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Further thoughts, on “peaking” of the pandemic

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Recently, we here at UD saw that global trend lines are curving over from exponential growth in new Covid-19 cases. Likewise, health authorities have been talking of the US and the UK peaking in perhaps ten days. Where I am, we are still growing: one, two, five, nine total. (And no, Black the Ripper is not credibly a Covid-19 case.)

Here’s a graphic that gives pause, with labelled phases — recall, the crest of new infections is the inflexion point on the growing arm of the S-curve of cumulative cases:

But, the further consideration is, onward waves triggered by fresh outbreaks or new strains once lock-downs . . . which cannot be long sustained . . . are relaxed:

These are schematic, here is a plot of the 1918 – 20 Spanish Flu’s waves, echoed in the death rates:

The peaking is coming through in how doubling times for cases to date are stretching:

A similar pattern is there in the 3-day rolling average, though US is spiking up again:

Let me add, daily cases log-lin curve:

So, it looks like we are going peak, though the peak may be more of a plateau before it falls.

Then, the next challenge is to find a more sustainable strategy than economy lock downs. Hopefully, treatments and vaccinations will make the difference, the sooner the better. END

80 Replies to “Further thoughts, on “peaking” of the pandemic

  1. 1
    kairosfocus says:

    Further thoughts, on “peaking” of the pandemic

    –> Sorry, a day later than I thought

  2. 2
    daveS says:

    Figure 3, the “conceptual global infection curve”, says something about human short-sightedness (along with other factors).

  3. 3
    kairosfocus says:

    DS, history tends to repeat, on steroids. KF

  4. 4
    Jim Thibodeau says:

    Did you know that if you die at home in America you don’t get tested for COVID-19? I keep waiting for an adequate testing regime to appear, and I keep waiting.

  5. 5
    kairosfocus says:

    JT, we are all looking at proxies, that the real signal breaks through, never mind issues. (I recall discussions at UD on that — my perspective here is that of strategic decision making.) BTW, GDP and price indices, stock market indices etc are all proxies, too. I have suggested in earlier threads that we need to do random or stratified random antibody based tests adjusted for demographics on a tracking basis, ideally. I doubt that proper antibody tests are yet in hand. When we have that sort of data, we can calibrate proper population models. But for fighting the campaign, a strategic management challenge, proxies are good enough. KF

    PS: In the case of the US, I doubt that a significant number of people who are seriously ill will not be hospitalised. How Covid-19 cases and deaths are identified is problematic globally. Singling out the US without that context erects a strawman. The US, BTW has done coming on 2 million tests, recovering from a stumble with an early FDA test.

    PPS: I added a log-lin world in data tracking curve. Notice, curve-over and how China is on a clear wave 2. Much smaller amplitude, though.

  6. 6
    kairosfocus says:

    DS, I added another plot. China is on a low amplitude wave 2 and S Korea has a plateau. The latter is a concern as it points to a residual pool and long term problem that can trigger onward waves. We may have to try for herd immunity. We need a vaccine ASAP. KF

  7. 7
    Truthfreedom says:

    @6 Kairosfocus

    We need a vaccine ASAP.

    We just need to wait, until one of those magical vaccines auto-creates itself. Like universes, you know.

  8. 8
    daveS says:

    JT,

    I’ve read articles stating that; I’m still not clear on the testing situation overall.

  9. 9
    kairosfocus says:

    DS, every statistic is riddled with issues, see here https://ourworldindata.org/coronavirus KF

    PS Note China’s wave 2, a weak one. S Korea has a plateau. Maybe we have wave and low plateau superimposed.

  10. 10
    Jim Thibodeau says:

    @DaveS The logic, it was explained to me, is why waste a Covid test on a dead person when we could use it on a live person which might help their treatment. Which makes sense. It just has the bonus effect of reducing the actual numbers of confirmed cases.

  11. 11
    vividbleau says:

    KF

    Learned a lot from my daughter in laws episode. She tested negative but they told her that 30% of tests register false negatives. BTW after 8 days finally got to go outside.

    Jim your parents good?

    Vivid

  12. 12
    kairosfocus says:

    Vivid, that’s significant. What is the rate of false positives? I do know they seem to do a double test before ruling positive. KF

    PS: How is Daughter in Law, do you have any better picture? How are others?

