What will happen if we reopen for business?

The following calculations are rough and do not use any fancy epidemiological equations. The poor availability of testing and flaky reporting of outcomes make it difficult to know exactly what the numbers are.

According to Johns Hopkins on April 16, 2020:

Case fatality rate 4.5%
Confirmed cases 636,350
Deaths 28,326
https://coronavirus.jhu.edu/data/cumulative-cases

A CONSERVATIVE ESTIMATE OF THE CURRENT COVID-19 SITUATION

600,000 confirmed cases
1,200,000 probable infected cases
---------
1,800,000

If there is a case fatality rate of 4.5% there is a risk of 80,000 more deaths. There are a variety of drugs and treatments in clinical trials, but finding out the outcomes for the people who are currently ill will require several more weeks. In a month there are likely to be much better treatments available, and hopefully enough personal protective equipment for all medical personnel.

WHAT HAPPENS IF WE REOPEN THE BUSINESSES AND SCHOOLS?

If the closures are all lifted here are some speculative numbers about the possible outcome.

Calculations for the newly infected assume that there are currently 1,000,000 infectious people in the US and these people stay infectious about one week.
People can actually keep shedding the virus for a week or two after the symptoms appear but it is still assumed that they only infect others for about a week.
It is assumed that each infectious person passes the virus on to two other people. (This assumes Ro = 2. Actual estimates before the shutdown were that on the average each infected person passed the virus on to 2.5 to 3 others.)

It is assumed that only about 10% of the new cases are people who will experience serious illness and that they will remain ill for about 3 weeks. These people are likely to need hospitalization at some point in their illness. Other people will need to care for them and they will not be able to work.

The number of people who are seriously ill is calculated by adding the number of new serious cases to the number of serious cases that were new in the previous two weeks.

By June it will be much more difficult to cough on someone who has not been infected. Unfortunately there are reports out of China that people who experienced a mild infection can sometimes be infected again and the second time the illness will be much worse. If this is the case it could be a problem for younger people who only had mild symptoms the first time they were infected.

Date____Newly Infected________New serious cases__________Seriously ill

4/16____1 million______________100,000____________________100,000

4/23____2 million______________200,000____________________300,000

4/30____4 million______________400,000____________________700,000

5/7_____8 million______________800,000___________________1,400,000
_
5/14____16 million____________1,600,000___________________2,800,000

5/21____32 million____________3,200,000___________________5,600,000

5/28____64 million____________6,400,000___________________11,200,000

6/4_____128 million___________12,800,000__________________22,400,000

6/11 Start getting closer to herd immunity. Maybe.

___________________________________

There will not be enough staffed hospital beds if we allow the epidemic to run unchecked.

The following information about available hospital beds is from American Hospital Association based on the 2018 AHA Annual Survey (FY 2018).

https://www.aha.org/statistics/fast-facts-us-hospitals

In all the hospitals in the US the total number of staffed beds is 924,107.

Intensive Care Beds in Community Hospitals

Medical-Surgical Intensive Care Beds in Community Hospitals 55,663

Cardiac Intensive Care Beds in Community Hospitals 15,160

Neonatal Intensive Care Beds in Community Hospitals 22,721

Pediatric Intensive Care Beds in Community Hospitals 5,115

Burn Care Beds in Community Hospitals 1,198

Other Intensive Care Beds in Community Hospitals 7,419

Total Admissions in All U.S. Hospitals
36,353,946

People will still be injured or become ill from other causes. Babies will continue to be born. Most of the existing hospital beds are needed for people other than Covid-19 patients.

Edited for typo

Share
up
22 users have voted.

Comments

Alligator Ed's picture

As of 4/15/20, 3,000,000 U.S. tests were performed. The number of "possible infections" can only be derived from the studied number of Class B patients as a percentage of the 3M tested. For now, information emanating from CCP and WHO must be disregarded, especially as to reinfection.

So, the estimate of 1,200,000 persons likely infected must represent the very mild Class A patients and the entirety of Class B patients studied. So, 1,200,000 / 3,000,000 = 40% of total US tested population affected. If you have a source for that, I would want to know.

The Johns Hopkins report you cited does NOT provide the information. What it does provide are only raw numbers, not percentages. Without adequate cohort of tested individuals, CFR cannot be determined by graphs, curves or any other device not involving real tests on real people. So far, all models have had to be revised downward. The initial Fauci-Birx estimate of up to 2,200,000 deaths can be seen as unwarranted hyperbole, even at the time such projection was made.

Initially Italy's fatality rate amongst proven infections was 10%--this overlooked many in the population who stayed at home and were not tested. That horrendous figure was based on a median age of 83 amongst decedents. Italy has a relatively elderly population. Their figures will not reflect conditions of countries with proportionately younger populations.

