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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
PS: Not that this is news to you; obviously you have participated in those discussions.daveS
April 28, 2020
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KF, I have been trying to read some of the posts from stats people here and elsewhere, and I gather that a key issue is whether or not an "extreme fluctuation" actually occurred. For example, lack of a control group, possible bias in selection of treatment and control groups, etc.daveS
April 28, 2020
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DS, no and that is not what I said either. Assume for the moment, the cocktail is useless. We deal with placebos that unpredictably work; classically, 38% of the time. The chances of a 100 string of successes under that as a simple case would be as indicated. The point is that placebo effects work sometimes but not always. But that is just to give a simple illustration of the real point, which is that extreme fluctuations in large enough systems are exceedingly rare. So, if we see a high proportion of cases treated with the cocktails showing a consistent rapid progress in clearing the virus as say Ms Lin described, the best explanation for that is not extreme fluctuation but a successful designed causal intervention. In short, the treatment works highly reliably under reasonable conditions. And yes, this is an application of the design inference. KFkairosfocus
April 28, 2020
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KF, I should add that none of the skeptics are saying that what happened in those studies is akin to observing a weighted coin (38% chance heads) come up heads 100 times in 100 trials. They are saying that the assumptions in the coin-flip model plausibly do not hold in the studies, of course.daveS
April 28, 2020
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For those interested in statistics, here is a report from the Association of American Physicians and Surgeons (AAPS) titled
The probabilities of clinical success using hydroxychloroquine with or without azithromycin +/- zinc against the novel betacoronavirus, SARS-CoV-2
It is dated Sunday. https://bit.ly/3bON2Pl It is a list of various studies done and most of the deaths are from the VA survey covered here last week.jerry
April 28, 2020
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For those of those who live in the US and are interested, it is possible to get a consultation with a doctor in each of the 50 states you live in. It is then possible to get a prescription from that interview and an online pharmacy that will deliver the prescription to you over night. They handle C19 issues. Obviously this is limited to those things. that could be discussed on line. If there is a requirement for lab work or other medical hands on tests, I do not know how. that works. But it is not for those who consider themselves liberal because it is partially sponsored by Jerome Corsi, noted conservative conspiracy theorist. (obviously sarcasm but I am sure no politics are ever discussed.). The link to the site is https://speakwithanmd.com/jerry
April 28, 2020
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DS, I am a policy person. Things I find relevant (starting with a Taiwanese doctor who had a design for a cloth mask that can take a filter insert) I have shared and will share, and that is across a regional network. The decision making framework was literally shared globally 20 years ago under UN auspices. I have found it consistently useful ever since. I am using it to see that we can rationalise baseline vs plausible alternative decision making and use it to frame evaluation of case data. Note, I also find a common problem in novel situations: dirty and partly contradictory data (hence, noisy proxies), bits and pieces of the puzzle from all over, requiring synthesis, conflict requiring going back to first principles of empirical, inductive reasoning, need to build critical mass, need to take in a wide bandwidth across the span of the environment, need for capacity building, need to find points of hope, light and steadiness. Remember, I have seen low grade civil war and chaotic disruption through volcano crisis [our friend has been quiet]. The problem is, just about everyone has his own views (often, media driven or peer/reference group driven) and on health matters there is now a movement in the name of natural remedies and health that at some levels will dismiss anything coming out of conventional medicine. Oh yes, the South Koreans are the clear case of beating this wave of SARS2, so we should take their conclusions seriously, just look for the SK trend lines in the charts. KFkairosfocus
April 28, 2020
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KF,
rather charming Ms Lin
😬 I'm sure she'll be glad to know this. More seriously, I'm curious whether you have presented these ideas to your own health authority? I guess it's a change in process, but I don't know whether it will result in better outcomes (I'm not equipped to make such a determination, in any case).daveS
April 28, 2020
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F/N: Watch these two CA doctors https://www.breitbart.com/tech/2020/04/28/youtube-censors-video-of-california-doctors-calling-for-reopening-of-country/kairosfocus
April 28, 2020
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F/N: I added the chart for the framework above in the OPkairosfocus
April 28, 2020
