Was abusing our children’s patience by walking through the 3-step process by which science is reported in popular media, as follows:
Somebody does a study.
Study author gets interviewed by a journalist, who writes something up.
Editors and headlines writers take a crack at it.
What could possibly go wrong? Let me count the ways:
Study is a piece of crap. My own private unpublished but peer-reviewed (I asked my son about it) study says: 95% of all studies you hear about on the news are crap. Prove me wrong.
You’d need a microscope see the chances the ‘journalist’ understands enough science to hold a printed copy of the study right side up. He couldn’t identify scientific evidence if it climbed into his lap and kissed him square on the lips. Basically, he got the gig because he was less terrified (or a more dogmatic SJW) than the rest of the reporting pool.
If, by some slim chance, anything accurate and useful made it into the article, an editor, who understand less science than even the reporter, is virtually guaranteed to screw it up. He’ll punch it up by making the opening paragraph as scary as possible, regardless of anything so mundane and boring as evidence.
The headline writer knows even less science than the clown parade that produced and edited the report he’s now skimming. He slaps an apocalyptical headline on it designed to get clicks. Thus, every warm day becomes global warming doom, every plastic straw is causing the extinction of cute little turtles, every remote possibility something might go wrong becomes the end of the world, even if the headline writer has to make it up.
Your average reader, if he even gets past the headline, stops after the first paragraph, where the editor did his job ‘punching it up’ by featuring gloom and doom.
And that’s if the people involved are trying, somewhat, to play it straight. If they have an agenda – I slay me! – it’s much worse.
Moral: if you heard about some science-y sounding thing on the news, it’s wrong. Just assume it’s wrong – the times you’ll be mistaken are negligible, and the disgrace you’ll suffer minimized.
(Aside: this is why Sagan was so popular: most scientists are (or at least were) very careful, and really hoped they could explain what they were up to. How boring is that? Plus, it makes you feel stupid. Sagan flattered the idiots, explained nothing, but put on quite the show. He knew the people publishing articles and producing TV shows didn’t want to feel stupid, were not going to put much effort into understanding anyway, so he just used his stolen glory as a scientist to sell them Scientism. This has born fruit, in the form of millions of Americans thinking they ‘believe the science’ whenever they fall in line with whatever the Officially Approved Authority Figure (an AAUF, pronounced ‘oof’ ) is saying at the moment.)
As I long promised, I’m plowing through the 2020 CDC death data to determine, as much as possible, how many people the d*mn virus can plausibly be said to have killed.
As predicted, the data is now still harder to find – the All Deaths data, which used to be a couple clicks in from the CDC front page, is now very hard to find – at least, it’s not obvious. After scanning the pages and searching using the CDC’s search box for the very specific title of the page, which I knew because I have that YouTube video by a Dr. Briand from John Hopkins wherein she analyzes the CDC numbers, I ended up snipping a tiny corner of her PowerPoint, expanding it, then manually typing in the wee fuzzy web address – and it came up. So, the data is still there as of today, it’s just not easy (possible?) to find from the CDC front page. I’m grabbing/downloading and backing up everythng.
About that main page – sheer, poisonous fear-mongering. They show 350K COVID death, just stated as a fact on Page 1 – their data, once I found it, showed 300K deaths involving COVID. So, where do those extra 50K dead people come from, if they’re not, you know, there in the CDC’s own numbers? No explanation is offered. Just shut up and be very afraid. Then, they have warnings about the danger to young people and children, how we need to be very afraid – while their numbers show – hell, take a look:
There were 149,198,677 Americans 34 and under, of whom 118,384 died in 2020. Of those poor souls, the deaths of 2,672 ‘involved’ COVID, meaning, if you were under 35, you stood a 0.00179% chance of dying of COVID last year. Slightly worse than your risk of dying of a shark attack or lightning strike. If you were one of the 103,258,356 Americans under 25, a sad 54,830 of your age cohort died last year, a whopping 585 of whose deaths ‘involved’ COVID. If you’re under 25, your chances of dying from COVID last year were 0.00057%. Slightly worse than getting hit by meteorite – but not by enough to worry about.
Before you dare mention lung damage, or lingering problems, or any other reason young people should be masked & locked up, one rule: show me the damn data. I don’t want to hear about some anecdote you heard on CNN – show. Me. The. Data.
I note one last thing from the CDC data now, with more to come when I’ve gotten a chance to digest the data: the overall death rate in the US in 2020, pending, of course, updates that should roll in over the next couple weeks and push it ever so slightly up, was 0.884. That’s 884 deaths per 100,000 Americans. Back in May, I looked up the UN’s 2020 projected death rate prior to COVID, and it was 0.888. This number just comes from extrapolating from long-term tends, nothing special, but, barring a deadly pandemic or other disaster, such a method should produce a pretty accurate forecast. So it looks like the US, despite a raging pandemic that’s killed, they say, 350K people, will have had pretty much the same number of dead people in 2020 as projected before the pandemic. Huh.
By now, I’ve despaired of convincing anyone who can open their own eyes and look around and is yet not convinced that the COVID 19 panic is and has been from the beginning a fraud. If you can’t see that, I don’t know what I could say to convince you. But, for my own satisfaction:
Way, way back on April 3, using then-available number, basic logic and a little math, I came up with an infection fatality rate (IFR) of around 0.25%, and said that was still probably quite a bit high. About 6 weeks later, the CDC published their “COVID-19 Pandemic Planning Scenarios“. Digging around a bit, their most likely scenario used an IFR of. 0.15 to 0.26%. That means the CDC expects about 15 to 26 out of every 10,000 infected people to die.
Imagine. And they evidently based this on their very ‘generous’ counting of COVID deaths. Now, I’m not some genius sleuth or anything, just pointing out that the data needed to reach these very-much-not-worth-panicking-over-numbers were right there all along, so that even I could reach them. And I’d still bet the CDC IRF is high by a factor of maybe 4. Just a hunch.
Thus: even accepting a world where we all are encouraged to imagine ourselves under dire threat from a disease where 95% of the attributed deaths are among very sick, often very elderly, people with multiple health problems and short, as in months, life expectancies, that risk is still TINY according to the CDC driving the panic. If you’re not in a nursing home or otherwise under palliative care, you are literally under more risk crossing the street than from catching this virus.
Those watching Our Betters decide that rioting over the approved issues immunizes people, while golf or church or a visit to a restaurant is literally courting DEATH for MILLIONS, all while even the ridiculously ‘generous’ death counts plummet, and STILL think the lockup was a good idea and people who don’t wear masks are evil, are not going to be convinced otherwise by math and facts. But I tried.
Charts, because we haven’t done those since they got boring:
In the US, boy, are they trying to make it seem bad despite all the evidence to the contrary. In a country with 330M people, where close to 8,000 people die on an average day, we’re supposed to cower like rabbits because, with ‘generous’ counting, because around 500 people (and falling), almost all of whom were very sick and most near death before they (may or may not have) gotten infected, are dying while infected per day.
No deaths at all since May 26. Note the hilarious “correction” on May 25, where they can’t say: “we overcounted deaths by a couple thousand, which is about 10% of the total,” Because that would be too easy. Instead, they said:
“Spain: On May 25th, the government decreased the number of total cases by 372 and the number of deaths to 26837. The discrepancy is the result of the validation of the same data by the autonomous communities and the transition to a new surveillance strategy. Discrepancies could persist for several days. We’ve adjusted our figures to reflect the new numbers [source] [source] [source]”
Over. Was over once a) it had ripped through the nursing homes; and b) spring weather arrived.
Stick a fork in it.
