but, without an effective, persistent and globally administered vaccine much of what we currently think of as "normal" will need to change.
What, permanently? Not an option.
Not changing isn't an option either. "Normal" is something that, even in the absence of a pandemic, is in constant flux. We'll come out the other side of this pandemic different, the pandemic itself will have changed us. The question is, what of the old normal will be retained, what will we give up and what new things will we introduce.
Foremost in my mind are sports and socialising (which includes seeing family and going to church). If social distancing becomes a permanent part of our lives then I don’t see how either of those is going to be possible, and if either of those are allowed then I don’t see how social distancing is going to be possible.
How many people here are willing, however theoretically, to never see friends and family or be able to go to church again?
As far as I can tell, the worst case scenario would require some significant easing of social distancing because much of our society simply can't function within the current restrictions. Of course, that lifting would need to be accompanied by social distances where possible, maintaining a lot of hand washing, and a large scale programme of track and testing. We currently have a test that works, the worst case assumes we won't have a vaccine that works nor significant improvements in treatment; there will be some acquired immunity but with a much reduced infection rate that will be a small proportion of the population. And, we'll see a lot of people dead before their time. We would need to engage in a significant public conversation to bring everyone on board, to accept whatever the optimal compromise between social activity, social distancing, reduced profitability (or increased costs) for many businesses such as pubs, incursions on privacy (eg: through tracking apps on phones) etc. But, that needs a government that accepts public conversation (which the current UK government doesn't appear to, though the Scottish government is further down that road). I don't see how we can make changes in behaviour knowing that they will lead to more people dying without all of us having a say on how many more than the minimum we can manage is an acceptable number of dead people.
Anything that backs us off from that worst case scenario (eg: a partially effective vaccine or better treatments) moves the balance point and will allow a greater easing of restrictions.
And, we'll see a lot of people dead before their time.
Yes. But what price a life that cannot be lived? Is it better to have life in its fullness for a shorter time, or or life severely abridged and restricted for a longer time? Is avoiding any untimely deaths really the only thing that matters?
I don't see how we can make changes in behaviour knowing that they will lead to more people dying without all of us having a say on how many more than the minimum we can manage is an acceptable number of dead people.
A referendum on ending lockdown, perhaps?
We see numbers of dead people as an acceptable price to pay in return for all sorts of things, from motorised transport to fast food. I fail to see why it’s such an unacceptable price to pay in return for our whole lives.
I’m waiting for the invention of a washable thin silicon ‘bubble’ in which we can hug our loved ones, then pack it up carefully - pop it in a bag and wash the (potential) virus away in the washing machine.
And, we'll see a lot of people dead before their time.
Yes. But what price a life that cannot be lived? Is it better to have life in its fullness for a shorter time, or or life severely abridged and restricted for a longer time? Is avoiding any untimely deaths really the only thing that matters?
I don't see how we can make changes in behaviour knowing that they will lead to more people dying without all of us having a say on how many more than the minimum we can manage is an acceptable number of dead people.
A referendum on ending lockdown, perhaps?
We see numbers of dead people as an acceptable price to pay in return for all sorts of things, from motorised transport to fast food. I fail to see why it’s such an unacceptable price to pay in return for our whole lives.
And, we'll see a lot of people dead before their time.
Yes. But what price a life that cannot be lived? Is it better to have life in its fullness for a shorter time, or or life severely abridged and restricted for a longer time? Is avoiding any untimely deaths really the only thing that matters?
I don't see how we can make changes in behaviour knowing that they will lead to more people dying without all of us having a say on how many more than the minimum we can manage is an acceptable number of dead people.
A referendum on ending lockdown, perhaps?
We see numbers of dead people as an acceptable price to pay in return for all sorts of things, from motorised transport to fast food. I fail to see why it’s such an unacceptable price to pay in return for our whole lives.
How many dead people would you accept?
In a straight either/or situation between permanent lockdown and freedom? Millions.
I mean, globally 1.35 million people die in road accidents in an average year, and that’s just the price we pay for the freedom to drive. Our whole lives are at least an order of magnitude more important than the mere freedom to drive a car, which compels me to state that a global figure of 10 million deaths wouldn’t be unreasonable if the only other alternative was permanent lockdown/social distancing. For the record, we’re currently at about 0.25 million.
I would not call that number of deaths a good thing by any means. But I would call it the lesser evil.
Ten million deaths. I think Spanish flu is a worry and warning, as it came in waves, although I don't know much about any restrictions in place, although some social distancing occurred.
And, we'll see a lot of people dead before their time.
Yes. But what price a life that cannot be lived? Is it better to have life in its fullness for a shorter time, or or life severely abridged and restricted for a longer time? Is avoiding any untimely deaths really the only thing that matters?
I don't see how we can make changes in behaviour knowing that they will lead to more people dying without all of us having a say on how many more than the minimum we can manage is an acceptable number of dead people.
A referendum on ending lockdown, perhaps?
We see numbers of dead people as an acceptable price to pay in return for all sorts of things, from motorised transport to fast food. I fail to see why it’s such an unacceptable price to pay in return for our whole lives.
How many dead people would you accept?
In a straight either/or situation between permanent lockdown and freedom? Millions.
I mean, globally 1.35 million people die in road accidents in an average year, and that’s just the price we pay for the freedom to drive. Our whole lives are at least an order of magnitude more important than the mere freedom to drive a car, which compels me to state that a global figure of 10 million deaths wouldn’t be unreasonable if the only other alternative was permanent lockdown/social distancing. For the record, we’re currently at about 0.25 million.
I would not call that number of deaths a good thing by any means. But I would call it the lesser evil.
I think that would mean about 100 000 deaths in UK. I don't know if people find that OK, I suppose it would be spread over years. Of course, a big issue is, how do you stop it at 100 000?
And, we'll see a lot of people dead before their time.
Yes. But what price a life that cannot be lived? Is it better to have life in its fullness for a shorter time, or or life severely abridged and restricted for a longer time? Is avoiding any untimely deaths really the only thing that matters?
