807
24 Jun 20
@sh76 saidWell, I appreciate your optimism Dr. Pangloss, but Covid deaths lag initial infection by around three weeks. Things are going to get worse before they get better, and there is no solid proof yet that antibodies hang around in the body beyond a couple months or so. This is not to say there is no hope, but "a dash of this" and "a twist of that," like we're mixing cocktails, is not going to deliver the nation from a serious 100-year pandemic.
"A state-funded study at Wake Forest Baptist Health shows nearly 10 percent of people tested in North Carolina have antibodies to the coronavirus."
https://www.wral.com/coronavirus/antibody-study-shows-more-people-infected-with-coronavirus-in-nc-than-numbers-show/19150903/
NC's population is ~10.5 million, implying about 1.05 million infections.
With ~ 1,269 deaths repo ...[text shortened]... ator), and I'm optimistic that the COVID IFR will settle in at less than .5% as the summer moves on.
@no1marauder saidWhat was the UV rating?
It was 86 in Rio today. https://www.accuweather.com/en/br/rio-de-janeiro/45449/weather-forecast/45449
Rio 5 or 6
NYC 8 or 9
You really are dense.
24 Jun 20
@soothfast saidA bit of circular reasoning there.
Well, I appreciate your optimism Dr. Pangloss, but Covid deaths lag initial infection by around three weeks. Things are going to get worse before they get better, and there is no solid proof yet that antibodies hang around in the body beyond a couple months or so. This is not to say there is no hope, but "a dash of this" and "a twist of that," like we're mixing cocktails, is not going to deliver the nation from a serious 100-year pandemic.
24 Jun 20
@eladar saidNot at all. Refined treatment protocols such as those sh76 mention are all very well and good, but they are in no way a cure, and many of the medications mentioned can have serious side effects. They won't win us through the pandemic, but they should help lower death rates some. Most of the medications are only recommended for those on death's doorstep, because some of them can hamper the immune system and invite secondary infections.
A bit of circular reasoning there.
Right now the best public health strategy is this: masks, hand washing, and distancing, with frequent testing, contact tracing, and lockdowns targeting places experiencing spikes. This all buys time for better treatments to be developed, and maybe, with a bit of luck, for a vaccine to come out in a year or two. Or five or never. It is still not at all clear a vaccine can be developed for this virus, though I remain hopeful.
@soothfast saidObviously, I'm not recommending against masks, etc. I wear masks myself whenever interacting with others in a public place. I'm just explaining why the IFR would have gone down.
Not at all. Refined treatment protocols such as those sh76 mention are all very well and good, but they are in no way a cure, and many of the medications mentioned can have serious side effects. They won't win us through the pandemic, but they should help lower death rates some. Most of the medications are only recommended for those on death's doorstep, because some of t ...[text shortened]... r. It is still not at all clear a vaccine can be developed for this virus, though I remain hopeful.
There seems to be a silly tendency to conflate any optimistic take with "let's ignore the dangers of COVID."
COVID is a dangerous disease and we should try to avoid it where we can. That doesn't contradict the idea that it's not as dangerous as we thought it was in March.
"Cure" is also a borderline irrelevant word. There's no "cure" for any viral infection. but we somehow manage to live our lives anyway.
24 Jun 20
@soothfast saidThousands of people are dying there everyday!
What is it in Arizona?
Texas??
Florida???
What are those death rates? Are the people who are dying living outside or inside with air conditioning?