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DS, first, let me go back a step: the SWOT-BAU-vs.-ALT sustainability oriented strategic change, decision-making framework is perhaps superficially simple. It has to LOOK fairly simple, if it is to work with ordinary stakeholders in consultations. It is in fact a subtle participative, scenario planning approach using world- models- rooted- in- bio-physical, socio-cultural, econ-governance & policy contexts to resolve problematiques that also embrace capacity-building challenges. It is not really original to me, I have adapted what Argentina's Bariloche Foundation put on the table 20+ years ago. That is, it is specifically designed to deal with challenges of mind bogglingly complex environmentally sensitive decision-making in the context of deep rooted highly polarised conflicts. Indeed, the diagram you may have seen is literally designed to be used with wall sized charts and stakeholder based community consultations, to create self-documenting deliberations. (Are you familiar with the ZOPP trick of using bristol board strips integrated into a larger framework . . . a sort of scaled up post it notes trick?) The resolution to such challenges is that participative empowerment and contemplation of scenarios and world models informed by environment threat and opportunity profiles embracing the multidimensional span of the environment . . . think, PESTL + BP . . . are transformative towards creating critical mass and mainstreaming robust, novel, well supported solutions. So, yes, I am all too familiar with management of high complexity and trade-offs. The application of this framework to deciding on robust pandemic treatment and response strategies is just that, application to an emergent bio-threat informed by the obvious want of sustainability and responsiveness of the cumbersome, $1 bn a shot decade long development exercises that have become all too typical. That is in part why the focus is that we have to shorten the OODA decisional loop drastically in the face of doing medicine on the micro-bio battlespace in WW V, the fifth World War, with a virus [or more realistically, an escalating chain of same since HIV and SARS etc now SARS2]. The pivot to that is we need to revert to prudence based epistemology, instead of hyperskepticism, scientism and blind unbalanced technocracy. In that context the point is, placebo effects are said to work 38% of the time, why that number as an allusion. The odds of a long, consistent chain in the hundreds being little more than belief-kills, belief-cures action are so vanishingly small as to be ludicrous. Let me clip the rather charming Ms Lin as Jerry just pointed us to:
Hydroxychloroquine used by Korea for Covid-19 while US is divided Apr 27, 2020, 9:52 PM South Korea recommended the anti-malarial drug HCQ to treat Covid-19 while political interference in the US over the drug has alarmed medical experts [ . . . ] Medical treatments have traditionally been a private decision between patients and doctors, but now it seems politicians are usurping their right to choose. According to Dr Jeffrey Singer, a general surgeon and Cato Institute fellow, this threatens the integrity of the medical profession and indirectly imperils patients, by denying them emergency options when no other alternatives are available. Moreover, the politicization of treatment options would not help Americans, given the fact countries such as Belgium, France and South Korea have used HCQ to treat Covid-19 with a good degree of success. 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 . . . . Hydroxychloroquine (HCQ), a well-known anti-malarial drug that has been around for decades, is now a political football between the Trump administration and Democrats during an election year in the United States. US President Donald Trump has repeatedly touted the drug and received significant pushback from the media and the Democratic Party, with the governors of Nevada, Michigan and New York even going so far as to issue executive orders restricting how doctors can use HCQ to treat patients suffering from Covid-19. Medical treatments have traditionally been a private decision between patients and doctors, but now it seems politicians are usurping their right to choose. According to Dr Jeffrey Singer, a general surgeon and Cato Institute fellow, this threatens the integrity of the medical profession and indirectly imperils patients, by denying them emergency options when no other alternatives are available. Moreover, the politicization of treatment options would not help Americans, given the fact countries such as Belgium, France and South Korea have used HCQ to treat Covid-19 with a good degree of success. 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. Last month, the Korea Centers for Disease Control and Prevention, the Korean Society of Infectious Diseases, Korean Society for Antimicrobial Therapy, Korean Society of Pediatric Infectious Diseases and a tuberculosis association recommended the use of Kaletra, an anti-HIV medication, in combination with HCQ, to treat Covid-19. This was bolstered by a French study that showed HCQ had an antiviral effect against Covid-19 in confirmed cases. Used in conjunction with the azithromycin Z-Pak, most patients cleared the virus in three to six days rather than the 20 days observed in China, drastically narrowing the period during which a patient can spread the virus to others. As such, Dr Jeff Colyer, chairman of the US National Advisory Commission on Rural Health, and Dr Daniel Hinthorn, director of the Division of Infectious Disease at the University of Kansas Medical Center, in a Wall Street Journal article recommended that the US could adopt this approach and use the treatment cocktail early rather than wait until a patient is on a ventilator in an intensive care unit. To be clear, these scientists and doctors now recommend HCQ as a treatment, not a preventive measure, for Covid-19. They argue that a positive effect of using HCQ early is the reduction of virus transmission to other people given the shorter number of days the patients remain contagious, thereby flattening the curve sooner.