I don't see how we can make changes in behaviour knowing that they will lead to more people dying without all of us having a say on how many more than the minimum we can manage is an acceptable number of dead people.
A referendum on ending lockdown, perhaps?
We see numbers of dead people as an acceptable price to pay in return for all sorts of things, from motorised transport to fast food. I fail to see why it’s such an unacceptable price to pay in return for our whole lives.
How many dead people would you accept?
In a straight either/or situation between permanent lockdown and freedom? Millions.
I mean, globally 1.35 million people die in road accidents in an average year, and that’s just the price we pay for the freedom to drive. Our whole lives are at least an order of magnitude more important than the mere freedom to drive a car, which compels me to state that a global figure of 10 million deaths wouldn’t be unreasonable if the only other alternative was permanent lockdown/social distancing. For the record, we’re currently at about 0.25 million.
I would not call that number of deaths a good thing by any means. But I would call it the lesser evil.
I think that would mean about 100 000 deaths in UK. I don't know if people find that OK, I suppose it would be spread over years. Of course, a big issue is, how do you stop it at 100 000?
You don't. If we lift the lockdown we're looking at half a million to a million deaths in the UK. If we were all equally vulnerable we could perhaps make a collective decision to accept the risk, but really what is being suggested is condemning a large proportion of the elderly and disabled and leaving the young and healthy largely unscathed.
I notice that Vietnam is reporting 250 cases, and no deaths. This seems mind-blowing in the West, but they seem to be saying that they took action very early, and initiated aggressive testing and tracing, and quarantine. For example, your travel history can be published online, so others can cross-check. I suppose also as a communist country, the state can intrude much more.
If we were all equally vulnerable we could perhaps make a collective decision to accept the risk, but really what is being suggested is condemning a large proportion of the elderly and disabled and leaving the young and healthy largely unscathed.
Do you think it would be better to permanently destroy everybody’s lives?
If you said half a million to a million deaths in the U.K. then current statistics suggest deaths possibly as follows: 200-400 children and teenagers, 23,000-45,000 adults under 45, 116,00-241,000 adults between 45 and 65, and 239,000-477,000 adults over 65. That’s without factoring in deaths from other causes e.g. those which would normally be preventable if the health service were not overwhelmed.
I don't see how we can make changes in behaviour knowing that they will lead to more people dying without all of us having a say on how many more than the minimum we can manage is an acceptable number of dead people.
A referendum on ending lockdown, perhaps?
A referendum would be a problem - because it's going to be very difficult to organise that while maintaining social distancing; we'd need to have a system of postal votes that actually works.
But, I was thinking more of the sort of public consultation exercise that's routine in Scottish politics (even if action on those consultations may be less than perfect - I'm looking at you local authority who conducted a consultation on a new road and then waved it through on the nod of the chief exec because they couldn't convene a council meeting due to social distancing requirements). Let the government draw up a document outlining the different options, the likely impacts of those on both society and the progression of infection and ask people to grade the options and state why they consider such and such to be more important than the impact on control of the virus. Couple that with things like TV news interviewing ministers and passing viewers questions to them, special Question Time, etc. The Parliamentary select committees calling people to testify may need to identify ways of doing their work as part of that process. I don't know how common these things are in England.
If you said half a million to a million deaths in the U.K. then current statistics suggest deaths possibly as follows: 200-400 children and teenagers, 23,000-45,000 adults under 45, 116,00-241,000 adults between 45 and 65, and 239,000-477,000 adults over 65. That’s without factoring in deaths from other causes e.g. those which would normally be preventable if the health service were not overwhelmed.
It would also mean 50-100 million world wide, although locally this would vary a lot. Up to 5 million in US? I would think these figures could have huge effects politically.
I suspect the math is way beyond most people's understanding.
Which is not to say that the math is complicated - it really isn't. But most people do not use math to think about the world, and are not prepared to do so.
Case in point - an acquaintance is all over Mrs C's facebook talking about how the number of deaths from Covid are "much less than we were led to believe" and so we should get back to normal. She completely fails to grasp the concept that deaths are as low as they are because of the lockdown, and is aggressively unwilling to believe that the excess deaths that match the Covid timescale but aren't tagged as Covid might just have something to do with it.
I don't know how this is anything other than deliberate blindness.
but, without an effective, persistent and globally administered vaccine much of what we currently think of as "normal" will need to change.
What, permanently? Not an option.
Not changing isn't an option either. "Normal" is something that, even in the absence of a pandemic, is in constant flux. We'll come out the other side of this pandemic different, the pandemic itself will have changed us. The question is, what of the old normal will be retained, what will we give up and what new things will we introduce.
Foremost in my mind are sports and socialising (which includes seeing family and going to church). If social distancing becomes a permanent part of our lives then I don’t see how either of those is going to be possible, and if either of those are allowed then I don’t see how social distancing is going to be possible.
How many people here are willing, however theoretically, to never see friends and family or be able to go to church again?
I was going to make a quip about our great grandchildren living a solitary, socially isolated life as if that’s just what people do. But of course if social distancing becomes permanent then none of us will ever have great grandchildren, because how the hell are people who aren’t already in relationships going to meet prospective partners if they’re not allowed to socialise with people they don’t know?
Dude, you really needn't worry. It would take more than coronavirus to permanently stop people socializing, dating, marrying, reproducing... The Black Death couldn't do it, Ebola couldn't do it, I don't think you have to worry about this horrible dystopia you've got in your head.
We will go out again eventually. We will socialize again at less than 6 feet distance eventually. And etc. etc. etc. It's not in human nature to avoid this permanently. How many people do you know, introverts notwithstanding, who chose to live without any live human contact prior to the pandemic? Even the hikikomori have parents.
So it's not "will we get together again." We will. The question is, how are we going to get to that happy state. And since there are several alternative roads (some involving a helluva lot more death and destruction than others), we need to think carefully at this point instead of freaking out, like the weirdos storming the state buildings on the news.
@Marvin the Martian I don't think a referendum would produce a result you'd like. Most opinion polls I've seen suggest the majority of people are in favour of lockdown if it saves lives.
