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Old 03-28-2020, 09:56 PM
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Predict the number dead from COVID-19 in America by end of 2020


I don't think this forum allows polls but please choose between:
  1. Less than 50K
  2. 50 to 100K
  3. 100 to 200K
  4. 200 to 300K
  5. 300 to 500K
  6. 500K to 1M
  7. Over 1 M

I'm going with option 2, 50 to 100K myself, and suspect upper middle of the range. That is BAD, and unless we can flatten the curve to the degree that it backfills in the low influenza rate summer months risks overwhelming local healthcare systems as it rolls from local surge to local surge. Spread out over five to six months, with most focus on protecting the most vulnerable, and it can be handled. Allowed to peak all in a month period in each locale and it will continue to be the stuff of horror movies.

I've come to the number through several ways but looking at the curves here, specifically the "COVID-19 Cases by Country, normalized by country population: deaths" (log version) it looks like it may level off around 200 to 250/million population is the course for Spain and Italy. U.S. population 330 million, skewed younger than Italy, comes to 66 to 82.5K.

Note this guess implies that NYC will top off at a bit over 2000 deaths, unless more die as a result of overwhelmed systems, roughly three times the deaths recorded there to dates.

Please note that a poll of ID experts reported on in the 538 blog has a predictions ranging "from 4,000 all the way to 1 million" with a "consensus" (?median?) of 200K. I wonder if our crowdsource will come up with a similar range. I suspect this crowd will skew to the higher numbers.
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Old 03-28-2020, 10:26 PM
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I think by the end of the week the US will be experiencing well over 1,000 deaths per day.

It is interesting to note that the top end estimate by all but 3 experts in the 538 poll woefully underestimate the cases at 30 March which will number over 150,000. Unfortunately I think 6 or 7 are on the cards.
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Old 03-28-2020, 10:31 PM
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Upper edge of one or just into two. 45-55k. Optimistic that one of the antiviral treatments pan out and get widely dispensed yet later this spring.
If not then I'm glad I don't live in or near a very large city or the vacation area of those that do.
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Old 03-28-2020, 10:44 PM
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Unfortunately I'm going with 6, 500k to 1M, though frankly I think there is a reasonable possibility of hitting 4M. I think there is no competent coordinated leadership taking charge. Even when state or local leadership is competent, it's not going to matter too much, because of the disarray at the national level. I think that when hospitals saturate with patients, and the staff are knocked out with COVID-19, that those who might survive with medical care will instead die without. That will skyrocket the death rate.

Vulnerable populations will be hit the hardest, but it will cut across all groups. Those stories I'm reading about the otherwise healthy 30-40 years olds who spent a few days in the hospital and are now recovering, will be stories about how they died waiting for help.

At this point I think all that is go to prevent high-6 to 7 digit deaths is a third act savior. 15 minute test kits being produced at 5k+/day, and distributed; an effective treatment with drugs already approved for human use, and that can be produced and distributed; a competent national COVID Council and Czar being created, with the authority to effectively coordinate things on a national level; a miracle vaccine, etc.

Of those, the test kits are the most likely, but the results still need to be effectively used to make any difference.

Please convince me I'm wrong.
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Old 03-28-2020, 10:45 PM
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OPs article also mentions that when the poll was taken, they currently had 3500 diagnosed cases (so around march 15th). Then they asked pandemic specialists how many cases on March 29th (ie today).

All but 3 experts predicted under 50,000, some well under 50,000. Only 3 predicted more than 100k as even being a possibliity, and nobody predicted 100k as the 'best estimate' (one had about 70k as his best estimate, everyone else was <50k by March 29th).

As of the 28th, we were at 113,000 cases, and I'm guessing we will be at 120-130k when official numbers come out for the 29th. So every one of the experts vastly underestimated how many cases we'd have within 2 weeks of being polled.

https://fivethirtyeight.com/features...l_taboola_feed

Quote:
How many total COVID-19 cases in the U.S. will the CDC report on March 29?
At the time the survey was in the field, about 3,500 cases had been reported. But the experts estimated that by Sunday, March 29 — a little under two weeks after they took the survey — the country would have seen anywhere from 10,000 to 75,000 cases. (The current count is 15,219.) The experts’ confidence in those estimates, however, varied greatly:

Andrew Lover, an epidemiologist from the University of Massachusetts who took the survey, said his estimates were “semi-quantitative” and based on the virus’s progression in other countries. “The doubling times have been 5-8 days most places, so it’s a matter of applying that with some sliding-scale adjustments (testing rates, population density, etc.) based on the ‘feel’ of the epidemic curves.”