Turned the corner yet? Hard to say. Southern hemisphere, but the population is mostly in tropical and subtropical climates – usually hard on airborne viruses. Not sure what’s happening, but remember: 220M people, many living in very poor conditions – kind of like Wuhan tenements. This level of deaths, while certainly tragic on a personal level, is not something to panic over. Will keep an eye on this.
Mexico (pop: 129M, or twice Italy or France) is approaching the Top 6 in deaths (above). Will keep an eye on our neighbor to the south.
Also also: William Briggs took the data in the CDC report linked to above, and produced this chart, showing graphically the about 62M infections generating those 1.7M cases we’ve heard about. Again, it’s that whole functionally numerate thing: if this doesn’t make you guffaw, maybe numbers aren’t your thing?
And Dr. Briggs’ analysis:
As of Wednesday night, and using our standard sources (which exaggerate death counts), there were 1,689,630 reported “cases” (positive tests) and 94,352 reported deaths. The crude CFR was 94,352/1,689,630 = 5.6%. Again, this bug is not killing 5.6% of those with symptoms. The RFR was 0.03%.
The number of estimated actual cases are anywhere from 8 to 30 million Americans. That is, about 2.4% to 9.1% of the US’s population had symptoms or were otherwise cases.
The number of estimated actual infections are anywhere from 37 to 62 million people. That is, about 11% to 19% of the US’s population are already infected.
If actual deaths are lower, then all these numbers will be too high.
The point of all this: to find more cases, all you’d have to do is run more tests – the infection is out there in millions of (asymptomatic or mildly symptomatic) people. Panicking over increased cases is idiotic. Or, to be more generous, shows a lack of understanding of the data.
The top 6 countries by COVID 19 deaths are shown below. These 6 countries barely represent 10% of the world’s population yet account for 56% of all cases and 72% of all deaths:
A political observation, something all these countries share:
USA – election of a ‘right wing’ administration revealed the vulnerability of the culturally and politically dominant Left, which, predictably, completely lost its mind. Now, under the COVID noise, indictments are coming down against the 3rd tier of Leftist operatives.
UK – contrary to the wishes of the politically dominant Left, the nation voted not only to reject globalism and leave the EU, but then enabled the despised non-Leftist Boris Johnson to become Prime Minister and form a government.
Italy – The anti-globalist 5 Star Party came to power in 2018.
France – Macron, a lifetime Socialist Party member, has been under siege by the Yellow Vests for over a year. The Yellow Vests are a mixed bag, politically – hey, it’s France – but include ‘populist’ anti-government factions. While Macron is often portrayed as pro-business, a cursory look at what he’s up to shows he’s pro giant global business, and pursues pretty much textbook Gramsciite social destruction policies.
Spain – a history of conflict, often violent, between Communists (under whatever name) and more conservative elements. ‘Right wing’parties have been making gains in recent years.
Brazil – Jair Bolsonaro’s election in 2019 put in power pretty much the Left’s nightmare candidate. As Wikipedia sums up: “He is a vocal opponent of same-sex marriage and homosexuality, abortion, affirmative action, drug liberalization and secularism. In foreign policy, he has advocated closer relations to the United States and Israel. During the 2018 presidential campaign, he started to advocate for economic liberal and pro-market policies.”
Each of these nations has a Left that’s having its power threatened. Somehow, that correlates remarkably to more COVID 19 deaths…
Now for some charts. Have COVID 19 daily deaths counts fallen off a cliff? Why, yes, yes they have: (All charts from Worldometers)
This is probably as low as Italy will fall, as far as daily death counts go, as they count COVID 19 deaths very liberally, and, with an older population, they will not lack from nursing home patients with the sniffles checking out. But, on a populations 60M+, we’ve reached the statistical noise level of deaths.
Ditto. Also note that the declines started in early April – with the arrival of spring, which is what any sane person would have predicted.
French data is extremely noisy – again, hey, they’re French – but the overall decline is still there. Those spikes are all related to reporting lumpiness. Tiny numbers.
So here’s the one country, of the six ‘leading’ country, where the decline is not evident from the graph. Brazil has over 200M people; 750 deaths are, as always, personal tragedies, but, statistically? Barely registers.
I’ll keep more of an eye on Brazil.
Even the birth palce of COVID Panic Porn is clearly on the way out. This data shows an odd weekly cyclicality: down, down, down, off a cliff, down, way up, repeat. Reporting quirk? I’d assume so.
As noted previously here, England has implemented a policy of listing COVID 19 on the mandatory reporting list, along with the Plague, Mad Cow Disease, anthrax – because a flu-like infection fatal well under 1% of the time is just like those things. The net result: as the infection inevitably spreads, more and more people who test positive will show up in the counts regardless of COVID 19 actually contributing to their deaths, or, indeed, despite showing no symptoms at all.
So, realistically, we’ve reached bottom unless the UK changes its reporting rules. It may even go up.
Finally, the US:
Same pattern, same issues as with the UK data. Given the political investment in keeping the lockdown and fear going by political conmen like the reptilian Newsom, I’d guess this is about as low as the daily counts will be allowed to go.
If you’re going to put Grandma or Grandpa in a nursing home — don’t put off making a visit. That’s the upshot of a U.C. San Francisco study published this week, which reveals elders often don’t last very long in care facilities.
Of its sample of nursing home patients who died between 1992 and 2006, a full 80 percent were dead within one year, claims the study, which appears in the current edition of the Journal of the American Geriatrics Society.
(UPDATE: Looked around for more data on nursing home mortality – it is made somewhat confusing, in that the definitions are not clear. What, exactly, is a nursing home versus Long Term Care? What kind of patient is in what kind of home? The most favorable study showed an expected annual mortality rate of 31.8% and an average stay of 2.2 years. Others were in between. Perhaps the 80% annual death rate is for a particular kind of nursing home? Alzheimer’s and dementias seem to take 5 or more years to kill their victims once they’ve been put in a home – perhaps the homes in the first study excluded such patients? Yet, even the low end annual mortality rate of 31.8% requires that nursing homes are home to a lot of people who are very near death.)
In the body of the report, it explains that numbers are not available for the US, Italy, Spain and some other places. Too bad. In the US, with only 35 states reporting, the report notes that there have been at least 10,000 nursing home deaths.
If we assume, not much of a reach, that the US is most likely more like the western European countries (+ Canada) on the right than the mostly smaller countries on the left of this chart, then the US rate might be 50% or more. We’ll have to wait and see if those numbers ever get reported. (I’m not holding my breath.) Also note that these numbers presumably do not include those cared for at home who might otherwise be in a nursing home, or hospital patients – also likely very sick people with a very short life expectancy.
(Aside: we also should not assume homogeneity: some people in nursing homes are a lot closer to the end than others – no reason to suppose COVID 19 isn’t killing proportionately more of the very ill. In other words, it would be simple-minded to assume 20% of the nursing home deaths attributed to COVID 19 were of people who otherwise would have survived the year. I bet close to 100% would have died this year– something like 95%.)
The bottom line here: my confidence that the total US deaths this year will not be much higher than the UN pre-COVID projection of about 2.903M is solidified by just about all the data that comes out. If 200K deaths are assigned to COVID 19 – unlikely, if they’re playing fair (Ha! I slay me!), then the total would go up by maybe 100K (a bad flu season)- IF it’s only the nursing home deaths that are padding the totals. I’m thinking, based on the ongoing collapse of US death counts (6 straight days of declining daily totals – Spring is here!), 200K is well out of reach.
When it is said, as it has been, that 95% of the COVID deaths in the US are of people with one or more “comorbidity”, that is identifying a population that is already a lot nearer to dying than the typical healthy person. To put it another way, 5% of the people who die of COVID 19 were otherwise healthy – for 70K deaths, that 3,500 otherwise healthy people who died of COVID 19. Not to be gruesome, but some percentage, probably a very large percentage, of the remaining 66.5K dead were going to die this year anyway, and thus were presumably included in the original death projections, and will thus not add to the number of overall deaths.