My source of information on Virginia is https://www.vdh.virginia.gov/coronavirus, combined with newspaper articles. The counties in northern Virginia which are hotspots are suburbs of Washington, DC, which has serious problems. I have seen reports of the COVID sweeping through nursing homes in Henrico and Chesterfield counties, which are also hotspots. I suspect that the city of Harrisonburg, which has a much higher rate than the surrounding county, also has a nursing home problem.
Montgomery county, where I live has 56 cases, seven hospitalizations, and 1 death. Unfortunately, in the past week there have been two new cases with one hospitalization. The county population is 98,000.
I don't think we have a serious problem.
Given deficiencies in testing I'm not sure you can be confident about the lack of problems locally. Using the CDC's website, the threshold for excess deaths for Virginia for the week ending April 18 (the last week for which complete data seems to be available) was 1,444. Virginia recorded 2,907 deaths that week, meaning there were 1,463 excess deaths in Virginia that week. (In other words the number of people who died in Virginia that week is about double what could be expected at the maximum range of random fluctuations for that time period.) 279 of those 1,463 were attributed to COVID-19. I'd be unwilling to bet that all, or even most, of the remaining 1,184 people who make up Virginia's excess deaths during that week had nothing to do with the current pandemic. In other words, the data indicates ~80% of COVID-19 deaths in Virginia aren't being counted as such.
I mean, globally 1.35 million people die in road accidents in an average year, and that’s just the price we pay for the freedom to drive. Our whole lives are at least an order of magnitude more important than the mere freedom to drive a car, which compels me to state that a global figure of 10 million deaths wouldn’t be unreasonable if the only other alternative was permanent lockdown/social distancing. For the record, we’re currently at about 0.25 million.
I would not call that number of deaths a good thing by any means. But I would call it the lesser evil.
You sound like an American automotive executive, claiming that vehicular deaths are some force of nature rather than something we can actually do something about with traffic laws and engineering. Their argument against literally every safety improvement (engineered crumple zones, air bags, seat belts, tempered glass windows, etc.) has been that it would price automobiles out the range of many people, depriving them of their freedom to drive. Somehow people still drive even with these supposedly unnecessary and unaffordable safety features, and it shows in traffic death statistics. Pay particular attention to the red line, deaths per billion VMT (vehicle-miles traveled). It shows that the cars we're driving now are a lot safer than the ones we drove in the 50s and 60s, to say nothing of the ones from the 20s and 30s.
Which is a roundabout way of calling shenanigans on claims that engineering away human deaths, whether by mechanical or social engineering, is a futile endeavor. It works.
- an acquaintance is all over Mrs C's facebook talking about how the number of deaths from Covid are "much less than we were led to believe" and so we should get back to normal. She completely fails to grasp the concept that deaths are as low as they are because of the lockdown, and is aggressively unwilling to believe that the excess deaths that match the Covid timescale but aren't tagged as Covid might just have something to do with it.
I don't know how this is anything other than deliberate blindness.
Just lethally illogical. No idea whether it's deliberate or just obtuse. Some people don't really get the logic associated with interpretation of numbers.
I suspect the math is way beyond most people's understanding.
Which is not to say that the math is complicated - it really isn't. But most people do not use math to think about the world, and are not prepared to do so.
Case in point - an acquaintance is all over Mrs C's facebook talking about how the number of deaths from Covid are "much less than we were led to believe" and so we should get back to normal. She completely fails to grasp the concept that deaths are as low as they are because of the lockdown, and is aggressively unwilling to believe that the excess deaths that match the Covid timescale but aren't tagged as Covid might just have something to do with it.
I don't know how this is anything other than deliberate blindness.
Yes, it's amazing how common this is. So many people saying, well, the deaths aren't that bad, as if all of us living in the coal hole has nothng to do with it. I don't know whether it's about maths or logic or denial. Probably the latter.
In the UK, people keep criticizing Imperial College for an inflated estimate. Yes, without a lockdown, FFS.
If we were all equally vulnerable we could perhaps make a collective decision to accept the risk, but really what is being suggested is condemning a large proportion of the elderly and disabled and leaving the young and healthy largely unscathed.
I think it's even worse than this.
Covid-19 has been around for what, 6 months tops? So we don't know what its long-term effects might be on the younger people who are infected. Most people survive chicken pox (caused by a virus) with no problems, but then are at risk for shingles. We don't know what this virus is capable of. There could be some nasty shit that pops up years later for these apparently unscathed people.
Moreover, the divide between who is potentially condemned isn't just along old-disabled/young-healthy lines. The risk would be disproportionately be borne by marginalized people: old people, poor people, black and brown people, disabled people, homeless people.
In short, the same people who are most likely to be shut out of decision-making in our societies. So they wouldn't even have a voice in this.
The suggestion that we should go back to living our normal lives is grotesquely inhumane.
1.) AFZ's discussion on mortality rate does not seem to take into account those who are out there who have had COVID but were asymptomatic. And because they are asymptomatic they did not get tested and are not included in the figures. Problem is, we just do not know how many people there are in that category.
2.) I have been noticing a gradual uptick in our state's total new cases over the past two weeks, which is, frankly, discouraging. Apparently, most of those new cases are coming from Yakima county which is in south-central Washington State. 75% of Yakima's is considered essential because of the agri-business complex there. Sounds like the State Department of Health is moving more resources into the area to help reduce their rate of infection.
I just want to get this over with, but we still might have two more years of this.
If Covid19 did the same as Spanish Flu, which seemed to preferentially kill younger, fitter, potentially whiter adults, we'd not be hearing the same noises about lifting the lockdown.
But then again, maybe not. Many of those protesting at the severity of the lockdown look like they're still in the higher risk groups.
1.) AFZ's discussion on mortality rate does not seem to take into account those who are out there who have had COVID but were asymptomatic. And because they are asymptomatic they did not get tested and are not included in the figures. Problem is, we just do not know how many people there are in that category.
To the best of my knowledge there's no indication that COVID-19 can kill people without developing symptoms (besides death). As such, you wouldn't expect asymptomatic individuals to show up in excess mortality statistics.
