Medicine News Of General Interest

What are Total Deaths Telling Us

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From the beginning of our Corona Virus madness, I’ve been saying that the flu season of 2017-2018 was horrible–and we did nothing. But now we’ve lockdown our economy and somehow have lost the key. Heaven help us.

I noticed this article at Powerlineblog.com that compared total deaths in the US from the start of the year in 2019 to those of the start of this year, 2020. Here’s a takeaway from the article:

According to the CDC, as I read the spread sheet, there were 809,704 deaths in the U.S. over the same time period last year. That’s right: through the first 14 weeks of the year, through April 3 or April 10, however the CDC counts the weeks, there were 37,619 fewer deaths this year than last, despite our supposedly being in the grip of the greatest health crisis since the Spanish flu.

The writer of that article at Powerlineblog.com tells us that after he published this data, the data was taken down at the CDC site. Have you heard of a ‘memory-hole’? Nonetheless, he had saved a copy of the data.

I used that data to compare early 2018 (the first fifteen weeks of 2018) with those of 2020 (again, the first fifteen weeks), which gets us through April 11th. Now, we know two things: first, that some of the worst weeks of the Corona virus have come in the last few weeks, and second, that the numbers being submitted are being played with. (There was an article out yesterday where funeral home employees are talking about some of this mischief.)

Nonetheless, here’s how these two years stack up against one another:
2018: pneumonia deaths (the primary cause of Corona Virus deaths): 67,747

2020: pneumonia deaths: 58,748.

IOW, up until April 11th, the 2017-2018 flu killed roughly 9,000 more people than the Corona Virus (N.B. pneumonia deaths also include death via influenza).

And we shut down our economy? This certainly wasn’t the Spanish flu.

Now the last three weeks have seen around 1,800 to 1,900 deaths per day for a total of arond 39,000 deaths due to Corona Virus. In 2018, over the same three week period, 10,000 died of pneumonia. Assuming that all pneumonia deaths this year are being attributed only to the Corona Virus, the new numbers are these:

2018: (through April 30th) 77,758

2020: 97,748

Excess deaths due to Corona Virus: 20,000. And we shut down our economy?

But, there’s more:

This year the total deaths from Corona Virus is 28,000. But I mentioned, early on, that a study was done for the 2014-2015 for the flu season in Italy. Excess deaths (that is deaths above the normal flu season rise) was 45,000. And where did these deaths take place? The very same Lombardy region where the Corona Virus took off.

Then, compare the “daily cases” graph and the “daily deaths” graph for the United States and Italy, and Spain, and Germany. Only in the U.S. have the number of cases and deaths stayed at high levels for so long. In those other countries, the deaths and cases tapered off. But not in the US. Why? Federal dollars, plain and simple.

But we can’t leave without talking about “shelter-in-place” policies. You know, Sweden. The graphs/charts from Sweden show something very different from the US/Germany/Italy/Spain. You see rises and falls that repeat. This looks like there has been waves of infections and death. This is what herd immunity should like in time. Our “shelter-in-place” policies will simply push these staggered peaks seen in Sweden’s charts from being ‘weeks’ apart to being ‘months’ apart. So, what have we gained? And how does Sweden’s numbers look like? They’re less than UK, Italy and Spain, but higher than their neighbors. Are they twice as high? Will the total deaths from the Corona Virus be twice as high as they now project when the peaks are added up? Very likely?

Look at the graph on Page 6 of this CDC file: Notice that BOTH flu and Corona Virus ER visits went straight up starting in week 11 of this year. This is exactly when the “lockdown” began. So why did flu-caused ER visits also spike? Remember, as many here are so fond of nitpicking, the flu is not the SARS-CoV2 virus. How can you explain the serious flu ilnesses rise seen to take palce during a ‘lockdown’?

So what has this huge dislocation of our economy given us? Not much. It’s supposed to save our healthcare system, but now this very same lockdown approach might COMPLETELY destroy the healthcare system of more rural areas. How then will we justify this lockdown? Why isn’t the country open now? Fear. Where does this fear come from? Fauci, et. al. and the media that loves him. Heaven help us.

