NY is swamped. It has more cases at any given time than it can handle, even it its theoretical capacity is greater than Bahrain. NY leaders acted too late and were rather dismissive of the threat. (Other places were as well).GCC leaders were pretty on the ball from what I recall back in Feb. They knew they could get swamped and overwhelmed. So they took proactive measures.
The issue is not the number of cases. The issue is active cases at any given time versus capacity. The shutdown and quarantine orders don’t reduce (too much) the eventual total number of cases, those are on track. What they do is spread it out over a longer period. As long as at any given time the active cases are within the capacity of a system to care for, they have a handle on it. And it keeps adverse outcomes low. NYC saw its capacity quickly saturated and exceeded. GCC countries, not yet.
341 deaths out of a population of 54 million is a tiny sample. Just going by the average mortality rate for the world, you’d expect 35,000 people in the GCC to have died in the past month. If just 1% of those deaths were caused by COVID-19 but not reported as such, that would double the number of COVID-19 deaths.
And if you click on each country and look at the “daily deaths” plot, you will see a steady increase.
:smack:
Come again? Dubai is one of the biggest hubs on earth and a massive tourist destination.
Its thebusiest airport by international traffic.
Both Abu Dhabi and Doha are also in the top 25.
(JFK is 17th).
Do Americans really think that the area is a bunch of guys with camels?
You are mistaken if you think the reason NY has 10-15 times the case fatality rate of the GCC states is that it has inadequate resources to take care of sick patients. Further, if you look beyond NY you will see that the Gulf is doing better than anywhere else in the world, including all the US states where the hospital system is nowhere near at capacity.
This is not correct on either point.
While 341 deaths is a small number out of a population aggregate of 54 million, the number of COVID cases is 40,000+, which is a very good sample. So the “tiny number” of 341 means a tiny number of deaths, not a tiny sample.
Which country do you think has a “steady increase”?
The average age difference is about 3 years.
There is no evidence that climate plays a contributing role, although it might. But the GCC states have done substantially better than, say, Arizona.
Population density has nothing to do with survival once you have COVID, and neither does traveling. You are confusing overall rates of infection with survival rate once you have been infected. The difference I am pointing out is the case fatality rate; not the overall infection rate.
While BCG has been suggested by many as a possibility, there is no data to support it, period.
Even adding BCG and climate together as factors seems like a weak explanation for a survival factor difference of ten-fold or better.
The New Yorker had a very good piece in the May 4 issue on where NY went wrong. Former CDC head estimated if NY had shut down only 10 days sooner, it would have reduced COVID-19 deaths by 50 - 80%.
15,000 deaths in NY compared to <700 in Washington at the time of the article.
You are confusing the death total with the case fatality rate.
I am pointing out the difference in the case fatality rate; not the overall numbers of people who get infected or the overall absolute number of patients who died.
Its not just the Gulf States. Worldwide there are striking differences in CFR and IFR.
In the early days of the infection - during the time when there is serious exponential growth the rates are always skewed, simply because it takes a few weeks from becoming symptomatic to dying. If you are seeing a daily increase of say double every three days, which most do before any measures are taken, and it takes say three weeks to move from symptomatic to death, you have a lag of 7 doublings = 64 times between current deaths and current infections. For as long as your country is on a steep exponential this will be true. Only when R[sub]eff[/sub] is well under control does the disparity close. This is why closed cases, not current infections is the important number to compare deaths to.
Many of the Gulf states appear to still be in rapid exponential growth.
Differences in testing, and reporting exist everywhere. It is difficult at best to directly compare countries. Some are only reporting hospital admissions with Covid-19 as infections, and do not even test anyone else. If a country changes their reporting protocol mid-stream the numbers also go out of whack. Many countries are not reporting useful stats for recovery. Many are not tracking positive testing patients that are not admitted. They might recover, they might die at home. Nobody knows. And many patients are still sick - so there is no statistic for them, they have neither died or recovered. During steep growth this also skews the numbers.
What would be good is if there was a generally agreed protocol for reporting CFR and IFR, and every country reported that, and didn’t leave the calculation to people looking at what are very limited and almost useless numbers.