Current global figures indicate 2,213,607 infected cases (which figure does not regard whether there were valid tests performed to confirm this number. Concomitant number of deaths is 146,344. This is 6.61% of all cases, whether or not confirmed by testing.

Current US totals are 709,377 infected and 35,568 deaths. This equals 5% of "proven" infected deaths. The mortality figure must take into account efforts by health departments to encourage treating physicians to categorize deaths of otherwise unknown cause as SARS2-related. Somebody found dead at home is thus presumed to be SARS2-related in some jurisdictions. Yet the number of sudden cardiac deaths is vast, much greater than perhaps the 1000's of spurious cases being labelled as SARS2 related, when in reality they are unrelated.

CDC figures for the US illustrate the immensity of the disproportionality of cardiac deaths to presumptive SARS2-related deaths.

US deaths and mortality 2018

Proportion of sudden cardiac deaths to all cardiac deaths 1999

These figures are the most recent (1999) on the CDC mortality report.

As can be seen from this chart, in 1999 the proportions of male sudden death out-of-hospital compared to in hospital was 41.7% . The female proportion of sudden out-of-hospital death to in-hospital is 51.9%

The total cardiac deaths collated by CDC in 1999 was 728,743.
41.7% of 353,500 male deaths = 147,409
51.9% of 375,243 female deaths = 194,751

Total male + female sudden deaths-out-of hospital is 147,409 + 194,751 = 342,160.

Assuming for simplicity that total deaths each day equalled every other day, then 342,160 people died over a 365 day interval. This yields 937 deaths per day of cardiac origin occurring out of hospital.

The "experts", like Birx and Fauci seem to hope, that by supporting reportage of deaths from unproven cause includes relatively large numbers of SARS2 victims.

92 days have elapsed since the first confirmed SARS2 death was reported on Jan. 17, 2020. Although the initial mortality rate was quite low, lagging about 7 to 10 days after initial infection, for the sake of simplicity, we assume that deaths occurred evenly distributed.

Although figures from 2019 are missing, we will use 1999 figures, which also was based upon a somewhat smaller total population than the current 330,000,000 people. Using this lower size population really under-estimates the current total of out-of-hospital deaths. Such a smaller population would tend to favor a more conservative estimate of total cardiac deaths and out-of-hospital deaths.

937 total non-hospital daily deaths (using 1999) figures means 937 X 92 deaths during this SARS2 epidemic would occur to date = 86,243 deaths.

It is quite easy to see that merely assigning 5% of those unproven SARS2-related deaths to the "definite" SARS2 death tolls would inflate the daily death toll by an additional 4312 persons.

There is more than ample reason to believe that massaging of the SARS2 deaths is happening. The reduction of reported cardiac deaths in favor of SARS2 deaths would likely be unnoticed. But the epidemic, by this subterfuge would be made to seem much worse.

Example: current SARS2 deaths are reported at 35,568 to which we add 4,312 = 39,980. Instead, we must know what percentage of alleged SARS2-related deaths were actually due to non-SARS2 causes. This figure is not available.

Using the line of reasoning that conflation of SARS2-related deaths and only cardiac non-hospital deaths will yield a substantially more lethal picture than is the case. And my example does not include non-hospital deaths from other disorders such as stroke, dementia, cancer, etc.

How many of the so-called SARS2-related deaths are not based upon scientific proof of infection. Even close contact with a SARS2 person does not prove infection in the decedent.

up
6 users have voted.

@Alligator Ed For me, I just consider who is actually being tested. It's largely people showing symptoms, so I conclude that the mortality rate is bogus. Without comprehensive testing, we just don't know.

up
10 users have voted.

@tle
The case fatality rate of 4.5 is based on outcomes for the 600,000 people who have been tested and have confirmed cases. Obviously someone who already has serious symptoms is more likely to have a fatal outcome than the person who just feels lousy for a couple days. Applying the 4.5% fatality rate to currently infected people who have been tested is reasonable since the 4.5% is based on outcomes from their group. Unfortunately we are almost certain to lose more than 100,000 people here in the US.

There are not any estimates for mortality in my simple weekly model because there are no clear numbers for the calculation.

An actual case fatality rate of 1% could be reasonable, but until there is sufficient testing it is only possible to guess.

This country would not be in this mess if widespread testing and tracing had started in February. Even by the stunningly low standards our government applies to itself the situation is truly outrageous.

up
9 users have voted.

@tle the standard for testing in all countries is based on those displaying symptoms. KCDC (Korea CDC) has been more transparent on this point that most other countries -- Frequently Asked Questions for KCDC

1. Diagnostic Testing

Q1. Who can get tested for COVID-19? Do you test asymptomatic persons too?