1.) AFZ's discussion on mortality rate does not seem to take into account those who are out there who have had COVID but were asymptomatic. And because they are asymptomatic they did not get tested and are not included in the figures. Problem is, we just do not know how many people there are in that category.
It depends whether you're asking about infection rates or mortality. @Crœsos is spot on, there's no record of people dying without first developing symptoms. If you want to know how many people in the population have the virus, then testing (ideally everyone but at least a representative sample) is the only way.
But if your question is how many is it killing then the excess mortality will answer that question with the greatest precision; for three reasons:
1. It will capture those that die from Covid-19 who were never tested.
2. Some of the people who die having tested postive, actually die from something else. (For example, there is data suggesting that people dying from heart attacks are incorrectly recorded as Covid deaths). The excess mortality figure 'automatically' discounts this.
3. The pseudo-unrelated deaths. People who die from something else but they would have survived but for the knock-on effects of a pandemic on society and healthcare systems.
For individuals it is not always possible to know but on the society level an accurate number is acheivable. For example, if you take 100 people who suffer heart attacks, something like 25 of them will die within 30 days. Let's say that in April 2020, 30 died instead of the expected 25. So the excess mortality is 5 in this simplistic example. If you want to talk about those 30 individuals, it's impossible to know which 5 of them would have survived and which 25 would have died anyway but on the population level we can be confident that 5 more people died than would otherwise have done. The most you can say about the individual is that their risk was changed. In absolute terms the risk went from 25% chance of dying to 30% and hence it's a 5% increase absolute risk. In relative risk though it's more impressive 30/25 = 1.2 and hence it's a 20% increase in the relative risk of dying.
The excess mortality figure will capture everyone who dies from Covid-19 whether they're tested or not because in 2015-19, no one was dying from Covid-19*
AFZ
*The only caveat here is that there will be a slight distortion in this figure if less people are dying than 'normal' from other causes, such as road traffic accidents. It's only when the figures are properly analysed later that this can be worked out fully. However, it's probably a safe bet that the reduced mortality groups are more than outweighed by the excess indirect Covid deaths (i.e. people who didn't actually have Covid but died because of the effects of the outbreak). So, in the excess mortality figure, unless something really odd is happening** there won't be any Covid deaths missed. Which is why it's the most important data for understanding the epidemic's mortality.
**This is just for completeness, please ignore unless you're as much of a pedant as me but if there's some other, unknown, factor distorting the data then this would be a confounder. Such as, if there was another undetected virus in the population that was killing people at the same time.... Yeah, it's not likely and should be discounted from serious consideration unless such a confounder showed up somewhere else. It's not really possible for something like that to exist without it being evident somewhere.
IIUC [and partially posted expecting correction] there are three reasons why mortality rate/asymptomatic carriers are interesting.
Firstly it gives an upper bound (in the absence of reinfections)
Relatedly, secondly if the rate is very low/there are vast numbers of asymptompatic carriers: It could be the case that we're too late, everyone's already had it, why are you not back at work! Even a crude random sample would pick up if this was the case (and I think it's been established that we've had about 5% infection at most). But from certain interest groups, and general wish fulfillment it's an attractive idea. Similarly you have the "it's just flu" brigade, despite that dream being even more proven bullshit.
Thirdly, if the rate is high/there aren't any asymptomatic carriers, then it makes contact tracing a lot easier. Unfortunately the flip side is that it means we've made no progress immune system wise.
In practice I get the impression that it's somewhere in the middle. So all of that is mostly practically irrelevant.
Given deficiencies in testing I'm not sure you can be confident about the lack of problems locally. Using the CDC's website, the threshold for excess deaths for Virginia for the week ending April 18 (the last week for which complete data seems to be available) was 1,444. Virginia recorded 2,907 deaths that week, meaning there were 1,463 excess deaths in Virginia that week. (In other words the number of people who died in Virginia that week is about double what could be expected at the maximum range of random fluctuations for that time period.) 279 of those 1,463 were attributed to COVID-19. I'd be unwilling to bet that all, or even most, of the remaining 1,184 people who make up Virginia's excess deaths during that week had nothing to do with the current pandemic. In other words, the data indicates ~80% of COVID-19 deaths in Virginia aren't being counted as such.
I'm not denying the excess deaths; I'm just saying that most of them are likely to be in the hotspots, which are all more than a hundred fifty miles from me.
The DC suburbs, which are almost three hundred miles from me have a total of 7297 cases with 230 deaths. I think there are likely to be far more uncounted deaths there than in Montgomery county which has 56 cases with one death.
What bothers me about the hotspot issue, Moo, is that infections from hotspots can and do spread. Across county and State boundaries. The only real defence is wholesale testing and tracing. The more people away from the hotspots relax, let down their guard, the greater the chance of them picking up the virus if the twin defences of testing and tracing aren't working properly.
And the other problem is that delays in effective testing and tracing do provide opportunities for the creation of lots of new cases before any symptoms appear.
We're still finding out both how to quantify those risks and control them effectively. Dr Fauci is right. We have to test rapidly and trace contacts rapidly in order to contain.
The whole State by State thing bothers me for this reason. Viruses know nothing about administrative borders. I'm not sure there are safe zones. There are safety precautions. Like safe distancing and frequent handwashing.
What bothers me about the hotspot issue, Moo, is that infections from hotspots can and do spread. Across county and State boundaries.
<snip>
The whole State by State thing bothers me for this reason. Viruses know nothing about administrative borders.
I agree about the need to take precautions. I'm just saying that it is appropriate for me to worry much less than someone who lives near a hotspot. There are at least twenty counties between me and any hotspot. If the virus spreads from a hotspot, I assume it will do so gradually. I can't see it leapfrogging all those counties.
Have you looked at the map I linked to earlier? Virginia is a strange shape. I am much closer to West Virginia and Tennessee than I am to any hotspot in Virginia. It would be useful to see COVID maps of West Virginia and Tennessee
My source of information on Virginia is https://www.vdh.virginia.gov/coronavirus, combined with newspaper articles. The counties in northern Virginia which are hotspots are suburbs of Washington, DC, which has serious problems. I have seen reports of the COVID sweeping through nursing homes in Henrico and Chesterfield counties, which are also hotspots. I suspect that the city of Harrisonburg, which has a much higher rate than the surrounding county, also has a nursing home problem.
