Been a week or so, so let’s look at some graphs, from Worldometers, as usual. Again, I focus on deaths, because however iffy the classification of deaths as caused by COVID 19, at least – sorry to be morbid here – somebody died and so there’s a body to count. Infections are unknown, and cases are a function of testing and changing definitions and instructions, and so can and do fluctuate unpredictably. I don’t know what to make of total case numbers, and I suspect neither does anyone else.
That’s not exponential growth, or growth of any kind. As the Philosopher pointed out 2300 years ago, what is not growing is dying. The curious thing: one would expect a decline at roughly the same rate as the rise. This seems to be falling more slowly than it rose. One reason might be that, with widespread infection and more broad testing, the listing of every death where COVID 19 appears on the death cert as a COVID 19 death would, over time, tend to cause the COVID 19 case death rate to converge with the overall death rate from all causes. In the hypothetical extreme, where everyone has been infected, every death will be attributed to COVID 19. This extreme is not going to happen in reality, but the principle applies: if, say, 30% of the population is determined to have or have had COVID 19 (so that they test positive), and that 30% dies at something like the normal rate, then 30% of all deaths for whatever reason would, under current practice, be classified as COVID 19 deaths.
The call for universal testing is a call, intentional or not, to inflate the number of COVID 19 deaths. If someone, say an older, weaker person, gets the flu, can’t fight it off, and it progresses to pneumonia and kills him – a very common way old people die – but tests positive for COVID 19, that is gong to be classified as a COVID 19 death just about everywhere in the West, certainly in the US, Italy and England. But – here’s the point – however classified, such a tragic death won’t push the annual numbers up. That death would have taken place anyway, so it doesn’t add to the annual total.
A plague worthy of the name adds to the total number of dead over its duration. So far , COVID 19 isn’t doing that, and there’s no reason to imagine it will going forward.
The UN projected that about 1.0658% of Italians would die this year, very slightly more than last year and in line with a decade long graduale climb as the population ages. Italy is home to about 60.5M people, so about 645K Italians were projected to die this year in the normal course of things.
So: will more than 645K Italians die this year? If a plague is killing a bunch of people, one might suspect so. But if people who, sadly, were going to shuffle off this mortal coil this year anyway, as people in nursing homes and hospitals frequently do, then COVID 19 will have little or no effect on overall deaths.
I bet there’s no increase, that right around 645K Italians die this year from all causes, just as if a no plague had taken place. Because (whisper) no plague took place. But because of the reporting requirements, virtually all deaths where COVID 19 can plausibly be claimed to be present in the deceased will be counted as COVID 19 deaths. Thus, unless they go with double counting, deaths otherwise attributable to heart failure and cancer and the afflictions of old age will drop, as will deaths from the flu, pneumonia, and any respirtory problems.
This switcheroo will only show up in the totals, or rather, will not show up in the totals.
Another thing – here’s the weather in Milan, the capital of Lombardy, over the last couple of months:
A bit cold and nasty-looking (to a Californian) until the second week of April – at least, cold nights and quite a few cooler days. Now, the weather is getting pretty nice, that lovely Mediterranean climate Italians and Californians love – and in which air-borne viruses quickly die out.
Same story. Here’s France:
French reporting has been very inconsistent, as this graph shows, but the trend, if any, seems downward. I’m reminded of a story I heard about the song April in Paris: Yip Harburg, the lyricist, was asked how he could write
April in Paris, chestnuts in blossom
Holiday tables under the trees
April in Paris, this is a feeling
No one can ever reprise
…when every Frenchman knew April in Paris is cold, wet and nasty. He replied: May didn’t fit the rhythm. So the positive effects of Spring sunshine won’t likely be seen for another couple weeks.
Now, on to America:
What is happening here? We get repeated lesser daily counts for a day or two, followed by new highs – three or maybe four times so far.
Following new CDC guidelines: “As of April 14, 2020, CDC case counts and death counts include both confirmed and probable cases and deaths. This change was made to reflect an interim COVID-19 position statement issued by the Council for State and Territorial Epidemiologists on April 5, 2020. The position statement included a case definition and made COVID-19 a nationally notifiable disease.
A confirmed case or death is defined by meeting confirmatory laboratory evidence for COVID-19. A probable case or death is defined by i) meeting clinical criteria AND epidemiologic evidence with no confirmatory laboratory testing performed for COVID-19; or ii) meeting presumptive laboratory evidence AND either clinical criteria OR epidemiologic evidence; or iii) meeting vital records criteria with no confirmatory laboratory testing performed for COVID19″ [source]Worldometers again
Since over half the deaths have taken place in the NYC metro area, one would look first there.
And, on that same page, are updates on how, over time, other states have changed their reporting practices to be more generous and inclusive – in other words, to include more deaths under the COVID 19 heading, following revised CDC guidelines. Whether these changes are warranted or not, they skew the results in one way only: more deaths reported as due to COVID 19.
So, are we in the same situation as Italy, where I predict no significant uptick in total annual deaths? I say yes.
I had hoped to be able to say that the numbers clearly show the US is well past its peak; but at face value, that’s not quite possible, given the upward spikes in deaths. On a local basis, the New York City/Newark area, unlike the rest of the country, has seen overall ‘excess’ deaths over what historical trends would find reasonable. This is real, and cause for concern. On the other hand, I have seen no reports to suggest the profile of the people dying has changed – it is still 80% people over 65, and 95% people who are sick, elderly, or both. In other words, at most 5% of the victims are younger and healthy. I say at most, because the prudent thing to wonder is if those younger, healthy victims did not, in fact, have underlying health issues that were undetected – maybe, maybe not, but the thought all but suggests itself.
Finally, one more set of pictures: Weather in New York City
Again, from a Californian’s perspective (I’m sitting out on the patio typing this, 80F, light breeze, beautiful) that’s some nasty weather, mostly cold and damp, and erratic. Maybe if Spring finally arrives in the northeast, we can put a stake in this thing.