As I get older, I get a glimmer into how odd I really am. Not that I think I’m all that different than anybody else in this regard, we’re each weird in our own way. For today’s post, I’m trying to remember that I simply process information in what is evidently an unusual way.
Example I’ve mentioned before: when we studied Euclid in freshman year lo these many decades ago, 9 times out of 10 I would look at the drawing, read the proposition – done. Working under stated premises and the rules of logic, you assert, for example, that the angles opposite equal sides of a triangle are equal? Sure. Prove it? Sure – hand me the chalk. It took me a good while to understand that the other students, generally very intelligent people, didn’t work this way, that the truth of the propositions was something they got to by working through the proofs step by step, and that they had little idea how to proceed with the proofs without first working through them.
Now, I’m an idiot when it comes to language and many other things – can’t seem to get even the basics, and forget them faster than I can learn them. But logic and Euclid? Evidently, I’m some sort of idiot savant.
I say this because of my growing frustration, where arguments over the virus seem to circle around and around the same irrelevancies and claims, while ignoring what, to me, are the glaringly obvious points and the inevitable conclusions to be drawn from them. Then I remember: I’m odd, perhaps these points are not obvious to others? Maybe I need to lay them out in some sort of rational order, and not skip any steps? So, today, for what seems to me to be the umpteenth time, let’s go over the basic issues.
1. Messy data, and what it tells you
Way, way back in January and February, we started getting information out of China about an epidemic. Over time, but before mid-March when the shutdown was imposed here, we got data showing case fatality rates from various areas in China. Most of the action was in Wuhan, but it had spread to other areas as well. The CFR for various regions were quite different, ranging from, if I recall, 4.5% in Wuhan proper to well under 1% in outlying areas.
The very first thing these numbers tell you: the data is very messy. These various outcomes CANNOT be caused by the virus alone. There must be – MUST BE – other factors at play. The next thing they tell you: if these numbers mean anything, they mean anyone’s chances of dying from the virus is heavily dependant on where they live.
I evidently need to harp on this: these CFR numbers, in themselves, don’t actually tell us how deadly COVID 19 is. To get to that point, you would need a whole bunch of additional information – information, it turns out, nobody has. I’ve harped on that in previous posts. But they do tell you that there is no one number that represents how deadly this virus is, that even so simple-minded a number as CFR varies enormously from place to place.
From the beginning to this day, the claim has been made that ‘we were acting on the best data available.’ I am here to say:
NO, ‘WE’ WERE NOT.
The best we knew, the clearest information we can get and could ever get from the early data or any of the subsequent data: the seriousness of the virus depends on where you live. There is no one CFR that expresses the seriousness of this infection.
The ‘information’ we acted upon, the evident cause of our panicked overreaction, was: dead Italians! 7.7% CFR! Ferguson’s model! Millions dead! If, instead, we had said: the data is very messy so it’s impossible to conclude much of anything from it, but, if it does mean anything, it means the CFR depends enormously on where you are when you get infected, we would then have asked different questions and proceeded differently.
But ‘we’ didn’t. We ignored the actual evidence in favor of wild, worse-case assumptions, that we then plugged into models, which, dutifully, produced worse-case numbers.
Garbage in, garbage out.
Model output in not data or evidence. Acting on model output is not acting on the evidence.
(This is why, by the way, I focus almost exclusively on deaths, and belabor how deaths are counted, and dismiss case counts and CFR as misleading – deaths are the ONLY way to meaningfully gauge the seriousness of the outbreak. And not that many people had died when our overreaction was inflicted. Some states were shutting down before a single death had happened within their borders.)
I’m putting a recap/expanded summary of what I mean by messy data and what that means to the numbers being tossed around in a footnote. The messiness of the data generally means one would need to be careful using any of them and caveat the hell out of any claims. In this case, with few exceptions, the messiness of the data tend strongly toward overstating the seriousness of the pandemic. I’ve been harping on this in previous posts, which I why I merely footnoting it here.
2. There is nothing novel about novel viruses
Whenever it is pointed out that, you know, people and viruses have evolved together for millenia, and that we need new flu shots every year because every year we have to deal with new versions of flu viruses, we are told “COVID 19 is a novel virus! It’s not the flu! Nothing that has happened with flu viruses has any bearing on COVID 19 (and: you are an idiot to propose it does – I’ve been told this).
But wait – every new flu bug is a novel virus by definition. And, while, according to the current classification system, coronaviruses are not flu viruses, there are and have been plenty of coronaviruses floating around as long as people have been alive. Some common cold viruses are coronaviruses, for example.
Just because COVID 19 is caused by a novel virus doesn’t mean it is any more scary than next year’s flu bug, which will also be a novel virus, or the next cold you catch, which could very well also be a novel virus, and even a novel coronavirus.
Novel doesn’t equal ‘super-scary’
If we want to look for a recent, comparable virus, how about SARS in 2002? SARS is a closely related coronavirus, much harder to catch but more dangerous if caught. It died out once the weather got nice. It made a brief reappearance the next year, and then died out for good.
The claim that COVID 19 requires extraordinary, job-destroying precautions simply because it’s novel is absurd. Humanity has endured novel viruses for millenia, year after year after year. There is no evidence to support the idea this virus is going to be particularly worse than any of the others.
Buuut – if you mistake model output for evidence, and ignore what the actual evidence is, then ‘novel’ means this virus is way different than the usual. As more evidence rolls in, it becomes clearer and clearer that COVID 19 has been wildly and irresponsibly overhyped. ‘It’s just the flu’ looks more and more accurate as each day passes.
3. (Recklessly) Assumed Homogeneity
Assume a spherical cow of uniform density in a friction free environment. A blog post from Sarah Hoyt reminded me of this old joke, how complex situations must be simplified to be modeled – and thus, why models so frequently give gibberish answers.
The models necessarily assume a particular spherical cow of uniform density: that there is *one* rate of infection and *one* fatality rate, and one value for any of the other variables. (You apply the calculus after you’ve entered the values.) True, you could build multiple models representing multiple populations – the Imperial College model did two famous ones- one for Britain, one for the US – but that should engender an uncomfortable discussion of which I have heard nothing: how small do we slice it?
The logical answer, based on the very earliest evidence out of China, and reinforced with every new piece of information, is: very, very small. Not a country, not a state, not a city. How about a cruise ship, or a nursing home, or a particular Wuhan tenement? Or a California suburb, a grocery store, or a school? Does anybody pretend to believe you are getting remotely the same CFR in an Italian nursing home and a Southern California grammar school? Or from one nursing home or school and the next (unless it’s zero)?
I can hear the ‘buts’ – but people interact! But people don’t stay in their school or suburb! So? What does the model do? Assumes *another* spherical cow of uniform density: that everybody interacts the same way and amount, that some ‘average’ rate of transmission represents what’s really going on, that human interactions can magically be reduced to some (assumed ) number.
That is again, stupid, and *assumed to be false* by the very mitigation efforts currently being imposed on us: our faith in the belief that quarantines and various isolations and restrictions can stop the virus means we accept the notion that how people interact is different and effects how the virus spreads.
We could, therefore, have focused on exactly which interactions between exactly which people are the likely vectors, and striven to control them. We tragicomically did not: in our fine state, churches and garden centers are shut down; homeless encampments and public transit are not. People shopping outside in fine weather or sitting for an hour in a church – too dangerous. People riding around in subway cars and buses, or camped out in their own feces – acceptable risk. The homeless, in particular, then go mingle with social services personnel and the people they panhandle from. Yet homeless encampments were explicitly exempted from the rules. Sound prudent to you? Either California wants the homeless to die and doesn’t care how many other people they take with them – not politically viable – or they think this lockdown is a joke. Or? Similar insane steps seem to have been taken elsewhere. New York, last I heard, had not even yet shut down subways and elevators!