Montgomery county, where I live has 56 cases, seven hospitalizations, and 1 death. Unfortunately, in the past week there have been two new cases with one hospitalization. The county population is 98,000.
I don't think we have a serious problem.
Then, I submit you don't understand exponential growth.
Croesos wrote:
To the best of my knowledge there's no indication that COVID-19 can kill people without developing symptoms (besides death). As such, you wouldn't expect asymptomatic individuals to show up in excess mortality statistics.
That's got to be the case. The UK stats may however contain some anomalies. Not sure exactly how it works in the US but I think in the UK it's been possible for there to have been deaths recorded in death certificates as due to COVID-19 which were not recorded as cases of COVID-19 infection because the person was never tested in hospital. I think that possibility has now been eliminated in the statistics.
United Arab Emirates - 14,163 (11,274 / 2,763 / 126)
Poland - 13,693 (9,070 / 3,945 / 678)
Romania - 13,163 (7,504 / 4,869 / 790)
Ukraine - 11,913 (10,077 / 1,548 / 288)
Indonesia - 11,192 (8,471 / 1,876 / 845)
South Korea - 10,801 (1,332 / 9,217 / 252) 2.7%
The listings are in the format:
X. Country - [# of known cases] ([active] / [recovered] / [dead]) [%fatality rate]
Fatality rates are only listed for countries where the number of resolved cases (recovered + dead) exceeds the number of known active cases by a ratio of at least 2:1.
Italics indicate authoritarian countries whose official statistics are suspect. Other country's statistics are suspect if their testing regimes are substandard.
If American states were treated as individual countries twenty of them would be on that list. New York would be ranked at #2, between "everywhere in the U.S. except New York" (#1) and Spain (#3). New Jersey would be between Russia and Turkey.
No countries have joined the 10,000 case club since the last compilation.
secondly if the rate is very low/there are vast numbers of asymptompatic carriers: (...)
Thirdly, if the rate is high/there aren't any asymptomatic carriers, (...)
In practice I get the impression that it's somewhere in the middle.
My favourite hypothesis for some time has been that there are a relatively small number of 'super-spreaders'. I gave up looking at the details of this some time ago, but I find it difficult to understand, in the absence and impossibility of a total lockdown anywhere, why there are not more cases given all we hear about the potential for airborne infection, contamination from surfaces, etc., especially not more cases among medical personnel (i.e. more than the more there undoubtedly are).
There are at least twenty counties between me and any hotspot. If the virus spreads from a hotspot, I assume it will do so gradually. I can't see it leapfrogging all those counties.
But, if instead of thinking of "twenty counties" between you and a hotspot, but instead think of "three hours on the freeway" you can see how leapfrogging those counties becomes possible. All it takes is the wrong person taking that journey.
I'd heard that Native Americans on reservations are having a very hard time practicing corona hand-washing hygiene--a good many of them don't have running water. Irish folk are helping them out, for an interesting reason.
secondly if the rate is very low/there are vast numbers of asymptompatic carriers: (...)
Thirdly, if the rate is high/there aren't any asymptomatic carriers, (...)
In practice I get the impression that it's somewhere in the middle.
My favourite hypothesis for some time has been that there are a relatively small number of 'super-spreaders'. I gave up looking at the details of this some time ago, but I find it difficult to understand, in the absence and impossibility of a total lockdown anywhere, why there are not more cases given all we hear about the potential for airborne infection, contamination from surfaces, etc., especially not more cases among medical personnel (i.e. more than the more there undoubtedly are).
You may well be right about super-spreaders.
However, I wouldn't read too much in the airborne infection and contamination of surfaces. These transmission methods do appear to exist (that's what the data shows - i.e. that the virus can survive on surfaces for a long time and that is can survive in the air for a period of time) but how frequently this actually happens in the wild, as it were, is a different question all together. It's important to know that these methods of transmission (especially surfaces) exist but on the population level, they probably aren't particularly important. If they were, I think the epidemiological data would be different to what we're seeing.
The reason for this is due to two inter-related factors. Firstly the virus does not remain viable on a surface indefinitely and thus the longer the time between the infected person touching said surface and the next person touching it, the less likely that the next person will be infected. Secondly, infective dose appears to be critically important with Covid-19, both in terms of the likelihood of getting an infection in the first place and also the severity of illness.
The following is hypothetical numbers to illustrate a point:
Fred has SARS-CoV2. He sneezes whilst talking to Suzie. His sneeze contains 100,000 viral particles. Suzie was fairly close and inhales some of them such that 1000 viral particles reach her mucus membranes and she becomes infected. Suzie develops a relatively minor illness and recovers in 2 weeks.
Later in the day, Fred sneezes on a bus, leaving 10,000 viral particles on the metal seat handle.
The same day, Peter is on the bus and touches the same handle (which now has 8,000 viral particles on it, due to natural decay). 1,000 are transmitted to Peter's hand. Before washing his hands, Peter touches his face leaving 500 viral particles on his skin. 200 of which enter the mucus membranes. Peter becomes infected but remains asymptomatic.
Evie gets on the same bus later in the day, by now there are only 2,000 viral particles on the handle, 250 reach Evie's hand, 125 get on her face and less than 100 enter the mucus membranes. In such a small number, the virus is unable to cause an infection because the innate immune system destroys it before it can start replicating.
Meanwhile, Fred has got a lot more ill and is admitted to hospital. After a couple of days, he deteriorates and needs intubation (insertion of a breathing tube so he can be put on a ventilator). Olivia is an anaesthetist and Mark is an ODP. Olivia gives the anaesthetic and intubates Fred whilst Mark assists her. Unfortunately, neither Olivia nor Mark were provided with adequate PPE. It is well documented that intubation is a very high-risk procedure - aerosolizing millions of viral particles which are breathed in by both Olivia and Mark. 100,000 viral particles enter the airways of both Mark and Olivia who get seriously ill within a couple of days.