  13. 13
    kairosfocus says:

    JT, I missed that. How are your parents? KF

  14. 14
    vividbleau says:

    KF
    She is much recovered after 8 days, family good, they all got out of the house and drove to a secluded out of the way place yesterday and enjoyed the outdoors.

    PS I was asking Jim T about his parents sorry for the confusion

    Vivid

  15. 15
    OLV says:

    KF,

    This OP is an excellent collection of graphical illustrations of the current situation and potential trends. Thank you for the effort to put this together for us here. This information you’ve gathered may help us to understand better what’s going on and what to expect in the near future, at least regarding this pandemic.

    Off topic:

    Any news from UD scientific contributor GPuccio?
    Haven’t seen his insightful technical posts since long time ago.
    I think he was preparing an OP on ID in immunology.
    I hope to see him back soon.

  16. 16
    Truthfreedom says:

    @12 Vividbleau:
    That’s good news.

  17. 17
    Ed George says:

    Vivid

    She tested negative but they told her that 30% of tests register false negatives.

    KF

    Vivid, that’s significant. What is the rate of false positives?

    Most of the error in the common testing method (PCR) is associated with the sample collection, not with the actual testing step. As such, I would expect to see a higher false negative rate than false positives. Here is a good article on why we see high false negative.

    https://www.theverge.com/2020/4/9/21213730/coronavirus-test-false-negative-results-isolation-treatment

  18. 18
    bornagain77 says:

    This may be of interest

    THE BEST GRAPHS AND DATA FOR TRACKING THE CORONAVIRUS PANDEMIC
    https://www.theverge.com/2020/4/2/21201832/novel-coronavirus-covid-19-best-graphs-tracking-data

    JOHNS HOPKINS 2019 NOVEL CORONAVIRUS VISUAL DASHBOARD
    https://coronavirus.jhu.edu/map.html

    THE COVID TRACKING PROJECT
    https://covidtracking.com/data/

    91-DIVOC
    http://91-divoc.com/pages/covid-visualization/

    WORLDOMETER
    https://www.worldometers.info/coronavirus/

    IHME COVID-19 PROJECTIONS
    https://covid19.healthdata.org/projections

    COVID ACT NOW
    https://covidactnow.org/

  19. 19
    kairosfocus says:

    OLV, GP is a physician in one of the hardest hit countries. I suspect he is busy. Let us pray, he fares well. KF

  20. 20
    Truthfreedom says:

    @ EG

    Most of the error in the common testing method (PCR) is associated with the sample collection,

    I guess those meat-robots need an update.

  21. 21
    kairosfocus says:

    EG, Thanks for link. It looks like a contamination problem with the polymerase chain reaction. But that, then further implies, proxies is what we have. Likely, there will be a materials challenge to support the chain reaction. KF

  22. 22
    OLV says:

    KF @19,
    Yes, let us pray.

  23. 23
    vividbleau says:

    EG
    Thanks for the link

    Vivid

  24. 24
    Truthfreedom says:

    @22 OLV:
    +1. Thank you Kairosfocus.

  25. 25

    .

    She tested negative but they told her that 30% of tests register false negatives.

    My elderly mother lives in an assisted living home, that preemptively locked down very early in this crisis. They eventually reported two cases inside the facility. We asked that she be tested, but they said they would only test if she showed symptoms, which was meaningless to us. So, we appealed and got her tested, and then removed her 5 minutes after the test. The results came in yesterday, negative with a 70% reliability. We will quarantine her at home for two more weeks.

  26. 26
    vividbleau says:

    UBP
    Yes the same with my daughter in law the whole family was told to quarantine even though the test came back negative

    Vivid

  27. 27
    Ed George says:

    My daughter-in-law just returned to work as a home-care nurse after maternity leave. Because of the shortage of PPE she is only issued two masks per day and told to only wear one if her patient is symptomatic. On the bright side (for a sad reason), most of her patients need the home-care nurse because they do not have anyone who can take them to the doctor or clinic for their care. As such, most are already self-isolating.

  28. 28
  29. 29
    JVL says:

    Upright Biped: So, we appealed and got her tested, and then removed her 5 minutes after the test.

    Why would you fight hard to have her tested and then remove her from the facility? It sounds like you were just using the facility to get the test done. I hope I am wrong in that so please elucidate.