We test persons who are “suspected cases” or “Patients Under Investigation (PUI)” as defined by our COVID-19 Response Guidelines (excerpt provided below).

Excerpt from COVID-19 Response Guidelines:

1. Case Definition

○ Suspected case:

A person exhibiting fever (37.5 degrees or above) or respiratory symptoms (coughs, shortness of breath, etc.) within 14 days of contact with a confirmed COVID-19 patient during the confirmed patient’s symptom-exhibiting period.

○ Patient Under Investigation (PUI):

(1) A person suspected of COVID-19 according to a physician’s opinion for reasons such as pneumonia of an unknown cause;

(2) A person exhibiting fever (37.5 degrees or above) or respiratory symptoms (coughs, shortness of breath, etc.) within 14 days of visiting a country with local transmission* of COVID-19, e.g. China (including Hong Kong, Macau); or * Refer to WHO or KCDC website (COVID-19 à Situation reports à Local transmission classification)

(3) A person exhibiting fever (37.5 degrees or above) or respiratory symptoms (coughs, shortness of breath, etc.) with an epidemiological link to a domestic COVID-19 cluster.

We do sometimes apply exceptions for certain high risk groups. For example, we tested all persons linked to certain major clusters (i.e., Shincheonji, Guro-gu call center) regardless of clinical symptoms. We have also recently tested all persons in long-term care facilities in Daegu City regardless of clinical symptoms.

And yet, the reports of tests in Korea appear to reflect those standards.
Total tested: 546,463
Tested Pos: 10,635
Tested Neg: 521,642
In-test: 14,186

Not logical that each of the confirmed cases led to an average of 50 contacts that also exhibited symptoms and therefore, were tested. That's a boatload of symptomatic contacts testing negative. (Korea has completed contact tracing for >80% of its confirmed cases and is working on the remainder.)

OTOH, half a million tests in Korea is hardly mass testing of a total population of 51 million -- it's more like 1% of the population. How can there be so many symptomatic people testing negative? Meanwhile, others postulate a mass of asymptomatic people that are spreading the virus; except not so much in Korea or Vietnam.

As the standard for recovery is asymptomatic and two negative tests, mass testing would be worthless to track down those who were infected but only experienced no or mild symptoms because they too would test negative. They will only be found if a reliable and cheap antibody test becomes available and is then deployed for mass testing.

Sure would be interesting to know something about all the people testing negative -- why were they even tested?

up
4 users have voted.

@Marie
Maybe recently they are going ahead and testing everyone the sick person came in contact with for the previous week? Since people are contagious before they have symptoms it could be necessary to quarantine family members, coworkers, and the clerk at the store down the street. It would be easier to test all those people and just let them go about their business if the test is negative. I wish we could do something like that here.

up
3 users have voted.

@ScienceTeacher

Maybe recently they are going ahead and testing everyone the sick person came in contact with for the previous week?

However, from the 31 March advisory, it doesn't appear that Korea has changed its operating procedures. Plus, if they were doing that, why not disclose it as they have done wrt to a few clusters? In those instances the additional tests only number in a few hundred. KCDC has been straightforward that contacts are to self-isolate and monitor for symptoms - fever, cough, malaise - and only tested if symptoms develop. As in China and Vietnam, those with symptoms and a positive test are assigned to one of three categories for monitoring: mild (at home isolation) moderate (quarantine isolation facility), and severe (hospitalization). A patient will be moved as his/her health improves or deteriorates. That way they avoid a common situation in the US of sick people denied testing and left to die in the home or rushed to a hospital shortly before they die.

I can only come up with three possibilities for this not so transparent aspect. 1) hypervigilence wrt to health care workers, a high percentage that have had contact with a Covid-19 patient. The slightest symptom, for example a cough, results in that person being tested and isolated until the test result is completed. That would be good medical practice and unlike the US, Italy, and China (during the initial phase), Korea seems not to have lost any health care workers. 2) Doctors are ordering tests for VIPs/elites who demand they be tested. (Korea's health care system is public health insurance and private health care services. 3) Hypochondriacs. In panic situations, hypochondria tends to increase (in the US a high percentage of people seem to be viewing testing as a panacea), and KCDC's specific guidelines to qualify for testing may be a blunt method to reduce the number of such people showing up and demanding to be tested. A fourth possibility could be random public testing to detect the incidence of asymptomatic carriers, but for several reasons I doubt this one and a combination of the other three possibilities is sufficient to explain the huge numbers of negative tests.

up
3 users have voted.

@Alligator Ed
The tragedy in New York shows what this virus can do if we do not keep it restrained.

Regarding the data on deaths provided below:

Confirmed deaths: People who had a positive COVID-19 laboratory test.
Probable deaths: People who did not have a positive COVID-19 laboratory test, but their death certificate lists as the cause of death "COVID-19" or an equivalent.