The point being that in the community, the biggest means of transmission is water-droplets. Surfaces are a risk, hence hand-washing becomes important. Aerosol is mostly an issue for healthcare workers. Controlling an epidemic is all about reducing the infection rate - at peak growth, each individual may be infecting 6 others. Hence the exponential growth. Get that number right down (by isolation, social distancing and hand-washing) and the epidemic dies away.
Key workers, however, need PPE because of the high risk of particular situations and procedures.
Do you think it would be better to permanently destroy everybody’s lives?
Social distancing will kill everyone? That's what permanently destroying lives usually means. I think you're losing perspective.
There's a difference between being alive and having a life. I've been saying since the start of this thread that merely preserving biological functions is not - and should not be - the only thing that matters.
Key workers, however, need PPE because of the high risk of particular situations and procedures.
Absolutely, and the people I see wandering round in the open air wearing what look like surgical masks drive me mad.
It seems to me though that it's pretty important to establish whether the scenario you quote is anywhere near accurate in terms of what sort of ending-lockdown measures should be implemented and which are an unncessesary over-reaction.
Unfortunately it looks as though singing in church is off either way, though.
(I'm also wondering when my dentist is going to be willing to see me again).
Key workers, however, need PPE because of the high risk of particular situations and procedures.
Absolutely, and the people I see wandering round in the open air wearing what look like surgical masks drive me mad.
It seems to me though that it's pretty important to establish whether the scenario you quote is anywhere near accurate in terms of what sort of ending-lockdown measures should be implemented and which are an unncessesary over-reaction.
Unfortunately it looks as though singing in church is off either way, though.
(I'm also wondering when my dentist is going to be willing to see me again).
The data is coming out all the time. I got an email from the New England Journal of Medicine last week highlighting some specific articles they're publishing. They have made all Covid-19 articles Open Access which is really helpful* I haven't read more than a fraction of the literature but I think we do have sufficiently precise answers to know how to safely unwind the lockdown. Whether governments (especially in the UK and the US) will follow said science is an entirely different question.
Test, track, trace.
AFZ
*Most of the medical literature is on a pay-for-access basis. In my current academic role I have really good access to most journals (paid for by the university). However, most doctors in the UK have only very, very limited access to journal articles. (The hospitals have no budget to pay for journal access) hence without the NEJM making their articles freely available, most of the clinicians in the world who really need to read them wouldn't be able to.
Comments
Anything that backs us off from that worst case scenario (eg: a partially effective vaccine or better treatments) moves the balance point and will allow a greater easing of restrictions.
Yes. But what price a life that cannot be lived? Is it better to have life in its fullness for a shorter time, or or life severely abridged and restricted for a longer time? Is avoiding any untimely deaths really the only thing that matters?
A referendum on ending lockdown, perhaps?
We see numbers of dead people as an acceptable price to pay in return for all sorts of things, from motorised transport to fast food. I fail to see why it’s such an unacceptable price to pay in return for our whole lives.
How many dead people would you accept?
In a straight either/or situation between permanent lockdown and freedom? Millions.
I mean, globally 1.35 million people die in road accidents in an average year, and that’s just the price we pay for the freedom to drive. Our whole lives are at least an order of magnitude more important than the mere freedom to drive a car, which compels me to state that a global figure of 10 million deaths wouldn’t be unreasonable if the only other alternative was permanent lockdown/social distancing. For the record, we’re currently at about 0.25 million.
I would not call that number of deaths a good thing by any means. But I would call it the lesser evil.
Why no singing? Is it because face masks might have to be removed?
Though that would surely apply to any spoken responses, too.
Because of the mechanics of singing as opposed to just talking - you're forcing your moisture-laden breath into the air much more vigorously.
At least, I do when I sing.
Thx.
I think that would mean about 100 000 deaths in UK. I don't know if people find that OK, I suppose it would be spread over years. Of course, a big issue is, how do you stop it at 100 000?
You don't. If we lift the lockdown we're looking at half a million to a million deaths in the UK. If we were all equally vulnerable we could perhaps make a collective decision to accept the risk, but really what is being suggested is condemning a large proportion of the elderly and disabled and leaving the young and healthy largely unscathed.
Do you think it would be better to permanently destroy everybody’s lives?
But, I was thinking more of the sort of public consultation exercise that's routine in Scottish politics (even if action on those consultations may be less than perfect - I'm looking at you local authority who conducted a consultation on a new road and then waved it through on the nod of the chief exec because they couldn't convene a council meeting due to social distancing requirements). Let the government draw up a document outlining the different options, the likely impacts of those on both society and the progression of infection and ask people to grade the options and state why they consider such and such to be more important than the impact on control of the virus. Couple that with things like TV news interviewing ministers and passing viewers questions to them, special Question Time, etc. The Parliamentary select committees calling people to testify may need to identify ways of doing their work as part of that process. I don't know how common these things are in England.
It would also mean 50-100 million world wide, although locally this would vary a lot. Up to 5 million in US? I would think these figures could have huge effects politically.
Which is not to say that the math is complicated - it really isn't. But most people do not use math to think about the world, and are not prepared to do so.
Case in point - an acquaintance is all over Mrs C's facebook talking about how the number of deaths from Covid are "much less than we were led to believe" and so we should get back to normal. She completely fails to grasp the concept that deaths are as low as they are because of the lockdown, and is aggressively unwilling to believe that the excess deaths that match the Covid timescale but aren't tagged as Covid might just have something to do with it.
I don't know how this is anything other than deliberate blindness.
Dude, you really needn't worry. It would take more than coronavirus to permanently stop people socializing, dating, marrying, reproducing... The Black Death couldn't do it, Ebola couldn't do it, I don't think you have to worry about this horrible dystopia you've got in your head.
We will go out again eventually. We will socialize again at less than 6 feet distance eventually. And etc. etc. etc. It's not in human nature to avoid this permanently. How many people do you know, introverts notwithstanding, who chose to live without any live human contact prior to the pandemic? Even the hikikomori have parents.