The consensus forecast generated by the individual responses indicates that we should expect roughly 19,000 reported cases by March 29, with an 80 percent chance of seeing between 10,500 and 81,500 cases.
Which makes me wonder if most of the experts are underpredicting in other areas. Because when it comes to deaths, they predict 250k deaths in 2020 as the highest probability.

But again, these same experts predicted 10-20k cases by March 29th as the highest probability.

Case rate and death rate, at least since March 15th, has been growing about ~30% a day, so doubling every 3 days.

https://en.wikipedia.org/wiki/Timeli...tates#March_15

I'm starting to fear 1-2 million deaths by the end of the year, assuming we can't maintian quarantine due to noncompliance and peoples fears for their economic safety. That number assumes we have no working drug therapy to take the edge off in severe patients, quarantine is ignored or only lightly enforced, hospitals are overrun, etc.
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Old 03-28-2020, 11:06 PM
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I keep lists of mass killings. I keep a list of the daily body count from this virus. I play the dead pool each year.


Count me out of this. It is distasteful.
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Old 03-28-2020, 11:16 PM
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Hasn't testing capacity increased dramatically since the 15th? If so, an increase in the number of cases isn't due to more cases, just the number of cases we know about.

In other words, experts being wrong about how many cases there would be on the 29th is not an indication they are wrong about the total number of deaths this will result in. The additional number of cases could easily be driven by testing capability and not because there are actually that many more cases.
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Old 03-28-2020, 11:20 PM
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Old 03-28-2020, 11:26 PM
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What exactly is the point of this morbid exercise? Are we going to start a betting pool on how many people, innocent of any wrongdoing other than living their lives, succumb to a virulent pandemic that they were not given good guidance or even marginally competent leadership to avert?

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Old 03-29-2020, 02:01 AM
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I believe trying to get a sense of what we are in for is actually pretty important for society, for economics, for social psychology.

I don't know whether to say 5 or 6, because I think it will be right around a half million.
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Old 03-29-2020, 02:27 AM
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Quick extrapolation, if we take Italy for example, which is probably close the the peak right around now, I'd say about 5.5 * (10000 + 10000 to 20000) = 110000 to 175000. But still, not enough constants and to many variables to even educationally guess let alone predict anything right now. Just one very crude speculation of many.
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Old 03-29-2020, 06:46 AM
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You all are using base numbers that have no basis in reality. Until you can AT MINIMUM test a representative sample can you make predictions about the future.

For example there appears to be a large segment of asymptomatic carriers. Are these people truly asymptomatic or people that just have mild cases, so mild they go unnoticed?

You also need to take account in quality of healthcare. A recent survey in Chicago showed dramatic difference in the recovery of heart patients, simply based on income level. (They could afford better treatment options, and hospitals).

Having a world class hospital is going to go more to helping than several marginal hospitals.

Far to many variances to make any serious prediction
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Old 03-29-2020, 06:53 AM
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What is the formula being used to extrapolate? Is it simple math with no restraints and no expectation of flattening the curve?
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Old 03-29-2020, 07:05 AM
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I hesitate to project. Recent news on the treatment front is that the virus is slow to mutate. This means we could be lucky and get a vaccine.

It also means that if the numbers are higher than we think, there are just lots of asymptomatic people, this means that by the end of the year, there could be lots of immune people.

If the virus is slow to mutate, and we get lots of immune people walking around, who had it without symptoms, we might get herd immunity.

Or we might be fucked.

Just sayin'
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Old 03-29-2020, 08:51 AM
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Here’s what I gather are the best guesses so far and why this is likely a very difficult prediction to make. Mortality seems to be around 1% in areas with good medical care where the system does not get overwhelmed. In areas where the number of patients overwhelms the local medical system it seems to be closer to 5-10%. The problem with making further predictions is that this misses an essential part of the question, that being how many people will become infected? That is a much more difficult question to answer and sadly to a large extent it will depend on the leadership of Trump. From what we’ve seen so far, Trump’s actions are harder to predict. My best guess is that the numbers will likely end up in the hundreds of thousands but I admit to being very uncertain about that.

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Old 03-29-2020, 09:10 AM
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I think less than 50K.

There are still counties in PA that have no cases of the virus.

I live near the NJ / PA border. I was glad to see the government shut down the large number of commuter buses running from PA to NYC – however, yesterday there were over 600 cars parked just inside the NJ border in a new bus parking lot. All of those people are driving directly from NYC to eastern PA. I would really personally and selfishly like to see that traffic stopped, and fear that that traffic alone might push things above 50K by continuing the spread.
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Old 03-29-2020, 09:24 AM
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I think less than 50K.