Cases: 122,148
Hospitalized*: 32,843
Confirmed deaths: 7,890
Probable deaths: 4,309
Updated: April 17, 2:30 p.m.

https://www1.nyc.gov/site/doh/covid/covid-19-data.page?ftag=YHF4eb9d17

The deaths below are from a CDC report for an entire year. The deaths in New York have almost all occurred in the last 36 days.

NY Leading Causes of Death, 2017
Deaths
1. Heart Disease 44,092
2. Cancer 34,956
3. Accidents 7,687
4. Chronic Lower Respiratory Diseases 7,258
5. Stroke 6,264
6. Flu/Pneumonia 4,517
7. Diabetes 4,176
8. Alzheimer’s disease 3,521
9. Hypertension 2,699
10. Septicemia ` 2,296

https://www.cdc.gov/nchs/pressroom/states/newyork/newyork.htm
(I just kept the column with the deaths and removed columns with other data to avoid clutter.)

In a time period comparable to the 7,800 Covid-19 deaths New Yorkers would experience about 4,400 deaths from heart disease and about 700 deaths from chronic lower respiratory disease. About 450 deaths would be expected from flu/pneumonia.

up
3 users have voted.

@ScienceTeacher
there's a graph that makes the truth of the current situation very clear.

https://www.nytimes.com/interactive/2020/04/10/upshot/coronavirus-deaths...

up
4 users have voted.

The earth is a multibillion-year-old sphere.
The Nazis killed millions of Jews.
On 9/11/01 a Boeing 757 (AA77) flew into the Pentagon.
AGCC is happening.
If you cannot accept these facts, I cannot fake an interest in any of your opinions.

@UntimelyRippd
But the real goal is to help others see what we are worrying about. The more ways we explain the situation the better. Thanks for all help with this.

up
1 user has voted.
Alligator Ed's picture

@ScienceTeacher

Probable deaths: People who did not have a positive COVID-19 laboratory test, but their death certificate lists as the cause of death "COVID-19" or an equivalent.

Under current CDC "guidelines", it is permissible to classify deaths as SARS2-related merely based upon suspicion. Suspicion without test confirmation. The point of my lengthy comment is that there are so many ways in which to attribute deaths to SARS2, simply by reassigning those deaths to SARS2 from other disease entities WITHOUT PROOF. Let's talk about excess deaths, for a moment. Are there other societal factors which might contribute to increased deaths? Consider for instance, malnutrition induced by social isolation preventing food shopping. How about increased rate of alcoholism-related deaths due to economic recession? What about drug overdoses committed for various reasons, especially from pandemic induced desperation and hopelessness.

A clearly political impetus has been given to increasing the SARS2 death toll arbitrarily, i.e., without proof. Governor Cuomo has messed up this health situation immensely, but has been outdone in his politically-motivated stupidity by Bill "Party hearty" Di Blasio. Color me unconvinced.

Until political machinations are divorced from health statistics, I am skeptical of all plandemic claims. Yes, plandemic--a politically motivated fear campaign superimposed on a foreseeable health event. 2018 mentions of upcoming viral outbreaks. Event 201 mere weeks before the "outbreak". People saw this coming. It is still unknown whether the "event" was man-made from the get-go. It doesn't matter if the manufactured virus, if it was such, originated in Fort Detrick or in Wuhan's Virology Institute.

up
2 users have voted.

@Alligator Ed
One of the values used to determine how fast and epidemic spreads is Ro, which is how many other people get the pathogen from each infected person. Early studies of Covid-19 showed values of Ro from 1.4 to 7.23. This means that each infected person might give the virus to 1.4 other people on the average or maybe as many as an average of 7.23 people. (Liu et.al. JournalofTravelMedicine, 2020, 1–4) Values of Ro between 2 and 4 were most commonly cited for pre-shutdown conditions.

My simple model assumes a very conservative value for Ro of 2. That means that each infected person passes the virus on to two other people.

600,000 x 2 = 1,200,000

That is how many people have probably already caught the virus from people who currently have symptoms. Most people develop symptoms in 5-7 days after exposure. Presymptomatic people shed viruses for several days before they become ill.

People who are presymptomatic and are never diagnosed due to testing shortages and people who remain asymptomatic and never have any symptoms can still spread the virus and cause serious disease in others. If there are large numbers of these people in the population that are not counted in the 600,000 they can spread the virus to people who will then become seriously ill.

up
3 users have voted.
Alligator Ed's picture

@ScienceTeacher IF, and that's a big IF, we exclude known high risk populations the mortality rate will be far, far lower than the dreaded "10%" number as seen in early Italian studies. So, consider the following: when people age >65 + 1 comorbidity AND people

up
0 users have voted.
Lookout's picture

exist in the population (ie an antibody test) all those stats are moot except for death numbers. (many of which are in nursing homes)

I've seen anywhere from 50% to 80% of people who have had COVID don't have symptoms.

