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Covid-19 Tracking the peak of Wave1 (w. OWID)

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We can best see the peak in the death statistics, as global daily deaths begin to decline:

However, we seem to have a prolonged inflexion, giving a linear growth since mid April, i.e. growth and saturation are in rough equipoise, though the very end is beginning to tip over:

The pattern of doubling time has shifted, with major countries slowing significantly, e.g. here is the USA in immediate context:

Daily fresh global cases shows the flattened peaking:

National patterns show this too, with China showing secondary etc waves:

It is noteworthy that the UK now views China’s data as questionable:

The British government will no longer recognise the number of coronavirus deaths reported by the Chinese Communist Party (CCP) over fears that the country is producing fake data during the pandemic.

The figures from the communist regime were included in Downing Street’s “global death comparison” until last week as questions began to mount over the accuracy of the strikingly low numbers of deaths in the country from which the virus was spawned.

“This data is used to judge the effectiveness of our own response, whether good or bad. It’s important we are comparing like with like, otherwise our own responses could be distorted leading to more deaths in the UK. Clearly No 10 believes the same as the rest of the world — that China’s data is unreliable and possibly false,” the Conservative Party chairman of the foreign affairs select committee, Tom Tugendhat said according to the Evening Standard.

So, overall, Wave1 is peaking but by no means over. We have to prepare for onward waves. END

F/N: The SWOT-ALT vs BAU scenario based decision framework for strategic change:

Comments
I feel the same way, I guess. It seems almost too good to be true.daveS
April 30, 2020
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DS, I will believe it when I see it, and I wonder about the trials process issues. Wonderful if we get a working vaccine accepted by relevant bodies, but I am not holding my breath. KFkairosfocus
April 30, 2020
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KF, Have you seen the Oxford vaccine that some are saying could be widely available by September?daveS
April 30, 2020
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The price of Zelenko’s cure which has a 90% reduction in deaths. Zinc sulfate- 7 cents a dose per day of 200 mg HCQ - 40 cents a dose per day of 400 mg - two 200 mg tablets Azithromycin - $1.33 a dose per day of 500 mg Cost per day $1.80 or $9 for 5 days. The recommended treatment period. These are posted pharmacy prices which mean they are actually much cheaper in mass purchase. For this combination of essentially harmless drugs, two of which are common prophylactics, we have sentenced tens of thousands to die. And we watch in real time here and elsewhere inane objections to their use which is essentially recommending no treatment and then watching hundreds of thousands die. The objections really are inane. Often criticisms of grammar or word usage to justify opinions.jerry
April 30, 2020
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Jerry - no, I'm not. But I am suggesting that those responsible for drug administration might be the people to go to. I suspect the CDC would say that too.Bob O'H
April 30, 2020
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the CDC might not know much, because it’s a drug, so they leave that to the Food and Drug Administration
So are you saying that those responsible for disease control do not know much about drugs? Do you know how specious a comment that it? Given that the CDC did make some major mistakes in its control of the virus. It is what happens when too much depends on bureaucrats.jerry
April 29, 2020
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BO'H, note, the remark in an Italian article previously highlighted, via GT:
Hydroxychloroquine is one of the treatments against Coronavirus being tested, and is approved by AIFA (Italian Medicines Agency). The pioneer in this field is the Director of Hematology-Oncology of Piacenza, Luigi Cavanna. It was the first in Italy to use it, an intuition that is proving significant. “Since February 25, I have treated 209 patients and in 90% of cases the response has been positive. Hospitalizations have collapsed: from 30% of hospitalized (serious or moderate cases) to less than 5% “. The change, according to Cavanna, came with the administration of hydroxychloroquine from the earliest stages of the disease, when patients were at home, and resulted in the hospitalization of very few cases in acute conditions. A treatment that, according to preliminary data collected and systematized by 5 different ASLs on 1,039 patients, is working throughout Italy.
Yet more "no evidence" KF PS With Remdesivir they are happy to report reduction from 15 to 11 days.kairosfocus
April 29, 2020
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Jerry from about 19 minutes in and from 10. At 12, recent Italy study of 65k lupus patients on long term HCQ, only 20 came down with CV19, using incidence for Italy we would expect 200 not 20. Much more.kairosfocus
April 29, 2020
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Jerry @ 40 - the CDC might not know much, because it's a drug, so they leave that to the Food and Drug Administration. And the FDA are basically saying don't take it for COVID-19 "outside of the hospital setting or a clinical trial due to risk of heart rhythm problems".Bob O'H
April 29, 2020
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For those of you interested, Jerome Corsi had two doctors who are pushing the Zelenko approach on his show today. They are Doctors Karladine Graves and Dr. JamesTodaro.. Skip to 1:30 seconds in order to avoid pr at beginning. Dr. Todaro has a plan for reopening the country using Zelenko's protocol. I haven't watched it but just found it.jerry
April 29, 2020
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KF, This includes having our authorities behave in such a way as to preserve the public health in the long term. In order to do this, these authorities must maintain credibility among the citizenry.daveS
April 29, 2020
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DS, the relevant value is that if we face loss of life as an inevitable outcome, such losses should be minimised on the full balance of alternatives. The loss of life from epidemic is ongoing. That due to economic dislocation is already on the table. So, we needed to get an idea of what we are up against, justifying measures that could trigger dislocation, given that unchecked Spanish Flu cost lives in the World War range. The Great Depression materially contributed to loss of life directly and through opening the way to a second world war. I rather doubt that there is much disagreement on the relevant values and lessons of history bought with blood and tears. KFkairosfocus
April 29, 2020
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For those who are interested in how the virus works and new treatments. Is there another arrow in the anti virus quiver? The antacid Pepcid. See Medcram episode 62 the latest video for a study now being done with HCQ and famotidine which is the main ingredient in Pepcid. Apparently patients in China who took famotidine had a lower death rate. There is apparently a molecular fit between famotidine and virus which disrupts the virus somehow. https://www.youtube.com/watch?v=DtPwfihjyrY Part of this video at the end is about what some think is the main way the virus acts. On blood ACE receptors in lining of blood vessels that lead to constriction of the blood vessels and coagulation. This puts the body under oxidative stress. This will be covered in more detail in subsequent MedCram lectures. (caveat - not sure of all the details)jerry
April 29, 2020
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KF,
DS, my policy analysis is driven by the implications of a pandemic vs those of locking down into recession, depression and famine, with war a likely onward horseman.
In addition to your values and risk profile, of course.daveS
April 29, 2020
