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5th Study: CFR Way Lower than Previously Reported

Barry Arrington
May 4, 2020
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Yet another study, this one out of Germany, confirms what was reported in Palo Alto, Los Angeles, Boston and New York. This one arrives at an infection rate of 15% (10X the previously thought number) and a CFR of .37%.

One wonders how orthomyxo will spin this (either “don’t believe it” or “it is what I have always been saying” is my guess).

Comments
In a major testing effort led by UC San Francisco in the Mission District, 2.1% of the 4,160 people tested for COVID-19 were positive. Of those who tested positive, 90% have been leaving their homes for work. Ninety-five percent of positive individuals were of Latinx heritage. From April 25 to 28, free, voluntary COVID-19 testing was offered to every resident in a 16-block area running from Cesar Chavez to 23rd Street and South Van Ness to Harrison Street. This is the second most dense area of the city and a little over half of the residents living here were tested. Researchers conducted two types of tests to identify those individuals who are currently infected and those who previously had the virus. The diagnostic test for active COVID-19 was implemented by collecting samples with nasal swabs while the antibody test was done with a finger-prick to collect a blood sample. Results were available within 72 hours. https://www.sfgate.com/news/editorspicks/article/90-of-people-who-tested-positive-for-COVID-19-in-15247476.phprhampton7
May 5, 2020
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PaV @23 " This also means that NO vaccine will be necessary." Throwing the elderly under the bus. So they must be eminently expendable in your view.doubter
May 5, 2020
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PaV, What percentage do you believe have already been infected? These studies are saying about 20% in NYC, and up to ~4% in Silicon Valley.daveS
May 5, 2020
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Somewhere along the line, based on the data from the Diamond Princess cruise ship, I calculated a preliminary CFR of around 0.33%. How about that? I believe that there is a good chance that the final CFR will be below even the 0.1% of flu viruses. Why would I say that? Because there's tons of asymptomatic cases. Actually, we may never catch up with them. Here's the real problem of SARS-CoV2: it's not that it's "highly contagious," it's that it's NOT "contagious" enough! What do I mean? We've seen SARS viruses before. They are "deadly"! When you get them, you die. Ergo, you're so sick that you wind up "isolated" in an ICU ward. Ergo, you CAN'T infect anybody else. And, therefore, the virus can't spread. This SARS virus is not nearly as deadly, but very, very nasty. (Although it appears that if a proper treatment protocol is used, the death rate is substantically lowered: i.e., HCQ + Z-pak + Zn, among other indications and possible regimens) Yet, a very large portion of people simply do not get sick from it, or, if they do get sick, they show no symptoms. That is, they feel a little "under the weather," and not much more. So, they go to work, they go to hockey games and basketball games, and they live a normal life, yet, the whole time they are infecting people whose immune systems are not so robust as theirs to this viscious virus. So, it spreads everywhere. But, again, not because it's so highly contagious, but simply because there are so many asymptomatics spreading it. Here's the flip side to this "spread": if there are so many asymptomatics, this means that loads of people have already been exposed to this virus--much more than we now know. If this is the correct view, then, contra the "illustrious" Dr. Fauci (il carotto), there will likely be but a minor spike come November. This also means that NO vaccine will be necessary. What a shame! How much money could have been made by some Big Farma company with the patent!PaV
May 5, 2020
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A simple graph from Bloomberg. I'd have a hard time drawing it any straighter with a ruler.daveS
May 5, 2020
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DS, I hear you but such should be far more noisy, I don't know if our snapshots are too coarse to catch that. Of course a v slow curve can look linear. y = kx +c just does not look right to me, with the balance of forces. KFkairosfocus
May 5, 2020
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KF, I'm noticing cases where the virus seems to finally be arriving in rural areas and spreading quickly, even as more densely populated areas are well past their peaks. This lag in peaks perhaps could also account for the current quasi-linear growth.daveS
May 5, 2020