30 Replies to “What are Total Deaths Telling Us

  1. 1
    bornagain77 says:

    Of related interest

    French coronavirus expert REJECTS second wave fears branding warnings a ‘fantasy’
    A LEADING health expert has dismissed fears France could be hit by a “second wave” of COVID-19 infections as officials unveiled plans to relax some of the country’s strict lockdown measures.
    By SIMON OSBORNE – Apr 29, 2020
    Excerpt: Prof Raoult said: “The second wave story is a fantasy that was invented from the Spanish flu, which started in the summer and has nothing to do with it.
    “Usually an epidemic happens in one curve. I hate to make predictions, but this way of constructing it is fairly common for epidemics.
    “In the past, epidemics disappeared long before we had the means to contain them. They disappeared anyway.
    “Humanity didn’t die from an epidemic, that’s the way it is. Epidemics start, accelerate, peak, disappear, and we don’t know why.”
    Prof Raoult said the French government’s plans to start easing lockdown measures on May 11 was justified.
    He also backed the results of a study carried out by Singaporean researchers who predicted 97 percent of COVID-19 cases in France would have happened by around May 7.
    Prof Raoult said: “The data provided by the president is not extravagant. 97 percent of the cases will have occurred around 7th May and 99 percent around 19th May.
    “This is the time when we should be able to confine and isolate infected people, knowing that by then the virus transmission will have become much lower.”
    https://www.express.co.uk/news/world/1275573/france-coronavirus-latest-news-second-wave-covid19-lockdown-updates

    Of note: D. Raoult is the top-rated expert in Communicable Diseases in the world.
    http://expertscape.com/ex/communicable+diseases
    Thus for him to ‘predict’ that there will not be a second wave of Covid-19 this coming winter is for him to make a fairly large ‘prediction’ since his reputation will be ruined if he is wrong.

  2. 2
    jerry says:

    So far I found the spread sheets incomprehensible especially the one linked on Powerline. It was only for about 30 weeks starting in late 2019. So is it a bad link? The download link says 1kb which essentially means nothing.

  3. 3
    vividbleau says:

    One thing that is conspicuous by its absence are the models that show what are the costs of this ‘economic shutdown as it relates to deaths, child abuse, domestic violence, depression etc. where are those models?

    Vivid

  4. 4
    doubter says:

    So this is supposed to be just another version of the cyclic flu that comes each season? Nonsense. It’s turning out that COVID-19 is unprecedented in that it attacks all the body systems and organs, not just the lungs. One of the most alarming effects is provoking strokes due to formation of blood clots. Example, from The New England Journal of Medicine:

    https://www.nejm.org/doi/full/10.1056/NEJMc2009787

    “We report five cases of large-vessel stroke in patients younger than 50 years of age who presented to our health system in New York City. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was diagnosed in all five patients.
    ……………………………
    Over a 2-week period from March 23 to April 7, 2020, a total of five patients (including the aforementioned patient) who were younger than 50 years of age presented with new-onset symptoms of large-vessel ischemic stroke. All five patients tested positive for Covid-19. By comparison, every 2 weeks over the previous 12 months, our service has treated, on average, 0.73 patients younger than 50 years of age with large-vessel stroke.”

    I suppose this is an example of the “fake news” the liberal media is supposed to be spewing about the coronavirus pandemic.

  5. 5
    jeffburton says:

    Be careful. I am with you on your overall thesis – that this pandemic is exaggerated and overblown. But a lot of what you say here is just wrong. First, the CDC has not removed this data. They updated it regularly here: https://gis.cdc.gov/grasp/fluview/mortality.html. I have been looking at this data for a while, and the numbers change as their reporting network turns in numbers. Today when I looked at it, there was a clear indication of “excess deaths” in this year’s series of total deaths. It’s easier to see this if you bring it into Excel and make a graph each year’s series. Week 14 has more deaths this year than any of the past six years.

  6. 6
    orthomyxo says:

    As Jeff Burton says, you can’t use the CDC mortality data in this way because it is constantly updated.
    as more states submit their information. This is clear form the “saved” data that you linked. On April 23rd, there 55. 981 reported deaths from week 7 (mid Feb), when I look at this today (download data from: https://gis.cdc.gov/grasp/fluview/mortality.html) there are 56,749 deaths fo this week. Mor recent weeks like Week 14 (the first week in April) have gone from ~42,000 to ~64,000.