There are still counties in PA that have no cases of the virus.
No *known* cases of the virus -- big difference.
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Old 03-29-2020, 09:26 AM
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Hasn't testing capacity increased dramatically since the 15th? If so, an increase in the number of cases isn't due to more cases, just the number of cases we know about.

In other words, experts being wrong about how many cases there would be on the 29th is not an indication they are wrong about the total number of deaths this will result in. The additional number of cases could easily be driven by testing capability and not because there are actually that many more cases.
Possibly, but if you check the chart both the rate of confirmed infections and the death rate has steadily been increasing at about 20-40% a day for the last 2 weeks.

https://en.wikipedia.org/wiki/Timeli..._United_States

If it were just the number of diagnosed cases going up, wouldn't the death rate be increasing more slowly?

On 3-28 for example the number of cases grew by 20% while the number of deaths grew by 28%.

Also my understanding is the death rate is actually higher. I forget which article I read it in, but supposedly many deaths aren't being properly reported, plus as the virus overwhelms hospitals there will also be deaths due to strokes, heart attacks, accidents, women in labor, etc who can't get proper medical care.
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Old 03-29-2020, 09:29 AM
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To those who find this exercise distasteful (yet hang on the daily tracker numbers slavishly, and often throw around about how there will be millions dead), well, don't participate. To me having a sense of how bad this is going to end up being by this metric is very important. And appreciating the lack of key information to the degree that the most expert minds are coming up with predictions of such wide ranges is also important to highlight.

RivkahChaya, we could get a vaccine, but not likely one that will available before the end of 2020. 12 months is optimistic, 18 months more realistic.

Addressing Carryon and Musicat's comments.

My stab at it was not using a formula at all, but looking at the log scale deaths/million "growth charts" on the linked cite. There is a common shape to those growth charts (reflective of both natural history of the disease in the populations and of the timing of the Western world's publics' and governments' responses to it). The curves originate at 1 death/million population and all of Italy, Spain, and France, are farther along on the curve from that point than we are. They all show the log curve beginning to get less steep around day 10 to 15 days into the curve. Projecting the Italy and Spain curves (farthest along of the bigger number counties) current trajectories have them both likely becoming flat at around 250 deaths/million.

I think that just as it reasonable to use previous children's growth to predict the adult height of a 2 year old, it is reasonable for us at day six from hitting that mark to use the growth trajectory of those ahead of us to make an estimate of what we will see. Yes it will not be exact just as few children follow the standard curves exactly (impacted by demographics and responses/capacity specific to each nation), but a good rough stab. (250 deaths/million) * (population of the United States) 330 million = 82,500. Those who predict many more times than that are predicting that we will have that many more times the deaths per million population than Italy, France, or Spain look to be on course to have.

Now it could be that my extrapolation of those curves is faulty, and that they do not continue to flatten any more than they have but stay at this lower rate for months, more gradually but consistently increasing over months, or even jumping up as restrictions are lifted. We do not know for sure that Italy's deaths/million are actually closing in on adult height.

But yes using the SIR type of model is fraught right now as it is so dependent on what is input into it as assumptions. My prediction based on those growth curves is consistent with what I calculate using assumptions of 1% fatality rate among those symptomatic enough to be labelled as having COVID-19, 8 to 9 others who get infected with SARS-CoV-2 but remain either asymptomatic or so mildly symptomatic as to never be labelled as having COVID-19, children mostly non-contagious, and herd immunity beginning to play a factor at an infection rate of 40% with bigger impact at 50%. How valid or invalid are those assumptions? They are not crazy ones but ...? The fact that we don't have some better harder basis for which assumptions are most valid is hard to excuse. Given that lack I'm thinking the growth chart analogy approach is the best roadmap approach for now. IMHO.

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Old 03-29-2020, 09:33 AM
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Quick extrapolation, if we take Italy for example, which is probably close the the peak right around now, I'd say about 5.5 * (10000 + 10000 to 20000) = 110000 to 175000. But still, not enough constants and to many variables to even educationally guess let alone predict anything right now. Just one very crude speculation of many.
I'm having trouble finding it, but isn't the peak supposed to hit in April or may? Assuming we do nothing, I thought (in the US at least) around May we will hit the peak when there are roughly half a million new cases every day. If italy is a couple weeks ahead of us, that would mean their peak is a couple weeks before that.