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The carefully unmentioned elephant in the room is the CFR confirmed fatality rate calculated for one specific age group: over 80 years old. This appears to be alarmingly high, about 20% with standard treatment protocol (without hydrochloroquine and using standard ventilator intubation). In this age group, with multiple preexisting conditions, IFR will not be as drastically lower than CFR as it is with the younger age groups. So COVID-19 is proving to be a true grim reaper culling agent of decimation for the elderly. COVID-19 can be dismissed as a catastrophic grim reaper pandemic only by ignoring the elderly.doubter
May 5, 2020
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DS, linear is exactly what we should not be seeing. Dragging a point of inflexion along suggests a decline in onward cases per case in some balance with number of cases. But there the plateau in fresh cases is. I am wondering if changes in testing and ways deaths are attributed means that we are gradually transforming mangoes into guavas? In which case, we are back to the noisy proxy problem. KFkairosfocus
May 5, 2020
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KF, The curves for total cases and total deaths are remarkably linear aren't they? According to worldometers, we'll be hitting 70,000 total deaths in the US very soon, with about 60,000 of those deaths in the last month.daveS
May 5, 2020
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Ortho, I am highly confident that we lack adequate tracking data, we only have crude, noisy proxies. Debating matches between idealised models and dirty proxies is almost pointless. KFkairosfocus
May 5, 2020
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Vivid, All you can do is carefully consider the assumptions of each model and then track both the outcomes and stats associated with those assumptions (like mobility data and current infection rates) to see how well they perform and if disagreement between model and reality of due to assumptions or model failure. It's not possible to predict what will happen without assumptions about the virus and, more importantly, the response to it, so I wish more of these models would include runs of the modern under specific scenarios. Would help both with to compare interventions and to test strength of models.orthomyxo
May 4, 2020
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Vivid, while spiky, the OWID wave of deaths peaked at over 10 k/day and is now heading down, at 3500 today. I am seeing a cluster of countries that have flat lined at low levels. This includes Bahrain, an early adopter of the HCQ cocktail. A significant number of countries have gone down to 1 - 10 cases/day, suggesting we are better at saving lives. The US plateau and global linear growth trends are of concern to me. KFkairosfocus
May 4, 2020
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Ortho I am on record of not being a fan of models however we now have two more predictions by IHME and John Hopkins. The IHME says that we will see 900 deaths per day peaking in August and JH predicts 3000 per day. So we have two models on record going forward how would one go about judging these models if they are wrong going forward without appealing to ad hoc explanations? Vividvividbleau
May 4, 2020
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Bufallo, You may want to read the giant blue information box at that website. And the text underneath it. And the footnotes to the tables. And the detailed explanation at the bottom of the page.orthomyxo
May 4, 2020
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As I said above, working through a calculation and focusing on the assumptions does move the conversation to more productive areas. The issue is now how many people will be infected, so I'll lay out the logic to get to 65% more carefully. The number is not arbitrary, So called "herd immunity" occurs when the susceptible proportion of a population is the inverse of the reproductive number (R zero). A pretty conservative estimate of R for this virus is 2.2 (it was obviously much higher than this in NYC) . Given that, you'll need the susceptible proportion to be 1/2.2 = 45% of the population (or 55% infected). But herd immunity doesn't stop the virus in its tracks, people infected with the virus will still pass it on (albeit to fewer than one person on average) so you'll "overshoot" the herd immunity threshold. I made a very conservative estimate of 10% overshoot to come up with 65%. So, why can we be sure that less than 65% of the population will become infected?orthomyxo
May 4, 2020
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hmmmmm. United States5 37,308 CDC Covid deaths as of May 1 https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm?fbclid=IwAR0wfA4zAAtfKDpq6BwMN0I5XP7VR21rzO_q2kc5ZNPMVka2u3OywD9LJB8buffalo
May 4, 2020
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Do you think the epidemic has ended in New York? Did you forget the lockdown enacted there?orthomyxo
May 4, 2020
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Ortho:
I”d like to know why we can be sure something will stop the virus from infecting ~65% of the population.