    The CDC is well aware of this issue and uses penuomia-coded deaths rather than total deaths as an indicator of epidemic flu. A few analyses have go there hands on data from states that report mortality qucikly, and the ecess in mortality is considerably higher than the reported covid-19 deaths in many places (e.g. https://www.nytimes.com/interactive/2020/04/28/us/coronavirus-death-toll-total.html)

    But we can’t leave without talking about “shelter-in-place” policies. You know, Sweden. The graphs/charts from Sweden show something very different from the US/Germany/Italy/Spain. You see rises and falls that repeat.

    You see weekends. it’s a reporting effect, not something real about the disease in Sweden.

    So why did flu-caused ER visits also spike?

    From the report, the definition of flu-like illness is temperature > 100F and a cough while covid-like is fever plus one of [cough/shortness of breath/difficulty breathing]. there is so much overlap that spike in flu-like illness is very like to be the result of covid-19 ( I don’t know, but it’s possible one visit could be coded as both flu-like and covid-like).

  7. 7
    AaronS1978 says:

    Number of infected going up death rates going down

    Until they accurately start testing all deaths for Covid don’t bother with the death rate

    It has been warned by WHO and the CDC that we do not know the accurate number of infected which will directly impact the death rate, infected will only increase

    Death is the numerator infected is the denominator

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

  8. 8
    orthomyxo says:

    Sure, but the excess in total deaths puts paid to the idea this is just like a bad flu season.

  9. 9
    kairosfocus says:

    Ortho, it isn’t a bad flu season, but a flu season is a yardstick of comparison. I add, I wonder how many are deaths brought forward 6 – 12 months? Would we see an echo in reduced deaths later? But fundamentally, we are dealing with noisy proxies not anything near definitive truth. KF

  10. 10
    orthomyxo says:

    A flu season is a good yardstick, at the moment the is pretty good proof that this is, despite suppression efforts, several times worse then a typical flu season. So PaV’s continued contraianism isn’t really warranted.

    It’s possible there is a “reaping” effect, where the frail are having their deaths accelerated. But it’s worth remembering someone who makes it to 80 has a life expectancy of 8 more years, and many of the listed comorbidities are common in people that live long lives with them.

  11. 11
    BobRyan says:

    The CDC wants higher numbers of deaths to justify just how wrong they were. They no longer require known COVID-19 deaths, since suspected work just as well. They also include anyone who tests positive and dies as being a COVID-19 death, which causes the numbers to be higher every bit as much as including suspected.

    The SARS part of SARS-CoV-2 is severe acute respiratory syndrome. COVID-19 attacks the lungs of a severely weakened host, which is why the older one is, the more likely they are to die. Countries with older populations will have more deaths than countries with younger populations.

    According to the Mayo Clinic:

    The severity of COVID-19 symptoms can range from very mild to severe. Some people may have only a few symptoms, and some people may have no symptoms at all. People who are older or who have existing chronic medical conditions, such as heart disease, lung disease, diabetes, severe obesity, chronic kidney or liver disease, or who have compromised immune systems may be at higher risk of serious illness. This is similar to what is seen with other respiratory illnesses, such as influenza.

    Some people may experience worsened symptoms, such as worsened shortness of breath and pneumonia, about a week after symptoms start.

    https://www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-20479963

  12. 12
    BobRyan says:

    Article VI, Paragraph 2 of the United States Constitution states:

    This Constitution, and the laws of the United States which shall be made in pursuance thereof; and all treaties made, or which shall be made, under the authority of the United States, shall be the supreme law of the land; and the judges in every state shall be bound thereby, anything in the Constitution or laws of any State to the contrary notwithstanding.

    This is known as the Supremacy clause and there are no exceptions to this clause. All states in the United States are bound by the US Constitution and no state can violate any part of the Constitution for any reason.

    Article I, Section 8 (Section 8 is powers given to the US Congress), Clause 3 of the United States Constitution states:

    To regulate commerce with foreign nations, and among the several states, and with the Indian tribes;

    Interstate commerce is under the sole discretion of the United States Congress and no state can put an undue burden on interstate commerce for any reason. When states shut down their economies, they did so in violation of the Commerce Clause.