There's considerable food for thought in that clip, including on the obvious not invented here factor that is driving a lot of the dismissiveness and hyperskepticism. KFkairosfocus
April 28, 2020
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KF, Do you have evidence showing that the changes you propose will result in a better overall outcome? From my perspective, that's what's most important. Edit: I think I understand your example (but am not positive). I am familiar with the binomial probability formula, however. Exactly what does your example illustrate?daveS
April 28, 2020
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DS, the evidence I am seeing is that collectively, there has been an ensconcing of gold standard fallacies, undermining valuable evidence that could make a difference in good time. I already discussed a Guardian piece on this, here: https://uncommondescent.com/ethics/guardian-exemplifies-the-placebo-control-gold-standard-fallacy/ KF PS: A little probability illustration. Say the odds that X happens by chance rather than by a candidate causally driven effect E are x, where obviously, each observation is independent. Now, string together n observations of X. The likelihood that it is a chance fluctuation all n times is x^n, so as n rises, it falls exponentially. Now set x = 0.38 and set n = 100. 0.38^100 = 9.5*10^-43.kairosfocus
April 28, 2020
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"The science police have arrived" daveS, And you get a ticket for for failure to maintain a scientific posture. ;) Andrewasauber
April 28, 2020
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The science police have arrived :)daveS
April 28, 2020
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"They’re trying to manage a very complex problem" daveS, Don't they earn large salaries just for occasions like this? Sounds like whining. Andrewasauber
April 28, 2020
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"they have to consider the reputations of the institutions they lead" daveS, Doesn't sound very scientific to me. Reputations? Why wouldn't science be the primary concern? Andrewasauber
April 28, 2020
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Ed George:
There is no point in keeping grocery stores open if the meat packers are closed due to the virus.
That's plain stupid. Grocery stores sell much more than meat. And seeing that OTC supplements can beat this virus, too, testing isn't really necessary.ET
April 28, 2020
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KF, [Warning: I'm from the USA, so I have no idea what's going on beyond our shores. :P Therefore I'm only addressing your post as it relates to my country .]
We need to go back to understanding what empirical evidence is, how warrant can be built up, why no inductive case can achieve incorrigible certainty and more.
While I'm sure there are a lot of lessons to be learned here, do you think Anthony Fauci or Robert Redfield don't understand what empirical evidence is? I really doubt these people are quite that ignorant. They're trying to manage a very complex problem to get the best outcome they can. Moreover, they have to consider the reputations of the institutions they lead and that every step they are taking now will be analyzed in the years to come. I don't think they need a Phil 101 refresher course at this point.daveS
April 28, 2020
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EG, The fact remains -- scroll up and look at the OP charts courtesy OWID -- that the USA plots to the same band as other developed countries. The difference in plateau level is likely that it has more population to grow into, especially in the zone with NYC. While testing for virus presence and for antibodies is important, we must remember that we are simply tracking proxies, noisy ones. Where also, the mathematics of exponential growth shows definitively that growth is on absolute mass, not proportions. Testing is an absolute process and so is contact tracing. Discounting for the FDA fumble, the USA is doing a responsible job with testing. Where, we must realise a basic fact: five minutes after a test, one can get infected, that is it is preventive measures and effective treatments that will make a difference, especially for frontline workers. On that front, I find it interesting that the same folks talking testing like a mantra are falling into gold standard fallacies in the teeth of evidence of an effective, low cost, readily deployable treatment that may actually be already making a difference under the radar. Vaccines are likely 1 - 2 years out and the standard bureaucratic process for drugs is too costly, cumbersome and time consuming to be relevant to pandemics. We need to go back to understanding what empirical evidence is, how warrant can be built up, why no inductive case can achieve incorrigible certainty and more. KFkairosfocus
April 27, 2020
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KF, what the data shows is, that with a few exceptions, the countries with the most testing per capita are doing better than those with lower levels. But testing without effective follow-up is of little value. Testing should me mandatory for all front line workers, including those in the food chain. There is no point in keeping grocery stores open if the meat packers are closed due to the virus. It is the testing that gives you the information necessary to make correct decisions. The more the better. And compared to many of the other COVID tool kit, testing is very cheap.Ed George
April 27, 2020
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EG, from the beginning, I noted how an exponential growth phase implies spreading at a rate dependent on the mass present, i.e. on absolute rather than proportional numbers. Proportional rankings are thus of little real value. Further to such, we have a general problem that we are tracking noisy proxies not the absolute truth; including that one reason for the plateau currently may be that more are being tested than previously, given the evidence of a high proportion of asymptomatic cases. That said, the US is part of the band followed by most industrial countries, showing a similar degree of policy success or failure. Attempts to single it out as though it were a unique failure, are ill advised. One key failure is that the FDA tried to create a special test, but this failed due to being contaminated with the virus itself and there was a linked bureaucratic challenge to get through with recognition of other testing. This is of a piece with the general problem of a new drugs etc system that is unresponsive to the pacing of a pandemic. . KFkairosfocus
April 27, 2020
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The USA is still 41st in testing per capita. Even if we limit this to medium to large sized developed nations, they barely crack the top twenty.Ed George
April 27, 2020
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Maybe for Wave1, likely except Africa which is getting started now. Wave2?kairosfocus
April 27, 2020
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Looks like this might be mostly over by mid-June eh?daveS
April 27, 2020
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Covid-19 Tracking the peak of Wave1 (w. OWID)kairosfocus
April 27, 2020
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