  30. 30

    Really JVL. Did you think about it before you typed?

  31. 31
    JVL says:

    Upright BiPed: Really JVL. Did you think about it before you typed?

    Yes, I did. Because I didn’t want to accuse you of taking advantage and getting someone else to pay for the testing.

    If I’m wrong then please explain your motivation.

  32. 32

    Someone else to pay? Are you a complete idiot?

  33. 33

    .
    Thankfully the staff there (whom we pay a substaintial sum to, and who has always had her best care in mind, and whom knew exactly what was happening, and why, and was part of the decision process, and whom will continue to be part of her care) has a different set of sensibilities than you JVL.

  34. 34
    rhampton7 says:

    Pentagon leaders anticipate that the coronavirus is likely to strike more Navy ships at sea after an outbreak aboard an aircraft carrier in the Pacific infected more than 400 sailors, a top general said Thursday. (April 9)

  35. 35
    Ed George says:

    KF

    EG, BTW, there is a development with Cardinal Pell. KF

    Why did you bring this up here, and why addressed to me? I have no idea who Cardinal Pell is, but I am glad that he was vindicated.

  36. 36
    BobRyan says:

    China has not allowed any independent testing. Prior to the current outbreak being noticed in Wuhan, no one was testing for SARS related illness anywhere in the world. Had it not been for Dr. Li, we would not be talking about COVID-19 now. We would be at the tail end of influenza season and it would have appeared to be mild compared to 2 seasons ago. COVID-19 mimics the flu and easy to miss unless you’re looking for it.
    We do not know when the outbreak originated, only that someone with COVID-19 had it and were in Wuhan at some point. Wuhan is the 7th largest city in China with a major international airport. COVID-19, much like COVID-2, from the same family, is a minor virus that does very little harm to the general population and can go unnoticed for years.

  37. 37
    Bob O'H says:

    kf @ 21 –

    EG, Thanks for link. It looks like a contamination problem with the polymerase chain reaction.

    I’m curious to know how you come to that conclusion. Wouldn’t that mean contamination by a taq inhibitor?

  38. 38
    rhampton7 says:

    Of the 146 patients hospitalized in U.S. military medical centers for the novel coronavirus, one-third are in intensive care units, including a sailor from the aircraft carrier Theodore Roosevelt who remains at U.S. Naval Hospital Guam.

    According to Defense Health Agency officials, 47 of the Defense Department’s 3,054 current cases of the novel virus are in ICUs. The agency declined to provide detailed information on whether the patients are on ventilators and whether they are active-duty troops, dependents or DoD employees or contractors.

  39. 39
    Jim Thibodeau says:

    Even if you survive this virus you could be permanently damaged.

    https://www.sciencemag.org/news/2020/04/survivors-severe-covid-19-beating-virus-just-beginning

  40. 40
    ET says:

    We have a “could be”. Do I hear a “possibly not”?

  41. 41
    ET says:

    So the DoD is ignorant of medcram videos? Really?

  42. 42
    rhampton7 says:

    A meat packing plant in Colorado where dozens of employees have contracted the novel coronavirus is closed for a deep cleaning and all workers will be tested before they can return to their jobs, officials said Friday.

    The union that represents 3,000 employees at the JBS plant in Greeley said in a letter to state, county and company officials that two of its members have died.

    The union says at least 50 employees are infected with the virus; the company, which is headquartered in Greeley, put the number of JBS workers with Covid-19 at 36.

  43. 43
    rhampton7 says:

    Kentucky Gov. Andy Beshear warned Friday that any state residents attending a mass gathering — including church services — will be forced to self-quarantine for 14 days in a preemptive bid to slow the coronavirus outbreak in his state over Easter weekend.

    “I think we’re down to seven churches statewide that are thinking about having an in-person service,” Beshear told reporters. The governor has warned that churches should switch to virtual or drive-in services to accommodate worshippers while protecting public health.

  44. 44
    rhampton7 says:

    While many churches across the nation plan to hold their Easter services online Sunday, a Louisiana pastor says his church near Baton Rouge is expecting a crowd of 2,000 or more despite federal coronavirus guidance advising social distancing.