    18 U.S. Code CHAPTER 115, §?2383. Rebellion or insurrection states:

    Whoever incites, sets on foot, assists, or engages in any rebellion or insurrection against the authority of the United States or the laws thereof, or gives aid or comfort thereto, shall be fined under this title or imprisoned not more than ten years, or both; and shall be incapable of holding any office under the United States.

    The states are committing economic rebellion against the United States. They are acting against the authority of the United States as a result of directly violating the Commerce Clause.

  13. 13
    orthomyxo says:

    Bob Ryan,

    Again, we are talking about the total number of deaths from all causes. It’s hard to see how the coivd-19 deaths can be greatly over-reported when there more excess deaths in April out-number the reported covid-19 deaths.

  14. 14
    BobRyan says:

    Orthomyxo,

    Doubter @ 4 is not the only one who believes COVID-19 to be something it is not. A lot of science-fiction is being taken as science. They believe anyone who tests positive for COVID-19 who has died, must have died from COVID-19.

  15. 15
    orthomyxo says:

    People are only tested for covid-19 if they have respiratory symptoms (and in states that got a long way being the disease only those with servers symptoms), so almost every who dies with a positive test will have died of the virus. The death data discussed in this thread makes the point that a substantial number of people who die from the disease are not included in the reported deaths .

  16. 16
    Bob O'H says:

    BobRyan @ 11 –

    [The CDC] also include anyone who tests positive and dies as being a COVID-19 death,

    Do you have a link to the CDC’s advice on this? The WHO have more nuanced advice:

    A death due to COVID-19 is defined for surveillance purposes as a death resulting from a clinically compatible illness, in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID disease (e.g. trauma). There should be no period of complete recovery from COVID-19 between illness and death.

    But I don’t know if the CDC follows this advice.

  17. 17
    doubter says:

    BobRyan @14

    I suppose you know better than one of the leading physicians actually treating and researching COVID-19. Note the three core pathologic processes. Also note the description, “…. historically high levels of morbidity and mortality from COVID-19.” Would you care to name some other, preferably flu-like, diseases with similar effects all coming from one infecting agent?

    The following is from EVMS CRITICAL CARE COVID-19 MANAGEMENT PROTOCOL, Developed and updated by Paul Marik, MD, Chief of Pulmonary and Critical Care Medicine, Eastern Virginia Medical School, Norfolk, VA; April 20th, 2020 (at https://www.evms.edu/media/evms_public/departments/internal_medicine/EVMS_Critical_Care_COVID-19_Protocol.pdf).

    Apparently you consider this science fiction rather than medical science. What planet are you from?

    “Three core pathologic processes lead to multi-organ failure and death in COVID-19:
    1) Hyper-inflammation (“Cytokine storm”) – a dysregulated immune system whose cells infiltrate
    and damage multiple organs, namely the lungs, kidneys, and heart. It is now widely accepted
    that SARS-CoV-2 causes aberrant T lymphocyte activation resulting in a “cytokine storm.”.
    2) Hyper-coagulability (increased clotting) – the dysregulated immune system damages the
    endothelium and activates blood clotting, causing the formation of micro and macro blood clots.
    These blood clots impair blood flow.
    3) Severe Hypoxemia (low blood oxygen levels) –lung inflammation caused by the cytokine storm,
    together with microthrombosis in the pulmonary circulation severely impairs oxygen absorption
    resulting in oxygenation failure.

    The above pathologies are not novel, although the combined severity in COVID-19 disease is
    considerable. Our long-standing and more recent experiences show consistently successful treatment if
    traditional therapeutic principles of early and aggressive intervention is achieved, before the onset of
    advanced organ failure. It is our collective opinion that the historically high levels of morbidity and
    mortality from COVID-19 is due to a single factor: the widespread and inappropriate reluctance amongst
    intensivists to employ anti-inflammatory and anticoagulant treatments, including corticosteroid therapy
    early in the course of a patient’s hospitalization. It is essential to recognize that it is not the virus that is
    killing the patient, rather it is the patient’s overactive immune system. The flames of the “cytokine fire”
    are out of control and need to be extinguished. Providing supportive care (with ventilators that
    themselves stoke the fire) and waiting for the cytokine fire to burn itself out simply does not work… this
    approach has FAILED and has led to the death of tens of thousands of patients.”