However I have no idea how effective the lockdowns and quarantines are at slowing the spread. Over here where I live, people don't seem to be taking it too seriously.
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Old 03-29-2020, 09:40 AM
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The number of people who will die who had coronavirus or are strongly suspected of having it will be around 250,000.

The actual increased mortality won't be that high; it'll be between a third and half that.

That's plenty bad enough.
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Old 03-29-2020, 09:44 AM
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Wow, less than 50k? Right now, the deaths are about doubling every 3 days. I bet it blows by 50k by the middle of April. Last year's flu season killed an estimated 34k people. I have seen nothing to assume this will be easier than the flu.
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Old 03-29-2020, 09:44 AM
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Oh not an infection of 40% but a functioning as "resolved" rate - which puts the 24% of the population that are kids in that bucket.

Please appreciate the fact that this following the growth chart analogy also projects most of the impact occurring in the next 30 days, which will be beyond overwhelming, not spread over 4 to 6 months, like an influenza season is. The one plus side is that since we were later the most vulnerable in particular were to large degrees already socially distancing before governmental edicts. That may get us flattening sooner than Italy or Spain. And that our baseline is more socially isolated for more of our higher risk populations than Italy or Spain's is. So maybe stretched out some more, one hopes.
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Old 03-29-2020, 09:52 AM
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Fauci just said that he expects in excess of 100k deaths, so I'm going with #4.

Cite: https://twitter.com/CNNSotu/status/1...944885248?s=19

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Old 03-29-2020, 09:59 AM
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The one plus side is that since we were later the most vulnerable in particular were to large degrees already socially distancing before governmental edicts. That may get us flattening sooner than Italy or Spain. And that our baseline is more socially isolated for more of our higher risk populations than Italy or Spain's is. So maybe stretched out some more, one hopes.
I am not optimistic about the coming results of earlier "social distancing" in the US. People are barely taking it seriously now outside of the hotspots.
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Old 03-29-2020, 10:04 AM
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Here’s what I gather are the best guesses so far and why this is likely a very difficult prediction to make. Mortality seems to be around 1% in areas with good medical care where the system does not get overwhelmed.
The mortality rate is a tricky statistic. The data seem to show that it's possible to keep the mortality rate down to beween 0.5 and 1.0% in places where there is widespread testing, very early identification of positive cases, and immediate quarantine and treatment available. All three of these things have to be present in order to keep the fatality rate below 1%. Some countries are getting lucky -- for now -- in that they don't have a lot of community spread disease. But once the disease gets into the community and once it gets piped into the transportation infrastructure and into the fabric of everyday living, this virus is off to the races and it's going to score some touchdowns.

Right now, the virus is off to the races. We're looking at a death toll probably around 5 to 10,000 within the next week or two, and there's not much we can do to stop it at this point. After that, I think we're going to see it slow a little. We'll see the rate of infection slow, and we'll hopefully see some cities catch up in treating the most extreme cases. Still, people are going to keep dying. Keep in mind that the case numbers now reflect infections from 7-14 days ago, which is when people started widespread social isolation - and only in some cities. I am hopeful that the number of fatalities will begin to slow. If we're fortunate, the initial wave of deaths will stay somewhere between 20,000 to 40,000; if we're not so fortunate, and if we keep getting in our own way, it could be over 50,000.

There's a very good chance of a second wave, not necessarily because of cooler weather (as the media is foolishly reporting) but because of more social gatherings. Schools will probably reopen. We will probably gradually bring back commerce. Some sports leagues may try to have a shortened season. We will have Thanksgiving and Christmas. We will try to do all of these things with extreme vigilance, but there's a good chance this won't work. I think this smaller wave will not be as bad as this one, but it won't be insignificant either. Our health systems will be better prepared, though this will certainly have an economic impact. If you look at the 1918 pandemic, the last wave (1919) was about 1/4 or 1/3 as bad as the 2nd wave (I'd argue that the fall wave of 1918 was really the first, as the Ft Riley outbreak was *mostly* contained initially).

So if we say that 50,000 people die in the first wave and another, say, 10,000 die in the second wave, that's 60K, and I'd call that a success. If we continue to flub the responses, though, then we could have a lot more than that. I'm gonna say between 50 and 100K, with the possibility of going higher than 100K. I'd be somewhat surprised if it exceeded 200K, though not absolutely shocked.
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Old 03-29-2020, 10:04 AM
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However I have no idea how effective the lockdowns and quarantines are at slowing the spread. Over here where I live, people don't seem to be taking it too seriously.
One of the many many things that frustrates me is that I have no idea how seriously people around me are taking this . . .because I am taking it very seriously. Except for walks around the block, we've been out of the house I think 3 times in two weeks, for grocery store, doctor, take-out in some combination each time. So I have no freaking clue if I am the only one doing this, or if 90% of my neighbors are following the same protocols.