So it's not "will we get together again." We will. The question is, how are we going to get to that happy state. And since there are several alternative roads (some involving a helluva lot more death and destruction than others), we need to think carefully at this point instead of freaking out, like the weirdos storming the state buildings on the news.
Given deficiencies in testing I'm not sure you can be confident about the lack of problems locally. Using the CDC's website, the threshold for excess deaths for Virginia for the week ending April 18 (the last week for which complete data seems to be available) was 1,444. Virginia recorded 2,907 deaths that week, meaning there were 1,463 excess deaths in Virginia that week. (In other words the number of people who died in Virginia that week is about double what could be expected at the maximum range of random fluctuations for that time period.) 279 of those 1,463 were attributed to COVID-19. I'd be unwilling to bet that all, or even most, of the remaining 1,184 people who make up Virginia's excess deaths during that week had nothing to do with the current pandemic. In other words, the data indicates ~80% of COVID-19 deaths in Virginia aren't being counted as such.
You sound like an American automotive executive, claiming that vehicular deaths are some force of nature rather than something we can actually do something about with traffic laws and engineering. Their argument against literally every safety improvement (engineered crumple zones, air bags, seat belts, tempered glass windows, etc.) has been that it would price automobiles out the range of many people, depriving them of their freedom to drive. Somehow people still drive even with these supposedly unnecessary and unaffordable safety features, and it shows in traffic death statistics. Pay particular attention to the red line, deaths per billion VMT (vehicle-miles traveled). It shows that the cars we're driving now are a lot safer than the ones we drove in the 50s and 60s, to say nothing of the ones from the 20s and 30s.
Which is a roundabout way of calling shenanigans on claims that engineering away human deaths, whether by mechanical or social engineering, is a futile endeavor. It works.
Social distancing will kill everyone? That's what permanently destroying lives usually means. I think you're losing perspective.
Yes, it's amazing how common this is. So many people saying, well, the deaths aren't that bad, as if all of us living in the coal hole has nothng to do with it. I don't know whether it's about maths or logic or denial. Probably the latter.
In the UK, people keep criticizing Imperial College for an inflated estimate. Yes, without a lockdown, FFS.
I think it's even worse than this.
Covid-19 has been around for what, 6 months tops? So we don't know what its long-term effects might be on the younger people who are infected. Most people survive chicken pox (caused by a virus) with no problems, but then are at risk for shingles. We don't know what this virus is capable of. There could be some nasty shit that pops up years later for these apparently unscathed people.
Moreover, the divide between who is potentially condemned isn't just along old-disabled/young-healthy lines. The risk would be disproportionately be borne by marginalized people: old people, poor people, black and brown people, disabled people, homeless people.
In short, the same people who are most likely to be shut out of decision-making in our societies. So they wouldn't even have a voice in this.
The suggestion that we should go back to living our normal lives is grotesquely inhumane.
2.) I have been noticing a gradual uptick in our state's total new cases over the past two weeks, which is, frankly, discouraging. Apparently, most of those new cases are coming from Yakima county which is in south-central Washington State. 75% of Yakima's is considered essential because of the agri-business complex there. Sounds like the State Department of Health is moving more resources into the area to help reduce their rate of infection.
I just want to get this over with, but we still might have two more years of this.
How long, O Lord?
But then again, maybe not. Many of those protesting at the severity of the lockdown look like they're still in the higher risk groups.
To the best of my knowledge there's no indication that COVID-19 can kill people without developing symptoms (besides death). As such, you wouldn't expect asymptomatic individuals to show up in excess mortality statistics.
It depends whether you're asking about infection rates or mortality. @Crœsos is spot on, there's no record of people dying without first developing symptoms. If you want to know how many people in the population have the virus, then testing (ideally everyone but at least a representative sample) is the only way.
But if your question is how many is it killing then the excess mortality will answer that question with the greatest precision; for three reasons:
1. It will capture those that die from Covid-19 who were never tested.
2. Some of the people who die having tested postive, actually die from something else. (For example, there is data suggesting that people dying from heart attacks are incorrectly recorded as Covid deaths). The excess mortality figure 'automatically' discounts this.
3. The pseudo-unrelated deaths. People who die from something else but they would have survived but for the knock-on effects of a pandemic on society and healthcare systems.
For individuals it is not always possible to know but on the society level an accurate number is acheivable. For example, if you take 100 people who suffer heart attacks, something like 25 of them will die within 30 days. Let's say that in April 2020, 30 died instead of the expected 25. So the excess mortality is 5 in this simplistic example. If you want to talk about those 30 individuals, it's impossible to know which 5 of them would have survived and which 25 would have died anyway but on the population level we can be confident that 5 more people died than would otherwise have done. The most you can say about the individual is that their risk was changed. In absolute terms the risk went from 25% chance of dying to 30% and hence it's a 5% increase absolute risk. In relative risk though it's more impressive 30/25 = 1.2 and hence it's a 20% increase in the relative risk of dying.
The excess mortality figure will capture everyone who dies from Covid-19 whether they're tested or not because in 2015-19, no one was dying from Covid-19*
AFZ
*The only caveat here is that there will be a slight distortion in this figure if less people are dying than 'normal' from other causes, such as road traffic accidents. It's only when the figures are properly analysed later that this can be worked out fully. However, it's probably a safe bet that the reduced mortality groups are more than outweighed by the excess indirect Covid deaths (i.e. people who didn't actually have Covid but died because of the effects of the outbreak). So, in the excess mortality figure, unless something really odd is happening** there won't be any Covid deaths missed. Which is why it's the most important data for understanding the epidemic's mortality.
**This is just for completeness, please ignore unless you're as much of a pedant as me but if there's some other, unknown, factor distorting the data then this would be a confounder. Such as, if there was another undetected virus in the population that was killing people at the same time.... Yeah, it's not likely and should be discounted from serious consideration unless such a confounder showed up somewhere else. It's not really possible for something like that to exist without it being evident somewhere.