  18. 18
    PaV says:

    Again, the last part of April, which was not included, is where the heavy death total comes. Looking at the CDC’s info, you’ll see that the P&I has now shot up and it is clear that we’re dealing with excess deaths. But, of course, on what scale.

    What has struck me the most, and which has swayed my from my initial view, is some of the anecdotal things we’ve seen and read about, like an ice rink serving as a morgue. I don’t ever remember reading about such a thing happening before. Along these lines, I think this article, which comes from a post on powerlineblog.com, is very enlightening. It is exactly the kind of anecdotal response to this contagion that I would have expected if this virus were as virulent as the numbers seem to point to. Doctors working at ER’s should have a “feel” for what flu deaths look like; and this virus is out of the ordinary.

    Having said that, we must also realize that this virus can be broken down this way: New York and New Jersey, and then the rest of the United States. The author of the linked article is from Harvard, and being so close to New York and New Jersey, may be seeing things much worse than in the rest of the country.

    With this said, there should be two plans in play for bringing the US economy back to up and running: one plan for New York and New Jersey, and another plan for the rest of the US. I’m here in California where Governor Gavin Goonsome is shutting down beaches because he doesn’t like the photos he’s been sent while less than 2,000 people have died from the virus and hospitals are furloughing their medical staff. Again, what an irony it would be if the lockdown causes the exact thing it was intended to prevent. A Republican governor would likely not be so ill-informed and risk-averse.

  19. 19
    orthomyxo says:

    Having said that, we must also realize that this virus can be broken down this way: New York and New Jersey, and then the rest of the United States

    I hear comments like this often (often with different countries or states in the comparison), but I’m not sure how well thought-through they are. A dense city like NYC or London will lead to a higher reproductive number, so more cases happening at once. But it’s teh same virus in NYC and Calfifornia. Best evidence is that about 0.5-2% of CA has been infected, so those 2000 deaths might be multiplied by >40 times before an epidemic burns out. Maybe that’s something you are willing to live (or die) with, but I think you to have what is and isnt’ different about densely populated urban centres clear when you make these comparisons.

  20. 20
    Barry Arrington says:

    Ortho

    so those 2000 deaths might be multiplied by >40 times before an epidemic burns out

    Still with the fear mongering? You should know that the rest of us are getting really tired of this tactic from you and all of the others who never seem to tire of it. It is also way past the point where it is even remotely credible.
    Yes, after the media had cried wolf for literally decades, their credibility was long since squandered. I wrote about that in The Media Squandered Trust; The Nation Suffered. At the beginning I thought they were crying wolf againand predicted fewer than 5,000 deaths. It turns out they were not merely crying wolf this time, but, to carry the metaphor further, what actually showed up was more like a coyote then the “two million are going to die” wolf they were heralding. Still, to suggest that there may be 80,000 deaths in California alone when there have been fewer than 70,000 in the entire country, is shameless fear mongering.

  21. 21
    orthomyxo says:

    Barry,

    My basic calculation was the R might be as low as 2.2 or so outside of a big dense city. So you’d get heard immunity at ~55% infection rate leading to maybe 65% infected (herd immunity is not a hand brake that stops an epidemic in its tracks). The re-analysis of the Santa Clara study suggests maybe 1-2% of CA has been infected. So you might well expect 30-60x more infections before an epidemic burns itself out.

    Now, there are a lot of uncertainties and approximations in the above, and we can talk about which way those uncertainties might cut. But is there any unreasonable assumption in there?

    If you don’t think 65% of the population would be infected then I have to ask what will stop that from happening? It’s possible a treatment will emerge that lowers the death rate for infections, but I’m not sure I’d bet on that. It’s conceivable that the current infection rate is higher, but even the upper bound of the likely-biased Santa Clara study is <5%.

    I think this is a much more credible way of thinking about the likely impact of the virus in California than looking at the current total for a nation which is made of my many different local epidemics each at different stages of the curve.

  22. 22
    Barry Arrington says:

    Ortho:

    Now, there are a lot of uncertainties and approximations in the above

    Finally, something about which we can agree.

    is there any unreasonable assumption in there?