I make no predictions. I am unsettled by how wrong the people in the 538 article were; it suggests that the unknown unknowns are massive.
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Old 03-29-2020, 10:50 AM
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To those who find this exercise distasteful (yet hang on the daily tracker numbers slavishly, and often throw around about how there will be millions dead), well, don't participate. To me having a sense of how bad this is going to end up being by this metric is very important.
And your method of doing this is to poll random people on the Internet? You'd have equal efficacy scrying into your whiskey or receiving emanations from Urim and Thummim. Asking a poll of non-informed non-experts on this issue is like asking how many of the hundred pregnant women in your town are going to have miscarriages. This is beyond poor taste.

There is totally inadequate data regarding infectiousness, mortality, the percentage of the population which is asymptomatically infected, and the ultimate effectiveness of all of the efforts going on now to improvise protective equipment and respirators so that medical personnel can continue to treat severe and critical patients who may die without support. The only real guidance we have right now is an empirical look at the trends in other countries which had outbreaks proceeding the United States and the relative effectiveness of those measures to limit the spread and blunt the peak of COVID-19 cases, and by that measure, the outcome does not look good. The US is trending more like Italy and Spain rather than South Korea, and to say that this is not good is like saying that rain is a little wet.

Quote:
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One of the many many things that frustrates me is that I have no idea how seriously people around me are taking this . . .because I am taking it very seriously. Except for walks around the block, we've been out of the house I think 3 times in two weeks, for grocery store, doctor, take-out in some combination each time. So I have no freaking clue if I am the only one doing this, or if 90% of my neighbors are following the same protocols.

I make no predictions. I am unsettled by how wrong the people in the 538 article were; it suggests that the unknown unknowns are massive.
All you can do at this point is take the best measures to protect yourself and your family based upon the best evidence that you have. The measures you describe are reasonable and at least reduce your risks far below the people who are standing around on a corner passing a vaping stick around (not kidding, I've actually seen this every day this week right outside my window) and despite all of the wealthy people suddenly buying out resort hotels or trying to travel to remote islands, staying home and limiting social contacts to the minimum necessary is really the best thing to do, because if Forrest Gump can't outrun this virus, neither can a bunch of i-bankers and CEOs.

The FiveThirtyEight.com article doesn't have a list of the 'experts' who made predictions so we can't know what the basis for their estimates are or what political or other biases may be skewing the results, but it is pretty clear that the best answer is "We don't know but possibly exceeding 2,000,000." Of course, it will skew to the high side if measures are not put in place both to enforce social distancing and isolation, and to help support people whose livelihoods have suddenly been destroyed by those measures so they don't go out and seek employment in ways that will obviate efforts at isolation. And until we have antibody testing to know who has been infected and what the distribution of people with acquired immunity looks like, we won't know how safe it is to ease up on measures or let people who are demonstrated to be non-carriers return to work while still providing to support to those at risk.

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Old 03-29-2020, 11:08 AM
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RivkahChaya, we could get a vaccine, but not likely one that will available before the end of 2020. 12 months is optimistic, 18 months more realistic.
My point more had to do more with the idea that since the actual number of people who have been infected and recovered is a mystery, there could be lots of immune people walking around right now, whom we have no idea are immune.

If the number of cases in the US turned out to be, say, 10x the known number, that's a lot of immune people, and if every diagnosed case represents 3 undiagnosed cases, AND we have a virus mutating very slowly, that will seriously slow down the rate of infection. The graph of infections may not be even on both sides. It may rise slowly with social distancing, but after it reaches a peak, it may drop precipitously, due not exactly to herd immunity, but something like, maybe "herd resistance," as it becomes more an more difficult for the virus to find paths to travel.

Yes, that's a "best case" scenario, but since we continually hear that there may be many, many more people infected now, or previously infected, I don't think it's impossible.
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Old 03-29-2020, 11:11 AM
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This exercise, distasteful or not, seems to be based on the assumption that a death will be definitely attributable to covid or not. But unless all people who get sick and die in the next months had been tested, you won't know which.

Patients will present to hospital today in heart failure, with a COPD exacerbation, in a delirium, and with heart attacks. Some of them, although asymptomatic in other regards, will have covid. In fact, covid may have precipitated their acute problem.

A relevant NYT article and one from JAMA Cardiology.