Another spherical cow, a somewhat more subtle one: that grouping people by age or any other characteristic makes all those in the class effectively the same. The class of, say, people 75 to 84 years old is somehow homogenous, thus any person in that class stands, according the CFR for that age cohort, a 10.32% (or whatever) chance of dying if they catch COVID 19.
Nonsense. Within that group are some older, some younger, and, much more important, some healthier and some sicker individuals. Some already have breathing and heart troubles, some don’t, and all this is a matter of degree. Lumping them together by age fatally muddies the answer to the underlying question: how likely is COVID 19 to kill them?
One subset is very likely to die, much more than any other. People are abandoned to die in nursing homes by the millions every year, with the people doing the abandoning feeling more or less bad about it. Some even visit. I guess all that daycay when we were kids gave us a high tolerance for other people’s misery. Be that as it may, it is BLINDLY OBVIOUS that the populations in nursing homes are way more likely to be seriously ill and ARE WAY MORE LIKELY TO DIE than their age cohorts in the outside world.
I asked a relative who worked for years in a nursing home. The staff knows that, likely as not, some little thing – a cold, a stomach flu, an infected scratch – will kill those people sooner or later. Probably sooner, if they are very weakened; maybe later, if they are stronger.
Dying after catching a viral infection is an extremely common way people in nursing homes to eventually check out. The virus would not kill them if they were not already old, sick, and weak.
Reports are that about 20-25% of all the COVID 19 deaths are people in nursing homes. This may – may – be understated, as it’s possible the decedent got sick and was shipped off to a hospital to die. Also – and I don’t know, but it seems very likely – some of those who die at home very well might be under hospice care – another (better) way we treat those who we expect to die soon.
So ‘where you are’ must also contain caveats about where you are healthwise. This information, which was available at the time of the US lockdowns, was effectively ignored. What happened in Italy, a country with a history of ‘excess deaths’ for even just seasonal flu, is that COVID 19 ripped through some nursing homes, then through some hospitals, and then started to peter out as soon as it had claimed, not random 81 year olds, but very sick 81 year olds and other people sick enough to be packed into a nursing home or hospital.
The point of all this: Now, it’s common among the educated to claim that our lockdown – and our sheep-like surrender of our constitutionally guaranteed right to free assembly – was merely prudent, based on what was known at the time, and that caution should be exercised in lifting restrictions. That’s a far as you can go and stay in the Kool Kids Klub. Further, other considerations, ones that were not available at the time the initial decisions were made, don’t retroactively make the initial decisions made without them somehow more reasonable. Excess deaths in (tightly-packed, #WohanStrong, subway & elevator ridden) New York and its suburbs NOW does not contradict or stand against what was know back in March: that packed conditions where people jostle about and breath the same recycled air in closed buildings, elevators and subways is *pretty probably a high-risk area* and that prudent steps should be taken there.
But NYC ain’t Laramie, WY or suburban California. A subway isn’t a suburban park. An elevator isn’t a garden supply store. Yet we model and set policy as if they are, not in accord with, but in defiance of, what was known at the time.
“Where is Every Body”: Fermi’s Ghost in China
Take a look at this picture, and note the date:
China started its by now famously effective and credulity-straining lock down on January 23, but didn’t get around to a general travel ban until January 30. The virus had spread all over China, presumably before January 30, such that cases were found everywhere. (Note that the size of the hexagons reflects cases, but more obviously, reflect local population densities: The huge one is of course Wuhan; the tiny ones are where few people live all spread out; the big ones where many people live in large cities. The 1.3 billion Chinese in China are not evenly distributed, and do not live in one uniform fashion or under one uniform climate or geography, etc.)
By the January 30 lockdown, COVID 19 had had about 2 months to spread out from Wuhan – and spread it did, as you can see by the map above.
The first US case was reported on January 20. The first furtive steps at control took place with travel restrictions in January, but full on, government-led efforts were not taken until March 16.
So: China and the US both had about 2 month of spread before strong steps were taken. China, with a more densely packed population in many places, poorer sanitation and personal hygene practices, and an outbreak in the dead of winter, might – might – be supposed to be a more favorable environment in which the virus could spread. Be that as it may, on March 31:
WASHINGTON (AP) — President Donald Trump on Tuesday warned Americans to brace for a “hell of a bad two weeks” ahead as the White House projected there could be 100,000 to 240,000 deaths in the U.S. from the coronavirus pandemic even if current social distancing guidelines are maintained.
When you build models, one thing you routinely do is a reality check: is my output reasonable? Are there any existing cases against which I can try my model to see if it makes sense, given what actually happened? This is simple prudence regardless of the type of model. When I used to use financial pricing models, I knew or could easily find out what was happening in the market – what people were charging for equipment financing, and what kind of yields the finance companies were getting (and cost and tax assumptions, expense allocations, cash flow timings and all sorts of related trivia). So, if I modeled a case where the output was wildly different to what was happening in the real world, I’d look into it hard. No way am I just going to use output that contradict reality. I’d get fired.
So, when his team told Trump a bit over 2 months into this, that between 100K and 240K Americans were going to die, even with all the restrictions in place, I have to ask: where is every body? where are all the Chinese dead?
Because China was 5 months into it by this point, had similarly had 2 months for the virus to spread unchecked, had if anything more favorable conditions for its spread – and yet, as of today, is reporting under 5,000 deaths. Would not logic dictate that, since there are 4 times the number of Chinese as Americans, and, as you can see from the map above, COVID 19 was just about everywhere in China, that something like 400,000 to a million dead bodies should be piling up by now? Under the assumptions used to predict 100K to 240K dead Americans?
So, this forcast fails the sniff test rather badly. Of course, I think the Chinese communists lie, and think they could probably lie their way around an order of magnitude more deaths – 40K, say. But 400K? A million? Possible – these are the people who offed something like 65M in the Great Leap Forward, after all – but that took years, before spies, satellite surveillance and a semi-open country. Seems kind of hard…
Or, perhaps they are not lying, and instead are only counting people where COVID 19 clearly killed them? As Neil Ferguson, the guy behind the model, recently said about deaths being attributed to COVID 19 actually being from other causes:
It might be as much as half or two thirds of the deaths we see, because these are people at the end of their lives or have underlying conditions so these are considerations.
I don’t know, but either their numbers or ours are bogus, or both are and something in between is happening: the Chinese are hiding some deaths, and we are wildly overstating ours.
More to the point: at the time when this “100K – 240K” claim was made, it could not have been based on ‘what was known at the time’. It was not based on science or even a good-faith effort. All the supposed data available makes it nonsensical. Instead, like all the doom and gloom projections so far, it seems based on wildly pessimistic assumptions that nobody sniff-tested. SOMEBODY needed to ask: what about China? And get a straight answer. Trump’s got the surveillance satellites and spies, after all.
Springtime for COVID!
Finally, one last thing that keeps popping up: there are some viruses that seem to survive the spring and summer months better than others. Not very many that anybody has heard of. In fact, the only ones I’ve heard of are the Spanish Flu, which survived for about 2 years in conditions – WWI, primitive medical care – that could hardly be farther from what we have now, and the 1957 Asian flu, which lasted about a year and a half. Each of these flus somehow survived the disinfectant effect of sunshine, and so came back for an encore once the weather got cold again.