    “Satan and a virus will not stop us,” Rev. Tony Spell told Reuters. “God will shield us from all harm and sickness. We are not afraid. We are called by God to stand against the Antichrist creeping into America’s borders. We will spread the Gospel.”

    “Like any zealot or like any pure religious person, death looks to them like a welcome friend. True Christians do not mind dying. They fear living in fear,” Spell told TMZ in an interview this week.

  45. 45
    rhampton7 says:

    Cargill Meat Solutions, a 900-worker plant in Hazleton, Pa., that packages meat in plastic for supermarket shelves in Pennsylvania and surrounding states, shut down temporarily on Tuesday as 130 hourly workers have tested positive for COVID-19 and a rash of employees called out sick, a union leader said.

    “These environments are almost impossible for workers to adhere to safe-distancing protocols,” Young said. “We want our folks back to work, but we want them back safely. Safe is more important than fast.”

    Young said the number of COVID-19 cases among Cargill hourly workers had risen to 164 by Thursday morning.

  46. 46
    Ed George says:

    R7@44, then that church should be forced to pay the medical and funeral costs of any of their parishioners that contract COVID-19 after the service. Or, better yet, remove the tax free status of any church that has in person services.

  47. 47
    rhampton7 says:

    Fears are mounting that the coronavirus pandemic could disrupt the American food supply chain, after outbreaks interrupted work at meat processing plants and truckers expressed fears of traveling to hotspots.

    Tyson Foods was forced to suspend operations at a pork processing plant in Columbus Junction, Iowa this week, after more than 24 employees there tested positive for coronavirus.

  48. 48
    rhampton7 says:

    A Smithfield Foods pork processing plant in South Dakota will temporarily close for cleaning after more than 80 employees were confirmed to have the coronavirus, the company announced Thursday.

    The plant, which employees about 3,700 people in the state’s largest city, has emerged as a hotspot of infections, accounting for almost 30% of cases in Minnehaha County.

  49. 49
    rhampton7 says:

    The U.S. Cattlemen’s Association sent Agriculture Secretary Sonny Perdue a letter urging him to do all in his power to keep meat plants open amid the coronavirus pandemic.

    “According to Cassie Fish of The Beef, ‘Estimates for this week’s slaughter are 570,000 to 590,000 head, which would be the smallest non-holiday kill for this week since 2016-2017.’

    “To further this point, USCA is hearing reports of plants slowing down production, or shutting down completely, due to workforce complications related to COVID-19,” the letter said.

  50. 50
    rhampton7 says:

    Health officials are investigating a “possible cluster” of COVID-19 cases at the Tyson Plant in Goodlettsville, FOX 17 News confirmed Friday night.

    Health authorities have been working with Tyson for the last few days, but could not provide additional details.

    A Tyson representative refused to share specifics about any employee’s health. The company claimed they notify anyone who has been in close contact with the infected person and asks them to go home and self-quarantine.

  51. 51
    Jim Thibodeau says:

    I’m seeing reports that a significant percentage of people who get this virus don’t wind up with antibodies later, so they can get it again in a few months. Ugh.

  52. 52
    rhampton7 says:

    The number of people in South Korea who tested positive for the coronavirus for a second time after apparently recovering has risen to 91 — an increase of 40 from the 51 reported earlier this week, according to a report.

    Jeong Eun-kyeong, head of the Korea Centers for Disease Control and Prevention, told reporters that the virus may have been “reactivated” rather than the patients being reinfected, Reuters reported.

    False test results also could be the cause, other experts said, or remnants of the virus could still be in people’s systems but not be infectious or of danger to the host or anyone else.

  53. 53
    JVL says:

    As of this morning, according to https://www.worldometers.info/coronavirus/ the US has/had 503,177 confirmed cases of COVID-19, more than the next three countries combined (Spain, Italy and France). Of those 457,102 are considered active which means 46,075 cases are not considered active. The US has registered 18,761 COVID-19 deaths second only to Italy with 18,849. New York state alone has more cases than all but two countries (the US and Italy) and more deaths than all but five countries (Italy, the US, Spain, France and the UK).