And, ftr DSeid, do you think those without health care who die without having interacted with the healthcare system will be adequately counted (or will have even been tested for the virus)?

The metric that will count - increase in all-cause mortality - won't be available until it is 'too late'.

So, the OP's question is ill conceived (and may lead, inadvertently or otherwise, to cause people to underestimate the threat).

Last edited by KarlGauss; 03-29-2020 at 11:13 AM.
  #31  
Old 03-29-2020, 11:53 AM
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And your method of doing this is to poll random people on the Internet? ...

... The FiveThirtyEight.com article doesn't have a list of the 'experts' who made predictions so we can't know ...
I believe it is informative to hear the thought processes of others, and to share my own, yes.

As to the group of, as you put it "experts", who were part of the 538 bit - surely you can manage to click a link to their source and open the pdf?
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Benjamin M Althouse Institute for Disease Modeling, University of Washington, New Mexico State University
Dr. Caroline Buckee Harvard TH Chan School of Public Health
Donald S. Burke, MD Graduate School of Public Health University of Pittsburgh
Mary Bushman Harvard T.H. Chan School of Public Health
Lauren A Castro Los Alamos National Laboratory
Sara Del Valle Los Alamos National Laboratory
John M. Drake University of Georgia
Stephen Eubank University of Virginia
Lauren Gardner Johns Hopkins University
Dylan George In-Q-Tel
William P. Hanage Harvard T. H. Chan School of Public Health
Andreas Handel University of Georgia
Michael L. Jackson Kaiser Permanente Washington
Stephen Kissler Harvard School of Public Health
Justin Lessler Johns Hopkins Bloomberg School of Public Health
Bryan Lewis University of Virginia
Marc Lipsitch Harvard T.H. Chan School of Public Health
Andrew A. Lover University of Massachusetts- Amherst
Steven Riley Imperial College
Caitlin Rivers Johns Hopkins Center for Health Security
Roni Rosenfeld Carnegie Mellon University
Samuel V. Scarpino Northeastern University
Shaun Truelove Johns Hopkins Bloomberg School of Public health
Srini Venkatramanan University of Virginia
Cecile Viboud Fogarty International Center, NIH
Ya, you're right, just "experts" with political biases.

Please be aware that NO ONE in this thread is encouraging letting up on any control measures at this time. In my strong opinion, the timing and nature of any let up of any sort has to be informed by actual facts, as we belatedly collect them, and as they occur. But this thread IS NOT about what should be done when and there are many other threads with that discussion contained. Take that discussion somewhere else and please do not hijack this one
  #32  
Old 03-29-2020, 12:20 PM
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Possibly, but if you check the chart both the rate of confirmed infections and the death rate has steadily been increasing at about 20-40% a day for the last 2 weeks.

https://en.wikipedia.org/wiki/Timeli..._United_States

If it were just the number of diagnosed cases going up, wouldn't the death rate be increasing more slowly?

On 3-28 for example the number of cases grew by 20% while the number of deaths grew by 28%.

Also my understanding is the death rate is actually higher. I forget which article I read it in, but supposedly many deaths aren't being properly reported, plus as the virus overwhelms hospitals there will also be deaths due to strokes, heart attacks, accidents, women in labor, etc who can't get proper medical care.
The death rate is going to lag the case rate by 1 to 2 weeks. People dying this week were new cases 1 to 2 weeks ago.

Your point is dead on, though. If the death rate, adjusted in time to the diagnosis date, is climbing at the same rate or faster, then the increase in case rate isn't just due to testing. I had included all that in my original reply but decided brevity was better.
  #33  
Old 03-29-2020, 12:31 PM
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This exercise, distasteful or not, seems to be based on the assumption that a death will be definitely attributable to covid or not. But unless all people who get sick and die in the next months had been tested, you won't know which.

Patients will present to hospital today in heart failure, with a COPD exacerbation, in a delirium, and with heart attacks. Some of them, although asymptomatic in other regards, will have covid. In fact, covid may have precipitated their acute problem.

A relevant NYT article and one from JAMA Cardiology.

And, ftr DSeid, do you think those without health care who die without having interacted with the healthcare system will be adequately counted (or will have even been tested for the virus)?

The metric that will count - increase in all-cause mortality - won't be available until it is 'too late'.

So, the OP's question is ill conceived (and may lead, inadvertently or otherwise, to cause people to underestimate the threat).
KarlGauss, strongly disagree that an informed discussion about how bad the storm that is making landfall as we speak is going to be, and about how best to use the emerging information we have to understand that as best we can, given the lack of factual key inputs to run the usual models, is "ill conceived."