Case fatality rate is not the same thing as infection fatality rate; CFR only measures the percentage of people who were tested and confirmed to have the disease, while IFR includes people who had COVID-19 but who were never tested. Per Worldometer, in New York roughly a third of the people tested were positive (927,438 tests versus 315,222 positive cases, as I write this); that ratio isn’t exact because some people may have had more than one test, but it’s probably pretty close. Meanwhile in Kuwait, out of 179,000 tests they found 4377 positives, or roughly 2.5% versus New York’s 34%. Similarly, in the UAE it’s 13,000 positives in 1.2 million tests, barely one percent; in Bahrain it’s 3170 positives in 134,000 tests, about 2.4%. That at least implies that those countries are testing a lot of people who are asymptomatic, probably as part of general surveillance, whereas New York has had well-publicized problems with test availability, to the point that even people with fairly serious illnesses have had trouble getting tested, and they’ve certainly not been able to do widespread testing of apparently healthy individuals.
If you do widespread surveillance testing, then you are probably going to diagnose a lot more mild cases, people who never do develop serious symptoms, and include them in the denominator of your CFR, whereas if testing is more narrowly confined then you miss most of the mild cases. Comparing 7.5% of mostly-serious cases to 0.5% of cases of wildly varying seriousness is comparing apples and kumquats; it’s definitely not comparing like to like. A more valid comparison would be something like “what percentage of the people in each country who are sick enough to be hospitalized end up dying?”, or perhaps compare “percentage of those with blood oxygen levels below X%” or some other clinical symptom. I have not seen good data for those yet.
AK84, also surprised by Dubai but would still be surprised if there was as much variety of international travel and as much of it staying there as New York City. But not interested enough to research it out, so I will admit that my impression that New York City is in a special class in that way may be just an impression. Chief Pedant yeah CFR reflects selection bias of who gets tested more than anything else. You confuse it for something that means something that requires some bigger explanation than that. Deaths per million (not absolute number of) being so low there is a bit more the issue. If you find CFR rate to be something that needs more explanation than that then you may end up muttering to yourself alone.
Not sure where you get the average age difference of only 3 years (or even why you think that difference would not be a big deal in terms of death rates once infected) but the median age in NYC is about 36 years old, in S.A. it’s 27.5 (and atypically more males in older age groups than females and in comparison there are more women than men in NYC).
I get that you think more than 4 times as many in the highest risk age group demographic is not meaningful to how many die. Personally I disagree.
Climate as a contributing factor is a hypothesis. Certainly it is not a factor that is the single most important item across the globe. The impact of climate, along with shorter term changes in humidity and temperature, on spread of infectious agents is a pattern that has been seen in the past for some other agents.
Population density has to do with deaths per million. More infections faster means both farther on the growth curve and able to get higher. It also can make it harder to protect the most vulnerable populations, including but not limited to the elderly, so IFR (unlike CFR a meaningful number even if we don’t have it at this time) is higher too.
No data to support BCG as a factor period? Wow. That’s a bold and ignorant statement. Fair to state that you are unaware of the data, or that it is not conclusive data at this time, but the reason that it has been mentioned several times is because there is in fact some suggestive data, even if it is just suggestive. The current evidence is suggestive enough that multiple RCTs are in progress in among front line workers.
I got to say your responses in this thread makes one think that you have a preferred hypothesis that you are looking for someone to suggest. Knowing your past history on this board let me guess! Genetic differences! If I was right do I win a prize?
Dubai doesn’t surprise me at all. It is a lot like Singapore, and in many respects it used Singapore as a blueprint. Huge ex-pat population. Many Brits, many Europeans, at one time lots of Russians (many plying less seamly trades.) They push extended visits for passengers in transit. Which isn’t terrible, once. It is a very convenient hub for travel. (I used to work for a company that had a villa there, so we would use it to break our journey. Emirates airlines make this a very convenient tactic for travel into Europe and the middle east, even the East coast USA, especially for those of us in Oz. I’d never go back to that life however. It got wearing.)
They have significant risks. Huge immigrant worker population. The place seems to have almost entirely been built by Pakistani workers. The actual proportion of naive Emirati citizens is low.
Can’t say I ever warmed to Dubai. Nothing to do but shop. They have (had?) a festival of shopping. Many people live in apartment buildings. Climate probably plays a lesser role simply because most of the year it is so hot outside nobody goes outside of air-conditioned buildings.
Which GCC states do you think are still experiencing “rapid exponential growth”?
Which do you think might not be testing or reporting only hospital admissions as positive?
I don’t find it helpful to get replies that suggest possibilities not supported by the data.