    As of this moment Worldmeter reports 68,589 deaths in the entire country. CA’s population is 39.5
    million. The population of the US is 328,000. So CA has roughly 12% of the US population. If 80,000 die in CA, and deaths in the US occur at the same rate, that projects to 667,000 deaths in the US. No one — absolutely no one — believes there will be anywhere remotely near 667,000 deaths in the US. The absolutely most pessimistic projection right now by the IHME is 114,000 — about 1/6 of the rate your scaremongering would suggest.
    So, to answer your question, the assumption that it is reasonable to even suggest that the single state of California alone will have 80,000 deaths is absurd.

  23. 23
    orthomyxo says:

    The IHME model assumes the outbreak will be “contained”, using the very severe lockdown on Wuhan as a model. PaV is taking about lifting restrictions, not making then harder.

  24. 24
    orthomyxo says:

    FWIW, i just read the IHME website a bit more, and it seems they no longer rely solely on the Wuhan lockdown for their curve-fitting. Nevertheless, they assume physical distancing measure remain in place all the way to August. They also predict that deaths per day will slow to ~1/3 of the current rate within a week. It’s hard for me to see how that could happen given the number of new cases-per-day (data that IHME model doesn’t use as far as I can tell) has not yet started falling appreciably (though, of course, this also partly reflects testing capacity).

    So, I think the IHME curves don’t address PaV’s point, and even then there is reason to think they are pretty optimistic. And, for what it is worth, there are certainly more pessimistic models out there. One with a point estimate of ~160,000 deaths by August https://covid19-projections.com/

  25. 25
    Barry Arrington says:

    One with a point estimate of ~160,000 deaths

    OK, for the sake of argument let’s assume that the most wildly pessimistic projection is 160,000, instead of 114,000. Your shameless fearmongering is only four times the most wildly pessimistic projectioin, not six times.
    Do I sound angry? It is because I am. You and people like you are going to burn the world down if someone doesn’t stop you.

  26. 26
    orthomyxo says:

    OK, for the sake of argument let’s assume that the most wildly pessimistic projection is 160,000, instead of 114,000. Your shameless fearmongering is only four times the most wildly pessimistic projection, not six times.

    The point estimate is 160,00, the upper-bound is 280,00. And that’s by August, with no reason to think the epidemic will just stop then. It’s not the most pessimistic model I know of (in fact, teh IHME stats are by some margin the most optimistic: https://projects.fivethirtyeight.com/covid-forecasts/).

    All I have tried to do here is make some of you understand the scale of the threat this virus represents. You can be angry about that if you like, but If you think it’s crazy to think it’s possible 600,000 could die in the epidemic if restrictions are removed in the US then you are going to have to tell me why I’m wrong.

  27. 27
    ET says:

    It seems to me that the scale of the threat is with unhealthy people. That is people who either don’t take care of themselves or who have pre-existing conditions that dampen their immune systems. So what we have is an example of natural selection. And seeing there is a prophylaxis, it could be that the ignorant are also going to be taken unless they stay sheltered.

  28. 28
    Barry Arrington says:

    Ortho:

    the upper-bound is 280,00

    OK, your fearmongering is 2.4X the upper-bound of the most wildly pessimistic model.

    All I have tried to do here is make some of you understand the scale of the threat this virus represents. You can be angry about that if you like, but If you think it’s crazy to think it’s possible 600,000 could die in the epidemic if restrictions are removed in the US then you are going to have to tell me why I’m wrong.

    OK, how about: your fearmongering is 2.4X the upper-bound of the most wildly pessimistic model. I suppose we will all have to decide whether to believe you or the models. Admittedly, I am not a great fan of the modelers, because they got it staggeringly wrong in the beginning. But they got it wrong on the high side. There is absolutely no reason to believe they are collectively a bunch of pollyannas whose conclusions we should reject in favor of a fearmongering internet troll such as yourself.

  29. 29
    orthomyxo says:

    I’m not sure you’re paying attention Barry. The MIT model is not the most pessimistic one out there, and the projections end in August, with a lot of susceptible people remaining at that time

    You also seem too forget the very high estimated deaths in models like the Imperial one are for a “do nothing” scenario.

  30. 30
    Barry Arrington says:

    Ortho,
    Yes, I am paying attention to the lies and scaremongering you continue to spread. And I am doing my best to combat them.
    Yes, the Imperial model was based on a “do nothing” assumption, and it would have still been wildly inaccurate for most places (excluding high density areas like NY and NJ) even if we had done nothing (as Sweden approximates).

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