Whenever people start arguing numbers, and flapping statistics and qualifiers and definitions around, I’m reminded of the quote from Mark Twain: “There are lies, damned lies, and statistics.”
I took a stat class at The Big U several hundred years ago. I don’t remember much at all, except that there are a dozen or so ways to take a column of numbers and twirl them with equations, and you get different results. Then, if you want to fine-tune your chosen results, you can kick some numbers out.
My qualifiers for who to listen to are the following: epidemiology experts, and in hindsight, who got the most answers right.
By those parameters, I don’t give a damn what the President or the Vice-President has to say.
The one number I will abide by is the number of fatalities. Dead is dead.
Death rate is measure by how many people have the disease. It’s more relevant for from a medical perspective because it tells you how relatively deadly a disease is even with the muddying factor or testing. The same muddying occurs with the flu. Many more people don’t get tested for the flu than covid (at least now that we have better testing) because they don’t get sick enough. “Deaths per thousand population” is a relative risk which is simply the probability of dying of anything. At the peak of the pandemic, Covid was the second leading cause of death according to this - Covid-19 has become one of the biggest killers of 2020
Even if it were to end tomorrow, covid-19 would still be among the leading causes of death in 2020 so far. At more than 235,000 lives lost according to official records, the disease currently ranks above breast cancer, malaria and Parkinson’s disease. And this figure is also almost certainly too low. In many countries, official covid-19 death tolls include only those who die in hospital or who have tested positive for the virus. Those who die elsewhere, or undiagnosed—as well as those killed by conditions that might normally be treated in intensive-care units now overwhelmed by covid-19 patients—are left out of the statistics.
Note both “this figure is also almost certainly too low” and, very importantly, “Even if it were to end tomorrow.” The comparison’s between covid-19 deaths so far and annual deaths from the other diseases; so between 6 months of deaths from a disease that was barely getting started in the first couple of months, and 12 months of already well established illnesses.
And it certainly isn’t going to “end tomorrow”. Nor do we know whether we’ve seen “the peak of the pandemic”; that might well be later this year, or sometime next year. Rates are rising again in a number of places.
In death rate per week during the peak of the pandemic. So it was one of the leading causes of death per week in April worldwide. Since it fluctuates, it’s hard to predict what it would be in the future.
You’re making a non-statement. HIV is a deadly disease that is almost impossible to get randomly. It was the posterchild of diseases easily avoided.
Covid-19 is easily spread but kills very few people. It requires a massive sample size in order to use the information for planning purposes. And regardless of how many people are tested the information is void in short period of time and you have to start over. Your analogy of the two are completely unrelated.
The testing doesn’t provide enough information for national or regional planning purposes. It’s more useful for micro planning. If a business shows a number of employees have the virus you can focus on everyone connected with the business. That’s the value of testing.
Exactly! Death rate is still decreasing only partly because we have better diagnosis and treatment now than before. However, it is also because the vast majority of new cases are young people who will not get as sick or may take longer to die. They will also be passing it on to middle aged and older people. I believe it is taking an average of 3 weeks for very sick people to pass away so we’re going to start seeing an increase in deaths a couple of weeks from now. In fact, Texas may be starting to see an increase. It’s certainly going to happen in San Antonio because hospitalization, ICU and ventilator rates have skyrocketed in the past few weeks even though the vast majority of new cases are under 40 yrs old. In fact, hospitalization, ICU and ventilator numbers are increasing for people 18-40 years old and there are as many people in this age group in the hospital as there are +65 yr olds. These data are being downplayed for death rates but this should also be stressed.
What I am waiting to see, is if COVID takes a nasty turn as the 1918 Flu Pandemic did: once young people became the infected population, the flu created what has been called a “cytokine storm.” It turned a disease that had initially been recoverable by the young into a rapid, deadly infection.
Admittedly, COVID is not influenza. However, the family of coronaviruses is notorious for mutating.
One thing I have observed from this pandemic, is generalities don’t work very well.
I confess, I used terminology that I did not investigate personally. The source I read described a collected set of observations (based on historical records) where young, healthy people were infected in the second wave of the 1918 influenza, and were dead in days, sometimes hours.
I’ve heard where influenza can morph or mutate into an infection that apparently triggers an autoimmune response whereby the body essentially attacks itself. I remember it being described as the small alveoli in the lungs essentially dissolve, and the victim drowns in his own blood.
Coronaviruses mutate. That’s one of their major characteristics. That fact alone would make me hesitate before I could ever say that the young people may become infected, but they’ll recover.
One book I have read is “The Great Influenza,” by John M Barry.
I got started reading “plague history” years ago, starting with “And the Band Played On,” by Randy Shiltz. That book knocked me flat by the government’s handling of AIDS, and I re-read it every so often to keep me grounded in truth and reality.
The description I provided about the “dissolving alveoli” with the flu patient drowning in his or her own blood is something I heard just a few years ago as a doctor described a steep decline in a young flu patient who unfortunately died.
During every flu season, we anticipate hearing about the aged, the immunocompromised succumbing to the flu. When a healthy young person dies, it’s considered news. Doctors and family members are interviewed.
Death rate per confirmed number of cases is almost certainly over-stated, though the actual IFR may be slightly understated. The IFR is likely going to be an educated guesstimate.
Another caution is that if you have an IFR of, say, 1%, that’s over the entire population. That metric can vary a lot based on the circumstances. You might have a relatively low fatality rate (maybe slightly under 1%) in areas that are sparsely populated and where the incidence is low. But in Phoenix (now), Houston (now), metro L.A. (now) or New York (in April), that rate could be much higher, particularly when ICUs fill up, healthcare workers struggle to find resources to treat them, and healthcare workers themselves become COVID patients. In that scenario, you might have an IFR that is well above 1%.
I think that’s really what I’ve been trying to emphasize. Yes, the death rate might be just somewhat worse than a bad flu - among all cases. When the case load spikes out of control, that death rate goes way up. That death rate is something we can influence with our own collective behavior.