    So, 18,761 deaths out of 46,075 non-active cases is about 41% which is way, way about the estimated fatality rate (The WHO estimated a fatality rate of 3.4% on March 3rd which is well out of date now) The seasonal flu rate in the US is about 0.1%. Most likely many of the active cases are recovering but not fully recovered. Also likely is that the number of cases and deaths are under the true numbers as many people recovered having had no symptoms and some deaths would not have been ascribed to COVID-19 and/or some COVID-19 sufferers who died may have had the cause of death listed as some other condition and the virus weakened their system. But those are the numbers we’ve got.

    (For the whole world the number of closed cases is 480,758 and 102,897 deaths which is about 21%.)

    The daily new cases and daily new deaths graphs for the US look to be levelling out at about 30,000 new cases per day and about 2000 new deaths per day. There are always reporting lags (and I assume some facilities are falling way behind on their reporting) but hopefully those are true levelling offs albeit it at scary levels. Also hopefully there won’t be a second wave of cases, a distinct possibility after some restrictions are relaxed. Widespread testing will help keep infectious people isolated and vulnerable people protected.

    A very unusual Easter weekend. I hope you all stay safe and healthy.

  54. 54
    kairosfocus says:

    BO’H: Pardon an error on my part. Obviously, PCR is generally subject to contamination. Of greater import here seems to be that accessibility of the virus can be elusive, even if present. And, with negative-result failures running at 1/5 to 1/3 it is obvious that we are seeing noisy signals . . . so, our statistics, again, are noisy proxies for the actual realities. In that context, it seems to me prudent to take it that if someone is showing reasonably characteristic clusters of symptoms, one should infer probability of the disease despite a negative test result. KF

  55. 55
    ET says:

    According to Ed George the politicians of NYC should be paying for all of the covid-19 cases there because of their callous nature during February’s Chinese celebrations.

    The PEOPLE attending any church services CHOOSE to do so. That means it is all on them.

  56. 56
  57. 57
    AaronS1978 says:

    I have a couple of updates on the virus by the way such as Iceland just came back with their numbers 50% of the people that have it shows zero symptoms

    Also I do not like how the CDC is definitely Categorizing all flu deaths, pneumonia deaths, and heart disease deaths as covid deaths if they had covid

    It has drastically reduced the numbers of death on all three diseases I mentioned up there. This is a problem

    But here’s the main thing I’m going to post this just in
    https://www.ccn.com/hiv-ebola-like-mutations-suggest-coronavirus-leaked-from-a-lab/

    If Covid came from a lab I can understand the craziness on the quarantine

  58. 58
    kairosfocus says:

    JVL, there is evidence of a high proportion of mild or asymptomatic cases. Also, it seems deaths tend to be within about 1 1/2 – 2+ weeks of onset of symptoms, but recoveries take significantly longer. I have seen it described as failing to make the bend on a U. The rising leg obviously adds time. You will note that I have pointed to noisy proxies. KF

  59. 59
    rhampton7 says:

    A new tally shows 2,246 people have died in nursing homes from the coronavirus in 24 states.

    The numbers were compiled by NBC News, which also reported that nearly 2,500 long-term care facilities in 36 states are battling coronavirus cases – an explosive 522 percent increase in just 10 days.

    The numbers are incomplete because the federal government doesn’t keep a formal tally of coronavirus deaths in nursing homes or the number of facilities with infections, according to the network on Friday.

  60. 60
    Ed George says:

    R7, this isn’t surprising. Old age homes, by their nature, encourage interactions between their guests. As such, if the virus got in before isolation actions were taken, the virus would spread widely. As of a few days ago, the majority of COVID deaths in Canada were at old age homes.

  61. 61
    ET says:

    It just proves that nursing homes are not properly taking care of their guests. I would bet that the bulk of the dead did not have proper vitamin D serum levels. That means they had compromised immune systems. It is also why flu seasons are during non-summer months when we don’t get enough sun to make our own. And then we complicate that by not supplementing properly.

    It’s sad and very preventable.

  62. 62
    kairosfocus says:

    ET, do not overlook the effect of this disease on the elderly, as well as contagiousness and management of air and surface contamination by viri with up to 7 – 9 day survival times. KF

  63. 63
    ET says:

    I am not overlooking that, kairosfocus. I am ecstatic about the over 90s who have survived it, though. This virus is bad, very bad. But we can beat it back if we just give our bodies the proper nutrition- well the majority, anyway. There will always be those who just have weaker systems regardless of what they do.