There's no doubt that the stay at home policy has slowed the spread (and helped collapsed the economy).

Sweden vs Denmark is a good comparison of the effectiveness of stay at home policy.
https://www.euronews.com/2020/04/12/is-sweden-s-covid-19-strategy-working

up
12 users have voted.

“Until justice rolls down like water and righteousness like a mighty stream.”

@Lookout
The weak effort in Sweden to lock down last month appears to be having consequences. According to the Guardian on April 5:

Sweden’s government is drawing up new legislation to allow it to take “extraordinary steps” to combat Covid-19, local media have reported, amid concern that its relatively soft approach may be leading to a higher death rate than in other Nordic countries.

Denmark and Norway are among the many countries to have imposed tough lockdowns, closing borders and shutting schools and non-essential stores, and Finland has isolated its main urban area around Helsinki. But Swedes are still able to shop, go to restaurants, get haircuts and send children under 16 to class.

On Sunday Sweden reported a total of 401 deaths so far from Covid-19, up 8% from Saturday and greater than the totals of its three Nordic neighbours combined. Sweden’s toll per million inhabitants is 37, compared with 28 in Denmark, 12 in Norway and 4.5 in Finland.

https://www.theguardian.com/world/2020/apr/05/sweden-prepares-to-tighten...

Mortality rates from Johns Hopkins on April 14 are:

Sweden 13 deaths per 100,000 people

Denmark 5.5 deaths per 100,000 people

Norway has 2.86 deaths per 100,000 people

Finand 1.4 deaths per 100,000 people

https://coronavirus.jhu.edu/data/mortality

up
10 users have voted.
Lookout's picture

@ScienceTeacher

The Denmark - Sweden comparison is valid because of similar cultures and population proximity factors. Shows staying home is an effective way to slow the progression.

The comparison will be interesting to follow.

up
12 users have voted.

“Until justice rolls down like water and righteousness like a mighty stream.”

@Lookout
I think there are a lot of people unknowingly spreading the virus even though they feel fine. My guess (which is really just a guess) is the the fatality rate is actually about 1%.

The official numbers say that about 20% of the people infected will become seriously ill. My model (such as it is) only assumes that 10% of the infected people will become seriously ill.

Until testing is widely available . . .

This appallingly unnecessary mess is so frustrating.

up
10 users have voted.
ggersh's picture

@ScienceTeacher https://www.zerohedge.com/health/navy-reports-alarming-stealth-transmiss...

Navy Reports Alarming 'Stealth Transmission' Rate: 60% Of Infected Carrier Crew Symptom-Free

Nearly 100% coronavirus testing aboard Theodore Roosevelt finds rapid stealth spread among young, healthy sailors.

249

All of this stuff is way above my paygrade

up
10 users have voted.

I never knew that the term "Never Again" only pertained to
those born Jewish

"Antisemite used to be someone who didn't like Jews
now it's someone who Jews don't like"

Heard from Margaret Kimberley

@ggersh
The Diamond Princess cruise ship provided a small amount of similar data, but the passengers were mostly older. The really big question is the spread among asymptomatic or presymptomatic young people.

There are a lot of fancy equations for modeling epidemics, but they are useless if there are not good numbers. You may well have hit the nail on the head about the petri dish thing.

up
4 users have voted.

@ScienceTeacher
Anyway, what we don't yet know is how many of them will develop symptoms.

up
5 users have voted.

The earth is a multibillion-year-old sphere.
The Nazis killed millions of Jews.
On 9/11/01 a Boeing 757 (AA77) flew into the Pentagon.
AGCC is happening.
If you cannot accept these facts, I cannot fake an interest in any of your opinions.

Alligator Ed's picture

@ScienceTeacher Contrary to your assertions, the number of passengers and crew on DP was 3700. Despite a presumably elderly population, only 6 people out of 646 proven infecteds died. I have written extensively about this 6 weeks ago.

up
1 user has voted.

@Lookout
As the media says. We destroyed the economy so that hospitals would not be overcrowded. That's all. Eventually, everyone will be infected and survive or not.
I'm guessing more people will die of malnutrition, exposure, and domestic violence than from COVID-19 as a result of destroying the economy.

up
2 users have voted.

I've seen lots of changes. What doesn't change is people. Same old hairless apes.

@The Voice In the Wilderness
The current situation is really depressing, but we can fight against this epidemic. There are a whole range of clinical trials for antiviral drugs and supportive drugs. There is a much better understanding of the issues about ventilator use.