But, we are constantly reminded, COVID 19 isn’t the flu! It’s a *novel* coronavirus. Way different! So, do we have any coronaviruses to compare it to? Why yes, yes, we do: the SARS outbreak of 2002-2003. That SARS virus is closely related to our current bug. Infections broke out in November 2002; the WHO declared it over in July of 2003. Then, for unclear reasons 251 cases were identified in Toronto in 2003-2004. That micro-outbreak ended in June, 2004, with an appalling 43 deaths, or 6% of all the deaths.
So, again, based on the evidence we actually have and not on worse-case assumptions about what *might* happen, the logical thing to assume is that what seems most definitely to be happening – nice weather is killing off the virus – is, in fact, what IS happening, and that, based on what happened with the closely-related SARS virus, little or no recurrence is likely to happen in the fall.
Again: evidence. If you want to claim that we need to cower in fear that this virus will, like the dream of postbellum South, rise again, then point to a similar virus that did so. No fair harping on how COVID 19 isn’t the flu, then turning around and using *the flu* as your example of Undead Viruses.
Conclusion: I’m appalled, as any reader of this blog knows, by misuses of the term science in connection with every hair-brained bit of panic-mongering that crosses the illustrious pages of our esteemed media. In a remotely just world, this pandemic will be remembered as a cautionary tale, and go down as yet another abuse of science from what future historians (one hopes, not in charcoal scratching on a cave wall) will call the Age of the Great Scientific Frauds.
The data is messy. Let me count the ways:
Some of the more important ways, at any rate.
The definition of a ‘case’ is not clear or consistent from place to place, and changes over time. Cases are not reported in an orderly or consistent manner. Cases may or may not include those diagnosed from symptoms alone without a confirming test. Cases are unlikely to include very many asymptomatic people. Cases are also dependent somewhat on how much testing is being done. What this means: case counts across time and space give us only a vague idea of the virus’s spread.
The definition of a ‘death’ is not clear or consistent from place to place, and changes over time, for many of the reasons given above. Filling out a death certificate is not simple. Often, the immediate cause of death is not clear. Further, nowhere, with the possible exception of China, is death by COVID 19 counted in the manne any reasonable person would consider fair, namely: did COVID 19 kill this person? Would he have lived if he hadn’t caught it? Estimate of how many deaths classified as caused by COVID 19 that could pass this common sense definition range from half – Ferguson’s high end estimate – to 12% or less by some Italian doctors. The US, Britain, Italy and France explicitly encourage or insist upon COVID 19 being listed as a cause of death if the decedent tested positive or could reasonably be supposed to have COVID 19, even if it is at most a minor cause. E.g., Ventura County reported 2 COVID 19 deaths a couple days ago: a 99 year old man (life expectancy in years = 0) and a 37 year old man, who died of a drug overdose but had tested positive for the virus. No reasonable person would count those as COVID 19 deaths. What this means: Death counts are not a fair representation of the number of people who were killed by COVID 19. It seems likely to be too high by 50% or more.
Cases are not infections. Nobody knows, and nobody ever will know, how many infections there are or were. Cases will always understate infections, often severely, unless the disease is near 100% fatal or near 100% generates unique, serious symptoms, or we accurately test everybody in the world. Otherwise, mild or asymptomatic infections will constitute a probably large number of infections that do not become cases. Early own, using the then-available information, I estimated that infections outnumbered cases by at least 400%. Since then, wider testing in, for example, New York and Miami, suggest at least 15 times as many infections as cases. What this means: The virus is much more widely spread, and therefore much less dangerous, than would be suggested by the number of cases.
Case Fatality Rate – CFR – is a) not the real fatality rate even in theory, b) can never be established with any confidence, given the uncertainty in the case and death counts, and c) needs to be measured over a more or less homogeneous population to mean much of anything. What this means: For the reasons above, the CFR may be 30 times or more higher than the true fatality rate: e.g., half as many deaths divided by 15 times the number of cases = 1/30 the CFR. if the number of infections is 15 times higher than the number of cases.
In conclusion: none of this is particularly hard to figure out, it should be obvious to any competent epidemiologist or model builder.
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]
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.
Long time, no bricks. When we last left our Eternal Insane Home Improvement Project, back at the end of last August, things looked about like this:
Once Daylight Saving Time kicks in and the weather get a little warmer, I am able (and motivated) to get back to work. Here’s where we stand today, after a couple weeks of getting in a few hours on most days:
As you can see, everything is at least in progress. Redesigned the brickwork around the water meter – the curve idea was looking weird when I tried to work out how to actually do it on the ground. The square shape is both easier and more aesthetically consistent. We’ll know in another week or two. Also have dug out around 8-10 wheelbarrows of dirt and screened out the the larger rocks as I attempt to prepare to pour the footings for the south planters/wall – the last walls to build!
Pictures! Cars parked on the curb prevented a good angle on this part:
Over on the south property line, we got some digging to do:
Rained Saturday through Monday, so had to mostly lay off. Did get a little more digging in before it got too wet. So, if it dries out enough, will work on this some more this evening.
My Beloved planted irises in one of the front planters:
They are very beautiful, a lovely deep blue with yellow highlights. They brought to mind Don at zoopraxiscope, who grows and takes beautiful pictures of flowers. So, if you want to see good pictures of beautiful flowers by a guy who knows his way around a camera and can tell one kind of flower from another (I’m always getting my jasmine and honeysuckle mixed up. Among others.) check his site out. Me, I’m more a tomato and fruit guy.
Future bulletins as events warrant, or when I fell like it and remember to take some pictures. Maybe at the end of the summer, if all progresses well, I’ll do a video walkthrough?
Breaking my goal of radio silence on the current viral kerfuffle to note a couple developments:
That last post, in which I tried to simply summarize the current state of the data being used to fan the panic, and make a few calm, reasonable conclusions, blew up this humble blog, thanks to a link on Instapundit by Sarah Hoyt (who reads this blog!?! Wow.), and subsequent links by some other people. Got a year’s worth of traffic over about 36 hours. A lovely discussion was engendered in the combox. Thanks to all who participated.
Got told I was virtue signalling. By analyzing the numbers? I guess? And to whom would I be signaling, exactly?
While I did spend a little longer than usual on that post, getting some links and trying for a less impressionistic logical structure, I’m still not entirely happy with it. It could be better. That’s what the following post is. I didn’t put in all the links this time.
Italy seems to have clearly turned the corner. The sawtoothiness (I insist that’s a real word) of the numbers in the US still leave things in doubt, but, if I’m right, we should see a serious downturn in deaths within 3 weeks, probably sooner. (Note: when I say ‘if I’m right’ I’m just one guy looking at numbers and history, helped essentially by the likes of William Briggs and Malcolm the Cynic, and others reporting from the field. I hasten to add that any errors are all mine, but these and others pointed me in the direction of interesting stuff.
How likely am I or someone I love to get infected with the coronavirus, to get sick, or to die? How bad is this thing?
Spoiler: looking at the numbers, at history, and using common sense, the answers are: Not very, very unlikely, vanishingly unlikely. You probably won’t catch the virus; if you did, you almost certainly will either not get sick at all (about 50% of the time) or get sick very little (about 48.75% of the time). If you were healthy before getting the virus, chances are near 100% that you will not get very sick and you will not die from it.
Near 100% means there will be exceptions, but that these exceptions, added together, are a tiny percentage of total deaths, in the ballpark with ‘get eaten by a shark’. Certainly, every death is a tragedy. We live with potential and actual tragedy every day, and take precautions based on how bad we think the risk is. Most of us look both ways before crossing the street, but few of us wear a helmet in case we get hit by a meteorite. There’s risk here, as everywhere.
This is what the data says, intelligently understood. Judging by almost everything you read or hear, people certainly don’t understand any of this.