Firstly it gives an upper bound (in the absence of reinfections)
Relatedly, secondly if the rate is very low/there are vast numbers of asymptompatic carriers: It could be the case that we're too late, everyone's already had it, why are you not back at work! Even a crude random sample would pick up if this was the case (and I think it's been established that we've had about 5% infection at most). But from certain interest groups, and general wish fulfillment it's an attractive idea. Similarly you have the "it's just flu" brigade, despite that dream being even more proven bullshit.
Thirdly, if the rate is high/there aren't any asymptomatic carriers, then it makes contact tracing a lot easier. Unfortunately the flip side is that it means we've made no progress immune system wise.
In practice I get the impression that it's somewhere in the middle. So all of that is mostly practically irrelevant.
I'm not denying the excess deaths; I'm just saying that most of them are likely to be in the hotspots, which are all more than a hundred fifty miles from me.
The DC suburbs, which are almost three hundred miles from me have a total of 7297 cases with 230 deaths. I think there are likely to be far more uncounted deaths there than in Montgomery county which has 56 cases with one death.
And the other problem is that delays in effective testing and tracing do provide opportunities for the creation of lots of new cases before any symptoms appear.
We're still finding out both how to quantify those risks and control them effectively. Dr Fauci is right. We have to test rapidly and trace contacts rapidly in order to contain.
The whole State by State thing bothers me for this reason. Viruses know nothing about administrative borders. I'm not sure there are safe zones. There are safety precautions. Like safe distancing and frequent handwashing.
Until she mishandles the scissors and deflates herself.
I agree about the need to take precautions. I'm just saying that it is appropriate for me to worry much less than someone who lives near a hotspot. There are at least twenty counties between me and any hotspot. If the virus spreads from a hotspot, I assume it will do so gradually. I can't see it leapfrogging all those counties.
Have you looked at the map I linked to earlier? Virginia is a strange shape. I am much closer to West Virginia and Tennessee than I am to any hotspot in Virginia. It would be useful to see COVID maps of West Virginia and Tennessee
Then, I submit you don't understand exponential growth.
There have been a total of three new cases in Montgomery county over the past ten days.
Oh, do I ever have a story about inflatable boats and scissors. Well, actually, it was a lobster. Same principle.
That's got to be the case. The UK stats may however contain some anomalies. Not sure exactly how it works in the US but I think in the UK it's been possible for there to have been deaths recorded in death certificates as due to COVID-19 which were not recorded as cases of COVID-19 infection because the person was never tested in hospital. I think that possibility has now been eliminated in the statistics.
The listings are in the format:
X. Country - [# of known cases] ([active] / [recovered] / [dead]) [%fatality rate]
Fatality rates are only listed for countries where the number of resolved cases (recovered + dead) exceeds the number of known active cases by a ratio of at least 2:1.
Italics indicate authoritarian countries whose official statistics are suspect. Other country's statistics are suspect if their testing regimes are substandard.
If American states were treated as individual countries twenty of them would be on that list. New York would be ranked at #2, between "everywhere in the U.S. except New York" (#1) and Spain (#3). New Jersey would be between Russia and Turkey.
No countries have joined the 10,000 case club since the last compilation.
My favourite hypothesis for some time has been that there are a relatively small number of 'super-spreaders'. I gave up looking at the details of this some time ago, but I find it difficult to understand, in the absence and impossibility of a total lockdown anywhere, why there are not more cases given all we hear about the potential for airborne infection, contamination from surfaces, etc., especially not more cases among medical personnel (i.e. more than the more there undoubtedly are).
"Irish dig deep to support virus-hit native Americans, repaying 150-year-old debt" (Telegraph via Yahoo).
I'd heard that Native Americans on reservations are having a very hard time practicing corona hand-washing hygiene--a good many of them don't have running water. Irish folk are helping them out, for an interesting reason.
You may well be right about super-spreaders.
However, I wouldn't read too much in the airborne infection and contamination of surfaces. These transmission methods do appear to exist (that's what the data shows - i.e. that the virus can survive on surfaces for a long time and that is can survive in the air for a period of time) but how frequently this actually happens in the wild, as it were, is a different question all together. It's important to know that these methods of transmission (especially surfaces) exist but on the population level, they probably aren't particularly important. If they were, I think the epidemiological data would be different to what we're seeing.
The reason for this is due to two inter-related factors. Firstly the virus does not remain viable on a surface indefinitely and thus the longer the time between the infected person touching said surface and the next person touching it, the less likely that the next person will be infected. Secondly, infective dose appears to be critically important with Covid-19, both in terms of the likelihood of getting an infection in the first place and also the severity of illness.
The following is hypothetical numbers to illustrate a point:
The point being that in the community, the biggest means of transmission is water-droplets. Surfaces are a risk, hence hand-washing becomes important. Aerosol is mostly an issue for healthcare workers. Controlling an epidemic is all about reducing the infection rate - at peak growth, each individual may be infecting 6 others. Hence the exponential growth. Get that number right down (by isolation, social distancing and hand-washing) and the epidemic dies away.
Key workers, however, need PPE because of the high risk of particular situations and procedures.
AFZ
There's a difference between being alive and having a life. I've been saying since the start of this thread that merely preserving biological functions is not - and should not be - the only thing that matters.
It seems to me though that it's pretty important to establish whether the scenario you quote is anywhere near accurate in terms of what sort of ending-lockdown measures should be implemented and which are an unncessesary over-reaction.
Unfortunately it looks as though singing in church is off either way, though.
(I'm also wondering when my dentist is going to be willing to see me again).
The data is coming out all the time. I got an email from the New England Journal of Medicine last week highlighting some specific articles they're publishing. They have made all Covid-19 articles Open Access which is really helpful* I haven't read more than a fraction of the literature but I think we do have sufficiently precise answers to know how to safely unwind the lockdown. Whether governments (especially in the UK and the US) will follow said science is an entirely different question.
Test, track, trace.
AFZ
*Most of the medical literature is on a pay-for-access basis. In my current academic role I have really good access to most journals (paid for by the university). However, most doctors in the UK have only very, very limited access to journal articles. (The hospitals have no budget to pay for journal access) hence without the NEJM making their articles freely available, most of the clinicians in the world who really need to read them wouldn't be able to.