Patients on ventilators are much more likely to survive and will have a much better recovery if they receive labor-intensive care during their illness. People in overcrowded, strained intensive care units are less likely to survive.
Hua et.al. Intensive Care Medicine volume 42, pages987–994(2016)

Working out the details of life-saving treatments will take a little time. Learning how to decrease the levels of disability in people who recover will take some time. Slowing this thing down can make a big difference.

Adequate levels of testing could allow a lot people to go back to work even before we get the vaccine. Testing and tracing contacts will only work if there is a low level of infection.

The economy is already a mess thanks to governmental incompetence. The sloppy, half-baked shutdown is not nearly as effective in slowing the epidemic as a coordinated shutdown would have been. The $1200 is not even a bad joke. It would be nice if everyone could have insurance, especially right now. Just lifting the shutdown without doing it in an orderly way will not fix the economy. It will unnecessarily kill a lot of people. It will also increase the risk of a mutation in the virus that can attack children and young people.

up
6 users have voted.

@ScienceTeacher
that we don't need. Our unemployed grandson and others like him are getting NOTHING. Not even food stamps. Apparently there's a floor as well as a ceiling on income for food stamp availability. Too bad you don't stop needing food when your income is zero.

up
7 users have voted.

I've seen lots of changes. What doesn't change is people. Same old hairless apes.

enhydra lutris's picture

@ScienceTeacher
and numerous other factors, but:
30. California

• COVID-19 confirmed cases as of 4/13/2020: 61.5 per 100,000 people (total: 24,334)

• Rank on April 7: 28

COVID-19 related deaths as of 4/13/2020: 1.8 per 100,000 people – 23rd lowest (total: 725)

• Total tests completed as of 4/13/2020: 4.8 per 1,000 people – 4th lowest (total: 190,334)

• Positive test rate as of 4/13/2020: 11.5% – 19th highest

• Date of first case: January 25, 2020

• Population density: 241.7 per sq. mi. – 11th highest

• Total population: 39,557,045

up
4 users have voted.

That, in its essence, is fascism--ownership of government by an individual, by a group, or by any other controlling private power. -- Franklin D. Roosevelt --

[video:https://m.youtube.com/watch?v=F39kVKSCP40]

Most of the data and relevant statistics are covered in the first five minutes of the video. I consider Dr. John Carpenter’s coverage of the pandemic to be even handed and well informed. YMMV.

up
8 users have voted.

Capitalism is the extraordinary belief that the nastiest of men for the nastiest of motives will somehow work for the benefit of all."
- John Maynard Keynes

@ovals49
He says that 86% of the people who have Covid-19 listed on their death certificate only died that month because they got Covid-19. The risk factors include diabetes and high blood pressure. I have know people who lived productive lives for many years with these and many of the other risk factors.

Only 14% just happened to have Covid-19 at the time when they died of something else. This sounds reasonable.

One article I read said that about 10% of the people with Covid-19 actually died from a secondary infection after they went into respiratory failure from the Covid-19. Since they would not have been likely to get the secondary infection if they had not suffered from respiratory failure what is the cause of death?

The real question is the number of excess deaths which is addressed quite well at the beginning of this video.

up
12 users have voted.

@ScienceTeacher
mortality in New York City is running at just about exactly twice the norm.

if that happened nationwide for just 2 months, there'd be 500K excess deaths.

but would it happen, nationwide, for 2 months, if we lift the stay-at-home orders? nobody can say. nobody knows.

up
10 users have voted.

The earth is a multibillion-year-old sphere.
The Nazis killed millions of Jews.
On 9/11/01 a Boeing 757 (AA77) flew into the Pentagon.
AGCC is happening.
If you cannot accept these facts, I cannot fake an interest in any of your opinions.

That number is likely to look worse if private-equity run hospitals and suppliers of contract medical staff continue to close facilities/lay off medical workers during a pandemic because they aren't hitting their profit numbers.

https://labornotes.org/blogs/2020/04/over-100-hospitals-cut-staff-pandem...

up
12 users have voted.

@MichaelSF
This is a great article. This part is especially good:

Hospitals and states should not be competing for protective equipment, ventilators, and staff. Instead, the federal government should coordinate allocation and distribution across the country. That means ditching the market and embracing a public system with the leverage to set prices and ensure that resources are not hoarded but sent to where they are needed.

Spain and Ireland have both nationalized their health care systems during the crisis. Even New York State has combined all the state’s hospitals into one large system under the New York Department of Health, in the hope of limiting market competition for workers and equipment and instead coordinating based on need.

Of course, we should also ensure that patients and hospitals don't go bankrupt by expanding Medicare to cover everyone in the next stimulus package.

up
4 users have voted.