Let’s start with deaths. The key steps:
Your likelihood of dying of COVID 19 or any other disease if you were to catch it is: the number of people who die from the disease divided by the number of people who catch the disease. You must grasp this simple fact before you go on.
the Case Fatality Rate (CFR) is NOT your likelihood of dying if you catch the disease. That is simply not how it is defined. The CFR is: the number of death certificates listing COVID 19 divided by the number of diagnosed cases of COVID 19.
The two components of the CFR do not correspond to the two components of the formula for your likelihood of dying:
the number of death certificates listing COVID 19 would include, for example, a man in England diagnosed with COVID 19 who gets hit a lorry crossing the street; an 85 year old woman in Italy with lung cancer if she is suspected of having COVID 19, a seriously ill American given 2 weeks to live who catches COVID 19 and dies. Each nation and sometimes areas within nations have rules about what must be included on death certificates; it’s not consistent, but strongly tends to overstate COVID 19 as a cause of death. One Italian doctor said that the virus was a significant cause of death in at most 11-12% of such cases.
the number of diagnosed cases of COVID 19 includes only people who were infected AND went to the doctor. 95% of cases have minor symptoms that look a lot like a cold or a flu; some large percentage of people don’t go to the doctor for that level of sickness. Such people don’t show up in case count. Then, 50% of infections are asymptomatic – no symptoms at all.
Thus, the CFR includes too many deaths and too few infections to be an accurate gauge of your or my or anyone’s risk of dying from COVID 19.
Let’s plug in a few numbers, just to put a stake in the ground to argue about: say only half of the people with minor symptoms go to the doctor. Half going to the doctor seems high to me, because I’m not going to see the doctor for sniffles, achiness and a low fever – I’m popping a couple Tylenol and going back to bed to sleep it off. But maybe that’s just me. So let’s use half. This means we can effectively double the number of cases, since these slightly sick ones make up 95% of the total cases. In other words, if 100 people with minor symptoms go to the doctor, we’re assuming for the sake of argument 100 more are sleeping it off or taking Dayquil and muscling through it. So, in this example, there are 200 infected people but only 100 cases.
Applying this to the world, at the moment there are about 1.3 million cases – so, to start, just to allow for people who don’t run to the doctor with minor cold or flu-like symptoms, we will double that number to 2.6 million people.
Next, we notice that 50% of infections are asymptomatic. We know this because in a couple places – Iceland, Israel – authorities have tried to do broad testing, not just testing people who are sick, and found that half the positive test results are from people who aren’t sick. Therefore, for our 200 people who are sick, there are likely another 200 people who are infected but are not sick. So, we can double the number of infected worldwide again, from 2.6 million to 5.2 million. That becomes our baseline number for infected people.
Next, about 73, 000 people have died and have COVID 19 listed on their death certificate as I’m typing this. But we know in some cases, COVID 19 is not the cause of death (England, where the law requires COVID 19 to be listed on the death certificate regardless of whether it had anything to do with the death or not), and suspect it’s not the main cause in most of the others – that’s what saying it overwhelmingly affects vulnerable populations boils down to in plain English: it won’t kill y0u unless you’re already sick. Let’s use the Italian doctor’s high end: in 12% of these deaths, COVID 19 played a significant part in killing the person. Note that this is what normal people really mean: when grandma is fighting cancer and catches a cold and dies, we don’t blame the cold. We all know that, if she didn’t have cancer, the cold probably wouldn’t have killed her. All we’re doing here is applying that common sense thinking.
So, 12% of 73,000 is 8,760. That’s how many people have been killed by the COVID 19 virus. Note that if we limited this number to vigorous, healthy people who came down with virus and died, we’d be talking double-digits. That’s what the numbers say. But we’re including people here who, in the opinion of that Italian doctor, might not have died, at least not as soon, if they hadn’t caught the bug.
Grand finale: the number of people who have been killed by the virus according to a common-sense understanding of what that phrase means: 8,760. A reasonable estimate of the number of people infected: 5.2 million. To determine death rate, divide the first number by the second number: I get here an estimated death rate from COVID 19 of 0.17%. Not the 4.5% CFR that is commonly tossed around, which is about 25 times too high; not 2.5% in the US which would be a 1-in 40 chance of dying if you got the bug, but 0.17% – or less than a 1-in-500 chance.
You should be able to see that the same logic drives the possibility you will get seriously ill (and run the risk of permanent lung damage) if you catch the virus way, way down. Not very likely, roughly the same as your chance of dying of it.
Note: This is just one educated pass at making more sense out of the official numbers based on the definitions of those numbers. If you don’t like the way I adjusted the numbers, say why it’s wrong, and offer an alternative. Just don’t foist off the CFR as if it’s somehow a purer or better number. It most certainly is not. Numbers of infected will ALWAYS be an estimate, unless we test everybody in the world – not practical. Cause of death will often be a judgement call on the part of the doctor or coroner, so these numbers, both the ‘official’ counts and my adjusted totals, will contain a lot of slop. The point here is that using the CFR as if it represented the real risk of dying is ignorant and irresponsible. It is sloppiness by most people, and criminal fearmongering by those who should know better.
How about the risk of coming down with COVID 19? We’re told it’s spreading out of control! People who not only could not factor a simply binomial equation, but don’t even know what the terms mean, are sure the virus is spreading ‘exponentially’, and that that is very bad thing, that it means we’re all going to die, more or less.
But that doesn’t seem to be what’s happening:
Italy, specifically, Lombardy, has been the poster child for The End of the World as We Know It. Here’s what cases and deaths there look like today:
New cases are tricky: they are functions of how much testing is going on and what qualifies as a case (a moving target, as mentioned in the last post) at least as much as how much the disease is spreading. Deaths, while morbid by definition, are somewhat more binary:
In Italy, a nation with a notorious track record of not dealing with even the common flu very well, the explosive ‘exponential’ curve up and died. The politicians are already patting themselves of the back, setting us up to be saved from the next tragedy solely by their expert intervention. But Spring has also sprung – all that sunlight (and UV) and warmth are hell on viruses, so maybe it’s not the political action, or not entirely. Also, once the virus runs through the nursing homes and hospitals – notorious disease vectors, and site of most of the deaths – crassly culling the weak, the survivors are more likely to be resistant. So now the virus has to get out in the sun and infect healthy people – it doesn’t seem to be very good at that. Most viruses aren’t.
The same is happening elsewhere now. The US is a week, maybe two, out from the same factors causing a collapse of cases and deaths – and from politicians patting themselves on the back for making ‘hard choices’ for all of us, like deciding the less affluent don’t need jobs, and retired people need a lot less money in their mutual funds.
So, no, you’re almost certainly not going to get COVID 19. So far, about 0.07% of the world’s population, using my adjusted numbers for many more infections than cases, has gotten it. That’s less than 1 out of every thousand people. For comparison, you are about 10 times more likely to catch malaria, which kills at least 750,000 people a year, than coronavirus.
But it could come back! So could the Black Death. Yes, viruses mutate, sometimes – rarely – into more virulent forms. Is that likely? Any more for the coronavirus than any other virus? In its current forms, the evidence is that it’s done for; it might make a resurgence in the fall – that sometimes happens – but worrying about that isn’t going to make anything better, and, as shown above, it likely won’t be that big a deal if it does.
Unless there is a reason to think it different, history – what has actually happened to viral infections in the past – would say: the coronavirus will die out once spring is in full gear.
Bits of the following have appeared in the past couple posts on this current coronavirus kerfuffle; for clarity and reference sake, thought I’d put them all in one place. Nothing original here, just compiling the information in one key place.
I plan to stop posting on this for the next 2-3 weeks, at which time it should be clear if I’m wrong or if I’m right. I will then crow/eat crow, depending.