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DS, my policy analysis is driven by the implications of a pandemic vs those of locking down into recession, depression and famine, with war a likely onward horseman. We face a dismal choice where some lives will inevitably be lost once a pandemic is on the gallop. Further, we have a fast-acting, fast spreading deadly disease in a context where the "gold standard" trials process would deliberately expose some to ineffective treatments to create an artificial baseline and would take so long that likely Wave 1 and Wave 2 would go through before we have something duly approved. Further the linked fallacy fails to understand cumulative evidence and the obvious natural baseline, allowing a comparison on cases. Where, the assumption of ineffective alternatives already gives ridiculously implausible odds that a placebo like effect or raw chance could give a string of even 100 successes. In short, there is an epistemological problem, and a suppression of the fact that across time any number of effective treatments, solutions, technologies etc have been successfully validated on chains of cases. Indeed, replicability is a part of science in general. We are seeing deep problems that we need to face and fix. KFkairosfocus
April 29, 2020
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Jerry, ambulance-chasing predatory lawyers thereby show themselves to be part of the problem not the solution. If doctors are intimidated into negligence, that to is a sobering sign. KFkairosfocus
April 29, 2020
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Or if you have a heart.
The CDC doesn't mention it. Nor have any of the high users of the drug seen problems with the heart. Certainly those who have heart problems should be monitored closely and the risks should be weighed. It is always interesting to see what you picked out to comment on.jerry
April 29, 2020
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There is only one thing for certain with regard to the use of HCQ as a treatment. The media and the politicians should just keep their nose out of it, other than high level briefings on treatments being examined, and let the doctors, epidemiologists and statisticians do the jobs that they are highly trained for. As the old saying goes, 'There are three types of people in the world. those who understand math and those who don't.'Ed George
April 29, 2020
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Jerry -
This is driving a lot of the reaction to HCQ not reluctance to use the drug which is essentially harmless. For those who disagree that it is essentially harmless, it is recommended by the CDC as a prophylactic and appropriate for pregnant women and children. The one negative is if you have psoriasis.
Or if you have a heart.Bob O'H
April 29, 2020
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KF,
Caution is appropriate but not selective hyperskepticism, given the elephant in the middle of the room. Thousands of cases.
Not necessarily selective hyperskepticism, but a difference in values. We all have our own risk profiles. I gather that yours is quite different from mine, perhaps due in part to differences in background. In this particular instance, I am perhaps more averse to the risk of a type I error than you are. This is not something that can be settled by reviewing the rules of right reason, etc., incidentally.daveS
April 29, 2020
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I expect health authorities to err on the side of caution in a case like this.
They're terrified of lawyers suing them. If they do not have an accepted protocol to go by and something happens, the lawyers will be taking tickets to sue if there is a bad result. This is driving a lot of the reaction to HCQ not reluctance to use the drug which is essentially harmless. For those who disagree that it is essentially harmless, it is recommended by the CDC as a prophylactic and appropriate for pregnant women and children. The one negative is if you have psoriasis. But without an accepted protocol for this particular use, if anything goes wrong, the doctor will be subject to a malpractice suit. So they are personally better off letting patients die. And they are encouraged by the press not to use this drug which is providing cover for their real malpractice, not prescribing the drug.jerry
April 29, 2020
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DS, there is a baseline that naturally emerged, Flu with complications extended to CV19. Imposing misleadingly labelled sugar pills or the like is an artificial baseline and with what is going on, raises ethical questions. Yes, doctors are prescribing and FDA issued two preliminary tiers. However there is a raft of serious issues at stake. Caution is appropriate but not selective hyperskepticism, given the elephant in the middle of the room. Thousands of cases. The problem with placebo controls here is first, ethical in the face of do no harm. Second, the gold standard fallacy causes improper dismissal of timely and otherwise legitimate evidence, in favour of a counsel of perfection that likely would take a year or more to meet bureaucratic requirements. We need capability to respond without undue controversy in real time to a pandemic. The polarisation is manifestly dangerous. KFkairosfocus
April 29, 2020
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KF,
the point of the decision framework is that there is no need to construct an artificial [and ethically challenged . . . ] baseline as a natural one exists in the de facto standard treatment.
Err, it might be more accurate to refer to "natural baselines" here, which highlights one issue. As I've said before once or twice, I'm not sure if there is a big disagreement here about what is happening on the ground (at least in the US; I don't know how this is playing out elsewhere). These drugs are being given to patients already. They have been "approved" in some fashion by our FDA. Jerry points out that the inimitable Jerome Corsi is helping to get the drugs to patients who want them. Sounds good to me. On the other hand, I think Dr Fauci responded appropriately. Perhaps this is where we get into values. I expect health authorities to err on the side of caution in a case like this. In particular, don't say something that has a good chance of being overturned in 6 months when the results of more carefully designed experiments come in.daveS
April 29, 2020