No question that just like for influenza epidemics, like H1N1, full accounting will never occur, and initial estimates during the moment will be modified over future years. That includes eventually making estimates of those who died without healthcare system interaction, from other causes due to lack of services during a period of the system being overwhelmed, and those who died later because of care and diagnoses delayed by lockdowns. Still it was useful during H1N1's emergence to try to understand what its landfall impacts were going to be.

If anyone gets the impression that the numbers need to be in the hundreds of thousands or more to be "serious" then they are not listening at all: 50 to 100K, (250 deaths/1,000,000 population) the range of a bad flu season, occurring as a surge in 1 month, which is the surge has looked like in Western countries ahead of us, is a nightmare scenario, in which a good many of them died because we failed to flatten the curve. IF that is a reasonable prediction, then slowing it down in communities not yet appreciably hit, so that it spreads over months and not weeks, requires taking action, well a week or two ago.

If you have some informed intelligent criticism of my thought that lacking other key information looking at the shape of the growth curves of death rates/million population (more likely a real number than "confirmed cases" which at this point is of near no value), or my interpretation of the shapes of those curves, I would be happy to hear it.

Last edited by DSeid; 03-29-2020 at 12:33 PM.
  #34  
Old 03-29-2020, 01:06 PM
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I keep lists of mass killings. I keep a list of the daily body count from this virus. I play the dead pool each year.


Count me out of this. It is distasteful.
I agree with the sentiment. However, I think it needs to be discussed. The early estimates of it doubling every 6 days are not represented in the number dying. I've been looking at it from different angles. NY is the bulk of deaths in the US and their total deaths per million today (29-Mar) match Italy's on 24-Mar. However, Italy's numbers in the last week show less than a doubling every 3 days. NY is showing more. Obviously large/dense cities with high rates of international travel will be affected more. How well shelter-at-home works won't be known for weeks. We broke even the last 2 days so fingers crossed.
  #35  
Old 03-29-2020, 01:18 PM
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I've been working with, well playing with different models, even the best one doesn't look good.
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Old 03-29-2020, 01:26 PM
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I'm an Computer Science person, so powers of two factor into my thinking.

1. The naive, horrible thought: We just had a doubling to 2000 deaths after a couple of days. There's time enough for maybe 10 doublings. That's a factor of 1000. So, 2 million dead.

2. The better, much better thought. With currently 100+k known infected (and presumably a lot more unknown), you can't really go 10 doublings and not get more people infected than total US population. So 10 doublings is clearly too much.

3. The not-so-naive semi-horrible thought. Let's say we have maybe 2% of the population who might have it right now. Some 50+% are going to get it. Round that to 64 in binary terms. That's 5 doublings. 5 doublings on top of 2000 dead already gives you 64k. Hey, getting into the ballpark of the UW guesstimate.

4. The really-less-naive-truly-horrible thought part 1: But there's a lag between infection and dying. A lot of infected people are a couple weeks from dying. Conservatively, add two more doublings. 256k dead. Bye-bye UW guesstimate.

5. The really-less-naive-truly-horrible thought part 2: The current mortality rate is for health care systems that are under stress but not completely overwhelmed. That's going to change. (We might be seeing this in NYC right now.) At best, that's another doubling. But realistically, we're looking at two doublings. 1 million dead. Probably more.

In the next few months.

The main hope is that the isolation stuff and what not helps part 5 quite a bit. But between the delay it buys and adding in the rest of the year, it's a wash.

This poll doesn't cover this side of things well.
  #37  
Old 03-29-2020, 01:32 PM
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Anyone thinking a flattening of the curve is close, just remember they only shut down Spring Break one week ago.
  #38  
Old 03-29-2020, 01:48 PM
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Florida also is a state with an older median age. Second biggest share of population 65+ in the country at 20.5%. (Only behind Maine.) Median age 42. (Four years more than for the United States as a whole.) It is going to get very bad there very fast I fear. No matter how locked down they are now.
  #39  
Old 03-29-2020, 02:34 PM
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4. The really-less-naive-truly-horrible thought part 1: But there's a lag between infection and dying. A lot of infected people are a couple weeks from dying. Conservatively, add two more doublings. 256k dead. Bye-bye UW guesstimate.
l.
the lag time between deaths and infected works both ways. As the number of deaths level off that's an indication that the number of infected leveled off earlier.

I don't put much stock in estimates of infected. Unless everybody is tested every day it's an estimate based on those who have been tested.
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Old 03-29-2020, 02:45 PM
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If you ever played "lunar lander", you know that waiting to long too fire your retros results in a very bad outcome; close to exponentially bad. That's what we've done with COVID-19.
We'll find out what the k is in a = e ^kt by fall.