Data or ‘Facts’
Before one can start talking about numbers, what exactly one is counting should be spelled out. This is called ‘being reasonable’ or ‘the scientific method.’ Note that all the dreadful numbers, death rates, how fast the virus is spreading, how infectious and deadly it is, all hinge on these few numbers. Knowing how they are created and measured is therefore critical to understanding what is going on.
Infected: Ideally, we should only count a person as infected if they have been tested for the infection at least twice. The unknown but almost certainly high number of false positives makes testing only once imprudent.
Of the 712 passengers and crew members of the ship who tested positive for coronavirus, 331 — or 46.5% — were asymptomatic at the time of testing, the CDC said.The agency said that the high rate of asymptomatic infections could partly explain the high rate of infection among cruise ship passengers and crew.
Point #1: Keep in mind that nobody knows how many people are infected, since asymptomatic people will never get tested except in somewhat unusual circumstances, and that it’s possible half or more of the people infected never get sick. The numbers of infected you hear or read are the outputs of models – not data – or otherwise pulled out of thin air.
Cases: Again, ideally, a case of COVID 19 infection should mean a situation where a person was tested at least twice and found to have the infection.
On Feb. 12, the national health committee announced that it was changing the way cases were counted in Hubei province. People with symptoms of the disease and with evidence of pneumonia on a CT scan but who had not been tested for presence of the virus — in other words, people who had a clinical diagnosis — would be added to the list of cases.
That day, the country reported a massive increase in cases — over 15,000. But since then, the daily numbers have tumbled. On Wednesday, China announced it was reverting to reporting laboratory-confirmed cases only. When the National Health Committee issued its update for Wednesday, it reported a net increase of only 394 cases — the first time in weeks the daily case increase was under 1,000 cases.
That was then; now, in every country around the world, we have some largely unknown number of ‘unconfirmed cases’ – still counted as cases, but not confirmed by tests.
When diagnosis is based on symptoms, plus sometimes on travel and contact history, things get more and more uncertain: someone who has typical cold symptoms but has a friend who recently came back from a trip to China might become an ‘unconfirmed case’ and then, depending on the availability of tests, might not get tested right away. And that’s in First World countries.
These symptoms are common to colds, flus, pneumonia, and probably more diseases.
Point #2: What a case *is* is not clearly defined, and is different over time and from country to country. Most important, cases are NOT equal to infections. Many, many more people may be infected than show up in case counts, however defined. DO NOT CONFUSE CASES WITH NUMBER OF PEOPLE INFECTED.
Deaths: Ideally, what we want to know is if COVID 19 killed somebody. Such a determination is clear, or as clear as it is likely to get, when a healthy person tests positive for the virus, and dies of respiratory failure after having progressed through some or all of the less serious symptoms.
Such cases are remarkably rare. Instead, we have COVID 19 deaths almost entirely restricted to vulnerable populations, people who have underlying health issues, including, especially, the overall weakness and infirmities associated with advanced age.
As in cases, it seems what constitutes a COVID 19 death may vary from country to country, and does not correspond to what a layman thinks when he hears ‘died of COVID 19’. Here’s how it is done in England:
Lee explains that in the U.K. if someone dies of a respiratory infection, the specific cause of that infection is not usually noted unless it is identified as a rare “notifiable disease,” not seasonal infections, like the flu.
“So the vast majority of respiratory deaths in the UK are recorded as bronchopneumonia, pneumonia, old age or a similar designation,” writes Lee. “We don’t really test for flu, or other seasonal infections. If the patient has, say, cancer, motor neurone disease or another serious disease, this will be recorded as the cause of death, even if the final illness was a respiratory infection.” The result, he says, is that U.K. certifications “normally under-record deaths due to respiratory infections.”
But COVID-19 is now included in the updated list of “notifiable diseases,” Lee explains. “That means every positive test for COVID-19 must be notified, in a way that it just would not be for flu or most other infections.” If any patient dies after having tested positive for COVID-19, “staff will have to record the COVID-19 designation on the death certificate — contrary to usual practice for most infections of this kind.” That might give COVID-19 “the appearance of it causing an increasing numbers of deaths, whether this is true or not,” writes Lee. (Read Lee’s op-ed here.)
Similar practices, or practices with the same result of over reporting deaths, seem to prevail elsewhere around the world. New guidelines for the US on how to fill out the cause of death on death certificates were released just yesterday. Minnesota Public Radio says “But new guidelines from the National Center for Health Statistics, which Minnesota follows, will err on the side of pinning more deaths on COVID-19, at least provisionally.”
Point #3: What the medical reporting means by a COVID 19 death is not what we commoners mean by it. As reported, a ‘death’ means ‘died while infected with COVID 19’ not ‘died OF a COVID 19 infection.’
Numbers and Percentages
The first thing to note, and the thing to keep in mind, is the vast amount of uncertainty in all this. We don’t know, and are very unlikely to ever know, how many people are infected with this virus. The number of cases can, and repeatedly has, shifted as the definition of what constitutes a ‘case’ has shifted. Deaths are in the same boat: Yesterday, for example, France added 884 deaths from some unknown number of cases in nursing homes, since they had not been counting deaths and, presumably, cases, from all their nursing homes up to that point. So, a major locus of coronavirus deaths – nursing homes, full of precisely the most vulnerable population – is not (they’re still counting it up) accurately included in the reported totals.
It would beggar belief to think France’s counting issues are unique or even rare.
Let’s revisit the key numbers:
How many people are or have been infected with the coronavirus so far? What is the peak likely to be? The honest if uncomfortable answer is: nobody knows. Yet, all sorts of numbers, ratios, and percentages that include some guestimate of the number of infected people get tossed out as if they are facts, or at least, strong enough guesses that policymakers are urged to impose martial law and cripple the economy based on them. One such estimate, as discussed here, was that 200 million Americans would get infected over the next 200 days. Baked into this number is the assumption that 100% of people are susceptible to infection.
Are we? On the Diamond Princess, only 18% of the people on board got infected; in Iceland, only about 6% got infected. These are places where something like a population was tested; all the national numbers you hear, like Italy’s or China’s, are almost entirely based on tests administered to a tiny subset of people with symptoms or with exposure to people with symptoms. We would expect much higher infections rates as determined by tests when all your test subjects are only people who you have good reason to think have the disease.
So, assuming 200 million infected people in the US, 60% of the population, is ridiculous. Then, applying a death rate based on one subset of cases, the author projects 11 million deaths. This scary scenario is created by applying a ratio of deaths to cases to a projection of number of infections pulled out of a hat. For about a week, this number – 11 million dead Americans if we don’t act now! – was treated as Gospel; then it became more like 500,000 dead Americans, despite actions being taken not nearly as drastically nor as quickly as demanded. Now? I’m still hearing numbers in the neighborhood of 250,000. Do not be surprised if the worse case numbers bandied about fall under 100,000, or, as I like to say, bad flu season level, over the next 2-3 weeks as Spring kicks into gear. We will pretend, often willingly, that we didn’t wildly overreact based on 11 million dead! and that we only had, say, 50,000 dead because we took such admirable, if extreme, actions as fast as we did.
We keep hearing about outrageous and terrifying death rates from COVID 19 infections: 4.5% in China, 11% in Italy, even 2.5% here in the US. Rarely do we hear it discussed that these are *CASE* fatality rates (CFR) NOT the percentage of people infected with the virus who die from it. The CFR DOES NOT represent our risk of dying if we catch the virus; rather, it expresses the risk of someone identified as a case having COVID 19 show up on his death certificate. That risk is much higher than your or my risk of dying from COVID 19.
To get some idea of our real risk of death from COVID 19, we’d need a better estimate of the number of people infected versus the number of cases. Then, we’d want to reduce the number of deaths to include only those where COVID 19 was the primary cause of death. Then, we’d have a number – inescapably, an estimate – that says how risky this whole plague is to the average Joe.