  64. 64
  65. 65
  66. 66
    kairosfocus says:

    DS, I saw PM Johnson has been released to the PM’s country home. KF

  67. 67
    daveS says:

    KF,

    A very positive development.

    On the negative side, I read that the famous mathematician John Conway has passed due to the virus. I don’t know if it has officially been confirmed yet.

  68. 68
    rhampton7 says:

    The Benton-Franklin Health District is reporting an outbreak of coronavirus cases at Tyson Fresh Meats in Wallula, WA.

    New coronavirus cases reported by the health district show that 35 residents from Benton and Franklin Counties, who work at the meat packing plant, have tested positive for coronavirus.

    Action News received news tips from several residents about a potential outbreak at the plant but we were unable to confirm the cases until now.

  69. 69
    rhampton7 says:

    After three employees tested positive for COVID-19 at its West Liberty, Iowa, processing plant, West Liberty Foods announced it would close the facility at the end of its second shift on April 9. Officials plan to reopen the plant on April 14 after performing extensive cleaning and sanitizing operations. The plant processes packages and slices turkey, beef, pork and chicken for foodservice and retail customers and employs more than 800 people.

  70. 70
    rhampton7 says:

    The Cargill plant in High River — about 60 kilometres south of Calgary — has roughly 2,000 workers.

    The union says currently there are 38 confirmed cases at the plant: five salaried employees, four contractors and 29 workers.

    Minnesota-based Cargill says it is temporarily reducing shifts starting Monday, and some wage increases and bonuses are now in place.

    “We also implemented additional safety measures like temperature testing, enhanced cleaning and sanitizing, prohibiting visitors, adopting social distancing practices where possible and offering staggered breaks and shift flexibility,” Jon Nash said in an email to CBC News.

  71. 71
    rhampton7 says:

    Tyson Foods said on Monday, April 13, 2020, that it would keep the pork processing plant in Columbus Junction closed through the end of the week. Officials said it was because of a continued assessment of the situation of the plant.

    Company officials announced the suspension of operations on Monday, April 6. At the time, they said that more than two dozen employees at the facility had tested positive for COVID-19. The company did not state whether any more workers had tested positive for the virus.

  72. 72
    rhampton7 says:

    The South Heartland District Health Department reported this weekend that 10 workers at a Western Reserve beef facility in Hastings, NE have tested positive.

    Hastings is in Adams County, just south of Grand Island, a current coronavirus hot spot. The number of positive cases in Adams County is growing too, with 54 people there testing positive as of Sunday.

    Lincoln Premium Poultry, the company that runs a Fremont chicken plant that opened last September and supplies Costco with millions of rotisserie chickens and other cuts, announced its first COVID-19 case Monday. The plant employs roughly 1,100 people.

  73. 73
    rhampton7 says:

    National Beef announced that its Iowa Premium plant in Tama will be idled until April 20, saying numerous employees had contracted COVID-19.

    The company said that it was taking steps to stop the spread of the virus and keep employees safe. Those include daily sanitizing and disinfection, temperature screenings, increased social distancing in common areas, and voluntary use of disposable face masks.

  74. 74
    Jim Thibodeau says:

    I watch the Johns Hopkins site every day, even though it’s about a day to 36 hours behind. Yesterday I saw 557,000 cases in America. We hadn’t had exponential rise for the last 10 days, it’s been about 30 to 35,000 new cases a day, and me and my friend in San Francisco were wondering if that was an artifact of testing. I saw only slightly more than that this morning. Now it’s reading 682,000 cases? WTF? Please tell me there’s a database error or something. 35k is the largest single day increase in cases prior to today, somebody tell me there’s a database error and we didn’t have 125,000 new confirmed cases today

  75. 75
    Jim Thibodeau says:

    You know the USS Theodore Roosevelt, where the captain decided to sacrifice his career to protect his sailors? There’s something like 600 positive cases in those sailors now out of 3000 or so.

  76. 76
    Jim Thibodeau says:

    Seems to be a corrected database error. Thank heavens.

  77. 77
    kairosfocus says:

    JT,

    WRT the Carrier, what is the proportion of asymptomatic cases? With Diamond Princess [the cruise ship quarantined in Japan], extensive testing revealed a large number of asymptomatic cases.