Last edited by Squink; 03-29-2020 at 02:46 PM.
  #41  
Old 03-29-2020, 03:30 PM
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Without extensive testing we have no way to tell how many deaths attributed to other causes are COVID related. I'll guess that come 2021, statistician well estimate the number of "excess" deaths which will give some idea of how much to blame on COVID. I'm pessimistic and thus pleased to be wrong but I'll go with 11. That's millions. In USA alone. Because [political potshot removed].
  #42  
Old 03-29-2020, 04:55 PM
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I keep lists of mass killings. I keep a list of the daily body count from this virus. I play the dead pool each year.


Count me out of this. It is distasteful.
Why? Especially why is it more distasteful than all the morbid stuff you say you do?
  #43  
Old 03-29-2020, 05:07 PM
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the lag time between deaths and infected works both ways. As the number of deaths level off that's an indication that the number of infected leveled off earlier.

I don't put much stock in estimates of infected. Unless everybody is tested every day it's an estimate based on those who have been tested.
You can be overly skeptical here. Every disease you ever heard of is underreported by this standard. But you can look at the testing regimes of different countries and make meaningful comparisons in the growth of the virus.
  #44  
Old 03-29-2020, 08:02 PM
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I don't know if it's an anomaly or because of 2 weeks of sheltering in place but the last 2 days were the same number of dead and today is half that. this could be the flattening of the first wave.

---date ---- per/day --total
3/15/2020--- 69------ 69
3/16/2020--- 24------ 93
3/17/2020--- 22------ 115
3/18/2020--- 39------ 154
3/19/2020--- 63------ 217
3/20/2020--- 85------ 302
3/21/2020--- 46------ 348
3/22/2020--- 71------ 419
3/23/2020--- 126----- 545
3/24/2020--- 230----- 775
3/25/2020--- 138----- 913
3/26/2020--- 264----- 1177
3/27/2020--- 523----- 1700
3/28/2020--- 527----- 2227
3/29/2020--- 248----- 2475
  #45  
Old 03-29-2020, 08:05 PM
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Possibly weekend reporting again.
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Old 03-29-2020, 09:09 PM
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As others have mentioned, there are several unknowns that would make it very difficult to come up with an accurate estimate. My semi-WAG comes out to about 150K excess deaths directly attributable to COVID-19 respiratory issues, assuming there is no second wave of infection this autumn. I of course would be very happy if this turns out to be a large overestimate.

Last edited by El_Kabong; 03-29-2020 at 09:10 PM.
  #47  
Old 03-29-2020, 09:21 PM
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One of the many many things that frustrates me is that I have no idea how seriously people around me are taking this . . .because I am taking it very seriously. Except for walks around the block, we've been out of the house I think 3 times in two weeks, for grocery store, doctor, take-out in some combination each time. So I have no freaking clue if I am the only one doing this, or if 90% of my neighbors are following the same protocols.
Around here people are definitely taking it seriously. Even major streets are largely empty and there is practically no traffic, even at rush hour or peak weekend errand-running times. Public transportation is quite empty. Lots of friends who use services like Instacart are reporting that it's practically impossible to get a delivery time slot, even if you try at 2:00 am. I hope that's representative of the rest of the country, but of course have no way of knowing.
  #48  
Old 03-29-2020, 09:39 PM
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Why? Especially why is it more distasteful than all the morbid stuff you say you do?
Oddly yes. This smacks of cheerleading.
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Old 03-29-2020, 09:49 PM
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As others have mentioned, there are several unknowns that would make it very difficult to come up with an accurate estimate. My semi-WAG comes out to about 150K excess deaths directly attributable to COVID-19 respiratory issues, assuming there is no second wave of infection this autumn. I of course would be very happy if this turns out to be a large overestimate.
But the flu generally kills about 50,000 people in America each year.

Coronavirus is far more deadly and more infectious.

5-20% of Americans get the flu each year. For coronavirus, it could be 20-70% of people who get it.

Also the death rate isn't known, but figures of the coronavirus being anywhere from 5 up to 20 or more times more deadly than the flu are considered serious answers.
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Last edited by Wesley Clark; 03-29-2020 at 09:50 PM.
  #50  
Old 03-29-2020, 09:50 PM
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Oddly yes. This smacks of cheerleading.
OK, that's just bizarre, but you do you. Honestly I find this far less morbid and disturbing than your mass killings obsession.
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