Can we do this? At least, get closer to reality than the CFR? All is not hopeless: we can, over time, refine our guess by intelligently comparing them to reality, or at least to much harder numbers.
Let’s start with the asymptomatic cases: about 50% of those who test positive in the general population (as in Iceland) for the virus show no symptoms. Applying this knowledge to the cases numbers means we can double the number of cases: if as many people who are infected show no symptoms as do show symptoms, and asymptomatic people are very unlikely to get tested and therefore show up as ‘cases’, that means there are (at least – more to come) twice as many infections as cases.
Next, the vast majority of cases show only mild symptoms:
Mild symptoms are largely indistinguishable from common cold or flu symptoms, as we saw above. So, how many people go to the doctor when they have the sniffles or a low fever? Compared to how many people just pop a couple of Advil, call in sick and climb back into bed? Or even take some Dayquil and go to work? Now, imagine you are a member of a less affluent society than ours: do you go to the doctor for what looks like the common flu?
So I would suggest that at least as many infected people with mild symptoms don’t end up as cases as do. This would push our infected estimate up to 4 times the number of cases, under the assumption that there are as many asymptomatic infections as symptomatic ones. This cut our real death rate to 1/4 of the CFR, or from 2.5% to 0.6% in the US.
(This also means only 1.25% – that’s 1/4 of 5% – of people infected with the virus end up with serious symptoms. 98.75% have mild or no symptoms.)
But that’s still not enough, again according to Dr. Lee cited above (He’s using British numbers for a couple weeks ago):
Also, we’re only dealing with those COVID-19 cases that have made people sick enough or worried enough to get tested. There will be many more unaware that they have the virus, with either no symptoms, or mild ones.
That’s why, when Britain had 590 diagnosed cases, Sir Patrick Vallance, the government’s chief scientific adviser, suggested that the real figure was probably between 5,000 and 10,000 cases, 10 to 20 times higher. If he’s right, the headline death rate due to this virus is likely to be 10 to 20 times lower, say 0.25 percent to 0.5 percent. That puts the COVID-19 mortality rate in the range associated with infections like flu.
If Sir Patrick is even a little correct, and we’re only off around one order of magnitude, real death rate will be 10% of the CDR – 0.25% in the US, well within common flu range.
And this counts everyone with COVID 19 on their death certificate! Which means we’d need to push that number down some more. How much? I’ve heard estimates of as little as 11-12% of of official COVID 19 deaths where the viral infection caused or seriously contributed to death, but alas, I can’t find the reference now. The point remains: given all the other uncertainty and out and out misrepresentations of the numbers, even if the reporting inconsistency is small, COVID 19 remains, at worst, a little more deadly than a routine flu.
But what about…
“1 out of every 6 people infected with COVID 19 get permanent lung damage.“
You mean, one out 6 of the 1.25% of people with a coronavirus infection who show serious symptoms? Surely this can’t mean that 1 out of 6 asymptomatic people – that’s 1/2, remember – suffer such damage? When? Without any symptoms? Or even that 1 out of every 6 people with mild symptoms? Their mild symptoms end up causing serious lung damage?
If this claim is, as I suspect it is, based on people with serious symptoms, 1 out of 6 our of 1.25% would be 1 out of every 500 people infected with the virus. We’re getting into ‘killed by a tornado’ levels of unlikelihood. I’d like to see the details of this claim – 5 minutes of web searching pulled up nothing.
Did you know NYC was home to the #WuhanStrong movement right before the outbreak got bad, where people were encouraged to hug and otherwise fraternize with those who had recently been to or come from China, in order to prove they were not evil raaacists like the Orange Man? This might figure into their problems.
In general, all healthcare everywhere makes capacity trade-offs. No one can afford to build and staff a hospital such that no emergency will ever catch them underprepared. They take an educated guess at what they’ll need, adjust it by what they can afford, try to coordinate with surrounding systmes, and hope for the best. And then, hey screw it up, because they are human. A local example: we in California know it is almost certainly just a matter of time before the next big earthquake or ARkStorm. You think our healthcare system could handle that? I’ll spare you the suspense: no, it could not. BUT – there’s no way our healthcare system could be maintained for years on end with the sort of capacity such disasters would demand. So they do what they can, and hope for the best.
The red line is 1, meaning a linear type increase. The current trend, if you can even claim to make it out, seems pretty flat, with occasional dips below the line. What is clear is a lack of any clear exponential explosion.
Check back in 2-3 weeks. If this virus acts like a typical air- and surface-borne virus, sunshine and nice weather will be the end of it (with a possible reprise in the fall). But, while it is tragic when people die, you’d be a lot better off getting some exercise and cutting out some calories than in worrying yourself over this virus.
Of course, I could be wrong. I’m just a numbers guy. This thing could explode tomorrow, mutate into something really deadly, and kill us all. It just doesn’t look like it will, from the available evidence and history.
So, WHY is everybody panicking over this? WHY is dominating the news and causing us to commit economic seppuku? Those are very good questions.
So, assuming this is a trend and not a blip, looks like the virus is winding down in Lombardy. Spring is here, the sun – the best disinfectant – is out, so if COVID 19 is like typical viruses, it, too, will largely die off once it’s warm out. Let us hope so.
14,000 dead so far in Italy. If the shape of the curve is typical of what I’ve seen for outbreaks – more or less bell-shaped – maybe 30,000 COVID 19 deaths?
Then, add the forbidden data: many of these people would have died soon anyway. Victims are predominantly old and sick. I’m seeing 11-12% tossed around as the percentage of deaths attributed to COVID 19 where the viral infection was a significant factor. In other words, a large percentage of 80 years olds with serious medical conditions die every year; of the half a million or so Italian deaths each year, some disproportionately large percentage is old, sick people. This is the vulnerable population, which we seem to assume we can ‘save’. I’m all for washing your hands and staying away from grandma if you’re coughing or running a fever, but I don’t think I’m going to go to my grave wracked with guilt if my mother-in-law, 82, who lives with us, were to catch something nasty – a bad case of the flu, for example – and die. I’d be sad, but I’m rational enough to know that it’s the being 82 part, not the flu part, that played the larger role in such a hypothetical death.
With COVID 19, we’re not that rational.
Now I’m watching Spain, France, and Germany, which should be next up to peak; UK lags a little more. Data in these countries are mixed – no exponential rise in cases or deaths, but no clear drop yet, either. Deaths and new cases are both dropping in Iran. If you add China and the US, that’s all the countries in the world with over 2,000 deaths attributed to COVID 19.
US data is spiky. At the moment, we’ve had an apocalyptic 666 deaths today so far – day is based on GMT, so it is almost over – after a much more frightening 1,049 deaths yesterday. New cases are still trending upward, but at what looks to be a decreasing slope. Small data set theater warning. The general trend for daily deaths still looks upward, but with occasional drops, too. I’ll stick with my guess that in another 2 weeks, it should be clear that we’re on the downslope of this thing. Let us pray that’s the case.
All in all, I was overly optimistic when I said we might only end up with 5,000 total deaths; 10K is looking like a sure thing at this point. We may end up in the ballpark of Italy’s 30,000 dead, unless – and this is a real possibility, but not what history seem to show for viral infections – we have new major outbreaks in the warm sunny part of the year, which we are just now entering.
So I remain fairly confident we here in the US won’t see that 100K dead that was touted as the *minimum* even if we took actions more drastic and sooner than those that were in fact taken; baring a disaster-movie-worthy upswing in mortality, that 11M dead we were threatened with remains a fantasy.
But I’m just a numbers guy. Of course, I could be wrong.