    Here, is a report on Iceland, where a local corporation is facilitating large scale testing on a scale that would be infeasible for very large countries . . . 360k is a world apart from 330 M or even 3 M or 30 M, much less 1.3+ B. I clip:

    Iceland’s testing suggests 50% of COVID-19 cases are asymptomatic
    The small nation might have an important lesson about the pandemic.
    Mihai Andrei by Mihai Andrei
    March 26, 2020
    in Diseases, Health & Medicine, News

    Iceland is a small nation of about 364,000 people with strong healthcare and a supportive social system. While most affected countries are only testing those who display severe symptoms, Iceland wants to test everyone in the country for the novel coronavirus.

    It can afford to do so in part thanks to its relatively low population, but also due to its well-organized and well-funded medical system. Iceland has currently carried out 10,000 tests — this is far less than what other countries have done, but on a per capita basis, Iceland ranks first in the world . . . .

    Not all the results from Iceland’s tests have come through yet, but the ones that have, show that half of all cases are asymptomatic (at the time of testing).

    This would suggest that, on one hand, the virus is not as dangerous as we thought, but on the other hand, it would also suggest that it has spread far more than we are currently aware of.

    These results are also indicated by a testing survey carried on an entire Italian town of Vo (population 3,300), where the results showed that more than 50% of all cases are asymptomatic.

    The whole population of the village was tested, and 3% of the residents tested positive. Then, after a two-week lockdown, the population was tested again. The transmission had been reduced by 90% and the results were confirmed: the majority of cases seem to be asymptomatic.

    We here see the pyramidical structure of a disease we are investigating: Cases that come to our attention do not represent the whole picture, whether serious cases or mild but noticeable ones. In addition, there is a hidden bulk that is generally invisible. Where, antigen testing [which is coming for Covid-19] allows us to detect after the fact.

    However, we must also recognise that our technological and logistical capabilities to test for infection are in a state of flux in an urgent situation. One in which 1/5 to 1/3 or so of negative tests are false negatives.

    Likewise, models depend on parameters that are hard to estimate and are prone to change.

    In short, the pictures we build are a lot less robust than we imagine.

    What I would like to see is to integrate sampling into census-based population structures, medical histories, case notes etc to form a more representative picture. But that will not happen overnight.

    KF

  78. 78
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    JVL says:

    As of this afternoon (April 15th) the US has/had about 30% of all declared COVID-19 cases in the world (616 K out of 2000 K), about 20% of all attributed deaths due to COVID-19 (26 K out of 129 K), and about 40% of all active cases (549 K out of 1403 K). Of the 66 K closed cases in the US, 26 K were deaths, about 40% of the closed cases. And that still leaves about 550 K active cases. As with most other countries this may not be counting a lot of asymptomatic cases or cases outside of hospitals.

    For comparison, worldwide there are about 624 K closed cases with 129 K deaths, about 21% of the total.

    The numbers change frequently and there is a lot of lag in the system so that some cases and deaths are only registered days after they occur. But those are the numbers we’ve got to work with. The Economist reported that deaths from cardiac arrests in NYC are much, much higher than at the same time last year, due to the virus or the health care system being swamped.

    From https://edition.cnn.com/2020/03/25/politics/trump-coronavirus-china/index.html

    President Donald Trump has in recent days criticized how China handled the coronavirus outbreak, saying Thursday that the “world is paying a very big price for what they did.”

    But as the virus spread rapidly across China in the month of February, Trump repeatedly praised Chinese President Xi Jinping’s response to the crisis, saying he’s handled it “really well” and that he was doing “a very good job with a very, very tough situation.”

    A CNN KFile review of Trump’s public statements identified at least 12 occasions in which the President praised or projected confidence about China’s response to coronavirus.

    This shift in tone from Trump represents a broader change in the President’s view of China, as he attempts to deflect responsibility for the ongoing global pandemic to Beijing’s initial handling of the crisis. It also shows how the President sought to downplay the threat of the virus in the weeks before the uptick of confirmed cases of coronavirus in the US.

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    Ed George says:

    JVL, I would place less stock in the numbers used for closed cases. Are these based on actual follow-up testing? Given the shortage of tests in most countries, I suspect that most confirmed cases that recover are not tested again. Does anyone know how the closed cases are determined?

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