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Jerry, it's an old remedy and it works. It makes sense on what we know about the immune system. Jump-starting immune response by using survivor plasma plausibly provides an early stock of antibodies, reducing stress and buying time for one's own immune system to kick in. IIRC colostrum, first mother's milk also does something similar as does antivenin. I am wondering, does this need type O donors, or even type O-negative [or else type-matched]? Again, ponder the notion of double-blind placebo testing to create an artificial baseline, vs comparison with the business as usual treatment pattern and results. Notice they report, on a run of 2600 cases, "We're quite encouraged by the results that we've seen. ... Nationally, what we're hearing is that it does appear to be a very safe treatment." So, what is the observed difference in outcomes . . . the dog that didn't bark. A clue in itself. KFkairosfocus
April 29, 2020
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Another encouraging treatment? This time plasma. Bring it on!!! https://bit.ly/2KG3yFxjerry
April 29, 2020
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Jerry, the strong, politically tinged resistance to an increasingly credible treatment speaks for itself. I note from Ms Lin, "South Korea was one of the first countries to be hit by the virus after China, reporting its first case on January 20 and peaking by late February, before suddenly tapering off in early March and “flattening the curve.” It also has a comparatively low mortality rate through a combination of testing, tracing, containment and HCQ." KFkairosfocus
April 29, 2020
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this measure that would mean over 100,000 COVID-19 deaths in the US.
Most of the deaths would be unnecessary if were not for politics. The real crisis in our society is not the virus but cynicism. And callousness. Too many in the world are like Harry Lyme from the Third Man. It’s too their personal advantage often just psychological that others die. They are just little dots, in our case statistics on a website, insignificant to them. For others these dots are not necessarily advantageous but still just insignificant as the virus hasn’t hit them personally. The number of virus cases is not the issue. But the deaths are unnecessary. In theory we all have to get it. That means 300+ million.jerry
April 29, 2020
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JVL, all global numbers are affected by the dubious nature of numbers out of China, something that led to recent action by the UK. I just looked at OWID, and see for China's daily deaths an utterly improbable mesa structure; and yes, that is a design inference. The US is having a flattened peak that may be beginning to trend downwards. Several countries have had that, and that leads to linear cumulative growth in totals, as can be seen in the global trend. I suspect the flattening is in part an artifact of growing testing, digging down into the bulk of the iceberg where mild and asymptomatic cases lurk. It also suggests a steady decline in number of onward cases per present case, which should eventually lead to stronger saturation and absolute falloff in the wave. The US, in a few days slipped from cases doubled in 12 days to now in 18 days, with UK just behind at 17 days; earlier they were at 2 - 3 days. Singapore has slipped to doubling in 8. Onward waves are historically likely. I am not a fan of ratios to population as the exponential growth phase points to a rate dependent on the actual mass of cases. KFkairosfocus
April 29, 2020
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As of this morning: April 29th: The USA has 1,035,765 registered cases of COVID-19, more than the next six countries (Spain, Italy, France, Uk, Germany and Turkey) combined. and about one-third of the planet total. Of those USA cases 854,261 are still considered active. The USA had about 60,000 registered COVID-19 deaths, about the same as the next two countries (Italy and Spain) combined, and over a quarter of the world total. I heard it pointed out that that's more than the total number of US deaths during the Vietnam War. It's also more than the US deaths attributed to influenza in 2017 (55,672) according to the CDC (https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm). All within three months, the first active US case being declared at the end of January. The USA has/had over 3000 cases/1 million pop, less that Italy and Spain but ahead of France, UK, Germany and Turkey and well ahead of the world average of just over 400 cases/1 million pop. The USA now has about 179 deaths/1 million pop, less than Italy (453), Spain (510), UK (319) and France (362). IF the USA catches up with the UK on this measure that would mean over 100,000 COVID-19 deaths in the US. Obviously the world totals and averages will change as there will be some really hard hit countries that have probably only begun their 'journey'. When you look at the Daily New Cases and Daily Deaths for the USA it looks like things are slowing down but there's still a long ways to go. Considering the number of active cases and the stats from other developed countries I expect the USA total to increase a lot yet. Relaxing the lockdown restrictions will expose some people who got missed so far. And many epidemiologists are saying a second wave is quite likely. Meanwhile New Zealand has claimed to have become new infections free. It looks like Australia is pretty much there as well.JVL
April 29, 2020
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DS, the point of the decision framework is that there is no need to construct an artificial [and ethically challenged . . . ] baseline as a natural one exists in the de facto standard treatment. It is in that context that we see a sharp reduction in time to clear virus load and in expected death rate; the latter, by some 90+ percent. On a baseline of cumulatively thousands of cases. Ms Lin's summary in 16 above speaks to that. Likewise, Italy has similar results. I gather that Dr Zelenko is in process of formal publication. That sort of result for so many cases is not plausibly explained on a particularly effective placebo result; that is, the matter of fluctuations is material. As for objections, far too many of them pivot on imposing a fallacious gold standard that locks out the sort of timely evidence we can expect and some have gone to the point of the hyperskeptical no evidence. With the sort of consequences in view and the dismal choice we confront, we have to do better. Hence, my point that we have to go back to the basics of empirically grounded reasoning. KFkairosfocus
April 28, 2020
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