@ScienceTeacher
"free enterprise" is in fact an inferior way of getting things done.

When we needed to fight fascism -- A system of merging industry with government to decide for the people what they wanted, and what they would get -- the US turned to ... Fascism. The Federal government dictated prices and wages; dictated what would be produced, who would produce it, how much they'd produce, and how much they'd get paid. And it worked.

I've said it before and I'll say it again. The correct answer to the question, "Who won WWII," is, "the Fascists". (Though of course, proper credit must be also given to the pseudo-socialist totalitarians of the the Soviet Union.)

up
8 users have voted.

The earth is a multibillion-year-old sphere.
The Nazis killed millions of Jews.
On 9/11/01 a Boeing 757 (AA77) flew into the Pentagon.
AGCC is happening.
If you cannot accept these facts, I cannot fake an interest in any of your opinions.

@UntimelyRippd
With state governments arbitrarily deciding what is necessary, and tilting the scales toward big retailers and banks.

up
4 users have voted.

I've seen lots of changes. What doesn't change is people. Same old hairless apes.

5/21____32 million____________3,200,000___________________5,600,000

5/28____64 million____________6,400,000___________________11,200,000

6/4_____128 million___________12,800,000__________________22,400,000

6/11 Start getting closer to herd immunity. Maybe.

Why stop there?

up
1 user has voted.
snoopydawg's picture

@gjohnsit

https://www.rt.com/news/485718-experts-warned-pandemic-years/

That a global pandemic was inevitable was known for decades, but as recently during Obama's tenure. After the h2n1 epidemic his administration did not restock the supplies needed for the next one. This is why I don't think it's only Trump's fault that we're seeing such a horrible response to this one. There is definitely enough blame for many others.

up
6 users have voted.

Which AIPAC/MIC/pharma/bank bought politician are you going to vote for? Don’t be surprised when nothing changes.

At the peak of our exponential phase I calculated that new infections were increasing ten fold every 14 days, two weeks. That's 100x in 4 weeks, 1000x in 6 weeks and 10,000x in 8 weeks.

Our current reported rate of infection is linear +or- at 30,000 new infections per day(edited). In the next year we will infect 10,950,000 people. If we back off from self isolation that number will be an order of magnitude higher in a much faster timeframe.

I suspect that people have the wrong idea of our progress relative to China. We aren't even close. China was able to stop the growth of infection rate and reverse it until today they have 116 active cases vs. our 592,674. You really need to understand the difference.

They are opening up just recently. Everyone wears masks, but their new infection rate is climbing, as are all of the other Asian countries who have been successful at reducing the new infection rate, but are trying to open up. Will it climb up on the exponential curve again? I think so.

So here's my conclusion - we are nowhere ready to open up. When the number of active infections reaches near zero we might want to try it. It looks probable that it is a roller coaster, opening up gets us back up on the exponential curve. That has an associated mortality, so whoever decides that is going to kill people. If the goal is herd immunity you are not going to get there, too many people. Right now we are at 0.19% of the US population.

So many are debating the practical and existential issue of killing people. Just what is the current CFR, case fatality rate? Good question. We don't know. Seems like a simple problem just do the math. So here goes: We have had 35,578 people die in the US. We have had 58,179 totally recover. The death rate is then the dead divided by those with a known outcome = 38%. This number is too high because we are not testing enough and really don't know who has been infected and recovered. Nonetheless, it's a big number and as we test more and hold the new cases to 30,000 per day over time it will get more accurate.

When we do have a significant percentage of the population with antibodies, will the virus simply mutate to a new strain? Probably. The key is to keep the total number of active cases to a minimum. If you have a huge body of infected people and a huge body of immune people then the virus will have ideal conditions to generate a new resistant strain. You will have a high emissions rate into new resistant subjects. Most will be immune, but it only takes one mutated virus for natural selection to take over. Pandemics have been known to have second and third waves.

We need two things, very low total active infections and a vaccine. To get there we need to emulate China with an extreme anti contagion methodology. We will know that we are there when the total number of active infections is very low.

If we survive this pandemic, we need to take a serious look at the relationship between wild viruses and the human population.

up
4 users have voted.

Capitalism has always been the rule of the people by the oligarchs. You only have two choices, eliminate them or restrict their power.

@The Wizard
Which always slows. So if we all sing "God Bless America". It will slow.
No matter what the media says, we would not be saved because of the singing, but because it had to slow anyway from mathematics. Exponential would be rocketing beyond 100% (like inflation) whereas hyperbolic tangent never quite reaches 100%.

up
2 users have voted.

I've seen lots of changes. What doesn't change is people. Same old hairless apes.