How about hard data instead of an arbitrary number you pulled out of your ass? NY is the hardest hit, by far, of all US states. According to New York Governor Andrew Cuomo, they "have undertaken the largest, most comprehensive study of New York state to find out what is the infection rate." Certainly Cuomo has no interest in understating the infection rate. The results of the survey varied by area, with the most densely populated zones hit the hardest. The survey showed an overall infection rate in the state of 13.9%. Yeah, that's right folks. Ortho helped himself to an infection rate 4.7X the rate of the hardest hit state in the union and projected that onto the country as a while, including Wyoming and Alaska. We should not be surprised. Yesterday he helped himself to death projections that were 2.4X the upper-bound of the most wildly pessimistic models in his comments to another post. Summary: Ortho is good at telling lies, scaremongering and pulling scary but random numbers out of his ass. So, dear readers, you can believe him if you want to. But I don't know why you would.Barry Arrington
May 4, 2020
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Of course, but makign the estimates this way allows you to talk about the assumptions instead of just throwing your hands up and declaring the result a lie or scaremongering. In this case, Barry thinks only a faer-mongering internet troll (https://uncommondescent.com/medicine/what-are-total-deaths-telling-us/#comment-700675) could think ~600,000 might die from this disease in the US. The next day, he parades an estimate of the IFR as being good news, despite the fact it would predict considerably more deaths than the fear-mongering number I implied was possible. Barry claims this is "wrong" without giving a reason. If he thinks this IFR is reasonable (why else be so excited by it?) we are only left with the total number of cases absent suppression as the wrong assumption. If that's the case then I"d like to know why we can be sure something will stop the virus from infecting ~65% of the population.orthomyxo
May 4, 2020
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Orthomyxo: But for now, let’s take it as true. If 65% of the US catch the virus, and the IFR is .004 how many will die? About 850,000. That's IF your assumptions are correct. That's the trouble with models; you base them on assumptions depending on what data you have. The Spanish flu pandemic of 1918-19 has been estimated to have infected about 500 million people, one-third of the world population at the time. The death toll has been estimated to have been between 17 and 50 million people. IF the death toll was 30 million and the world population was 1.5 billon then that's 2% of the world population. Let's hope we aren't even close to that this time around. It's going to take some time for COVID-19 to get to its maximum spread so it's going to take some time to get some good solid numbers.JVL
May 4, 2020
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Ortho
If 65% of the US catch the virus, and the IFR is .004 how many will die?
Yes, we can all do math. Just like the guys at Imperial who ran the numbers and predicted 2 million deaths. They were wildly wrong. You are wildly wrong.Barry Arrington
May 4, 2020
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OK so just under 1 million in the USA. We can whittle that down by following the guidelines in EVMS CRITICAL CARE COVID-19 MANAGEMENT PROTOCOL, and sequestering the weak.ET
May 4, 2020
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Texas nursing home 88 of 89 recover - https://bit.ly/2KXk7wz Guess what they used? The treatment recommended by Zelenko. Dr. Todaro estimates .03 percent will die if this treatment is used early and often. That is a incredibly low CFR So current no treatment CFR's are much higher than necessary. Who is getting in way of using treatment? 330 million times .0003 is a lot of people, about 90 thousand. A lot less than currently are dying though. As of today it wa 70,000 with the current estimate of 10-15% infected. Most of whom could have been saved. That is about 500-700 thousand with no treatmentjerry
May 4, 2020
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sigh. Probably a small blip of people amongst all the other diseases that are killing everybody all over the world https://www.worldometers.info/ Looking at NYC numbers and comparing them to everyone else all over the globe causes me to greatly question their methodsAaronS1978
May 4, 2020
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0.4% is a little lower than I would have guessed, given the NYC data. I will have to look at the design, statistics and age structure. But for now, let's take it as true. If 65% of the US catch the virus, and the IFR is .004 how many will die?orthomyxo
May 4, 2020
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