@The Voice In the Wilderness
remains small in proportion to the total population. early on "geometric" seems to be the best description -- and you can always find people to argue whether geometric growth is or is not exponential. (It's all about perspective.)

up
5 users have voted.

The earth is a multibillion-year-old sphere.
The Nazis killed millions of Jews.
On 9/11/01 a Boeing 757 (AA77) flew into the Pentagon.
AGCC is happening.
If you cannot accept these facts, I cannot fake an interest in any of your opinions.

Alligator Ed's picture

@The Wizard

We have had 58,179 totally recover. The death rate is then the dead divided by those with a known outcome = 38%. This number is too high because we are not testing enough and really don't know who has been infected and recovered. Nonetheless, it's a big number and as we test more and hold the new cases to 30,000 per day over time it will get more accurate.

The quoted figure is bogus. The answer is obvious. We still do not have an accurate case fatality rate (CFR). Two errors obviate the current figures:

1. The numerator: the total number of decedents is unknown for two opposing reasons.
A. the number is underestimated because of no proven cause of death. We can't even distinguish the figures of those who died with COVID-19 (SARS2) and those who died with it. Although I haven't located any documentation as to what number of deaths, mainly non-hospital, showed positive viral tests or even positive antibody tests, some health department jurisdictions encourage ALL unexplained deaths to be registered as SARS2-related, as I indicated in the first comment in this thread. Other jurisdictions may have more stringent reporting requirements.

2. The denominator: as we are well-aware, the testing, even though much more rapid in the past week (week--not weeks) with > 3 M tests done, the number of tests just 10 days ago in the entire US was on the order of 125,000. The less people are tested, the smaller the denominator in determining CFR. Until this past week, and only this past week, have tests been available in quantity so that minimally symptomatic patients are tested. In my county's health dept, until 1 week ago, tests were confined to only symptomatic cases and only if symptoms were accompanied by either known contact or fever > 100.4˚

Nonetheless, it's a big number and as we test more and hold the new cases to 30,000 per day over time it will get more accurate.

How was that figured derived? What is the rationale for such a high infection rate as being a necessary guidepost to re-open society? The percentage of population recovered from SARS2 to ensure herd immunity is unknown. This percentage can only crudely be extrapolated from other viral epidemics, particularly influenza, precisely because this is a new virus.

up
2 users have voted.

@The Wizard
At least the current strains of the virus seem to leave the kids alone. The SARS and MERS coronaviruses did not. I suspect that Chinese citizens cooperated with their lockdown not only because they are socialized to be community-oriented but also because they remember their fear of SARS. You are so right. Decreasing the number of people infected decreases the risk of mutations.

One nightmare is that someone in the Middle East might give this virus to their pet camel. If the camel had MERS and the two viruses recombined . . . .

up
4 users have voted.
boriscleto's picture

Sets me on edge...

Dr. WIlliam Hanage breaks it down well...

No matter how you crunch the numbers, this pandemic is only just getting started

He takes issue with the Centre for Evidence-Based Medicine in Oxford complaining about the lockdown...

An editorial in the British Medical Journal has reported data from China suggesting that as many as four in five cases of Sars-CoV-2 infection could be asymptomatic. It then goes on to quote people from the Centre for Evidence-Based Medicine in Oxford, who say that if this is true “What the hell are we locking down for?” I wish those people would be brave enough to go and repeat that opinion in an ER in the Bronx right now, in which actual medicine is going on. Worrying about the exact rate of asymptomatic infection, or the currently unknown duration of immunity and a possible “second wave”, is like politely applauding the performance in a jazz club and murmuring “nice” while the building is demolished around you and the piano player gets decapitated.

He goes on to say that, based on current data, the UK would have 600,000 deaths to get to herd immunity. Assuming the presence of anti-bodies grants immunity.

Finding a vaccine to offer a complete solution to this pandemic is, even in the best scenarios, still a long way off. But it is not hard to see many ways we can slow the pace of the pandemic and save lives. One of them is greatly improved testing to identify cases and their contacts, which could be supplemented by clever digital methods to spot who has been at risk.

Governments around the world are attempting ways to keep jobs and businesses afloat while lockdowns are in place – but the pressure remains to swiftly end such shutdowns. I get that this is going to be a mammoth strain on the economy. But the deaths of many thousands of people would be too: it is simply not possible to thoroughly insulate an economy from the impact of a pandemic of this kind.

Where I live, in Cambridge Massachusetts, I keep hearing sirens. This crisis is not close to over, quite the reverse. The pandemic is only just getting started.

• Dr William Hanage is a professor of the evolution and epidemiology of infectious disease at Harvard

up
9 users have voted.

" In the beginning, the universe was created. This has made a lot of people very angry, and is generally considered to have been a bad move. -- Douglas Adams, The Hitch Hiker's Guide to the Galaxy "