Thanks! From the blog post linked there posted on January 23: "Our primary data source is DXY, an online platform run by members of the Chinese medical community, which aggregates local media and government reports to provide COVID-19 cumulative case totals in near real-time at the province level in China and country level otherwise."
I'd surmise that it was the primary source since, at the time, the spread of the virus was still contained within China for the most part.
According to NYT, over 10x that number are self-quarantined in NYC alone [1].
Now it's technically true that those cases aren't medically 100% factually confirmed, because NYC has only performed 35 tests total so far. But it gives a very inaccurate picture of reality. Garbage in, garbage out.
This dashboard is not intended to visualize computed estimates from models. It tracks the official confirmed cases, which is a very different and useful piece of data.
You are unfair by stating it is garbage and misrepresenting what it shows (confirmed cases vs. estimated cases).
The WHO fact-finding mission to China reported that they ran 350,000 tests in the province of Guangdong alone (though it must be noted that its population is 110 million) ...
It's not just Oregon; that's just a number I saw this morning in the local paper, but I suspect it's similar everywhere. The US did not use the advance warning we had to prepare.
Georgia, with 50 tests/day and 10,000,000 people is at 0.005 per 1K people.
Oregon, with 40 tests/day and 4,200,000 people, is at 0.0095 per 1K people.
Italy, with about 2500 tests/day and about 60,000,000 people, is doing around 0.04 per thousand people. It's about an order of magnitude more.
The point isn't a pissing match between states, it's that the entire US has not responded well so far. Hopefully things ramp up, so that we stop seeing these situations where people get exposed and have no idea what's going on.
The fact that Georgia and Oregon are testing at virtually equivalent rates is what's wrong.
I feel like ~50/day is an appropriate number for GA. I feel like ~50/day is not an appropriate number for Oregon (sandwiched in-between Washington and California).
The federal goverent should be doing a stronger job of quarterbacking this to allocate scarce resources.
If Oregon needs surge capacity of testing labs across the Midwest, then by god make that happen.
Some amount of testing likely needs to happen in every state in order to prevent panic, but the most resources should flow towards the places with the most known infections.
Yesterday, I read the US had 100 confirmed cases, and had tested 500 people.
Trump fired the a big part of the CDC that deals with pandemics back in 2018 and hasn’t replaced them. I don’t think the US government will make any serious effort to contain it, despite the recent theatrics from congress.
Not testing sick people will inflate the official mortality rate. If the disease hits 70% of the population (projection from yesterday), there will be more panic than there should be. Last I heard, WHO (poor testing on average) estimated 3.4%, but in areas with thorough testing, it looks closer to 0.6%.
I've seen comparisons like that doing the rounds. They're just plain wrong. The 500 number is the number of patients that had been tested by the CDC about a week ago, excluding state and local labs, whereas the 100 confirmed cases is a newer figure and a lot of those cases were diagnosed by the very state and local lab tests that aren't being counted. From looking at an old version of the CDC web page, at the point when diagnosed cases hit 100 the CDC alone had tested about 1,500 patients. At one point the CDC pulled the number of tests from their web page to try and stop people making this error, but everyone just started comparing the old and increasingly outdated number from before they did this to the number of confirmed cases in the latest news headlines.
The stuff blaming it on Trump firing the part of the CDC that deals with pandemics is untrue too. (Though sadly, the testing might have rolled out more smoothly if he had culled the CDC a bit... their in-house facilities seem to have really screwed things up.)
If I fired my team of system security engineers, then a data breach was discovered, and great harm came to my company because there was no one there familiar enough with the system to know what to do, you'd probably think it was my fault. Ya know, because I did piss poor risk management. And did not conduct due diligence with risk analysis. Especially if my company had more than enough funding to have them there... Because data breaches don't happen often, but they are BAD NEWS when they do; there's a good reason that job exists.
The CDC stopped posting the numbers of tests they'd run a few days back. I don't know if they started again. It's not confidence inspiring.
I don't know if this has anything at all to do with firing the pandemic team, but you have to figure that didn't help, either.
Any administration has a lot of competent career professionals working for them. Events like this are the time to let them do their thing without hindrance, and without random commentary from uninformed leaders.
You are right but unfortunately almost everyone calculates the mortality rate based on confirmed cases alone, and that leads to a gross over-estimation of the dangerosity of this virus. So these visualisations are still kind of misleading in a way.
I am not sure. Looking at the CDC website [1], it looks like they extrapolate cases for the flu. They seem to estimate that roughly half of the people contaminated with the flu do not see a doctor (I would have guessed the numbers would be even lower, I had the flu a couple of times, it didn't even cross my mind to see a doctor).
I don't agree. The sample is not representative of the whole. The only useful inference is a lower bound on how many cases there are, but this is more likely to mislead that inform.
If you know that officially confirmed cases don't reflect reality, and you care about reality, then the dashboard is not useful.
According to this estimate[0] based on viral mutations, there were 600 cases in Seattle on March 4th. That puts the multiplier at about 20x cases per confirmed case. With an estimated doubling time of 7 days[1], that's about one month worth of spreading.
(Disclaimer: all numbers approximate, high uncertainty everywhere.)
Why is it inaccurate to state the number of confirmed cases, over reporting the number of self-quarantined? If I go to the hospital w/ flu-like symptoms and they tell me to stay at home just to be safe and it turns out I just got another disease, do I count towards the self-quarantine numbers? Does my family? If I work from home by choice to avoid exposure to public places, does it count? Does the number track compliance rates? Are we really getting accurate meaningful data from that measurement or are we feeding a bias towards alarmism?
It's inaccurate because the US is not testing people with symptoms who certainly would have been tested in other countries.
South Korea has performed over 100,000 tests. NYC has performed ~ 35. [1]
I'm really curious what possible reason there could be for that. Regardless, there is no reason to believe "tested cases" is going to give a remotely accurate picture of "actual cases."
> I'm really curious what possible reason there could be for that.
It's right in the page you linked:
> If you are experiencing fever, cough or shortness of breath, and traveled to an area where COVID-19 is spreading, call or go to your health care provider. Your provider will work with the Health Department to determine if you need COVID-19 testing.
Right now, the city is only testing symptomatic people that have been outside the country recently to one of the five nations with widespread cases, and people in direct contact with confirmed cases in the city. It's a (possibly too) conservative rationale, but it is a rationale.
You can't realistically track "actual cases" accurately anyways. For example, people might not go to the hospital. This is a well known challenge with population estimation e.g. domestic violence numbers)
What you seem to be getting at is that a) this chart doesn't display the total number of tested cases and b) external reports of number of tested cases point to very low number of tests in the US
But that's not a reporting problem, it's a risk/cost analysis problem by the part of the responders. Yes, you could in theory test everyone in the country every two weeks, but it would arguably be very wasteful and impractical to do so, so CDC/hospitals/etc need to figure out what is the right balance as the epidemic unfolds. Whether they are doing a good job is indeed debatable, I agree.
This is just a straw man. No one is suggesting that they test everyone in the US, but at the level that epidemiologists and the WHO says is absolutely necessary to understand and respond to the spread of the disease.
That they’re not doing testing at anywhere near the necessary levels, while countries like South Korea are, is not “debatable,” but evidence of their failure.
Also your supposition about tracking actual cases is false. Singapore has significantly curbed the spread of the disease by doing extensive contract traces, testing, and quarantines.
It's not a straw man, the spectrum goes from no testing to testing everyone, and _measuring_ "actual cases" accurately (especially after community transmission stage) requires one to be on the latter end of the spectrum. I did say that it's unrealistic to go that far, and you're right that more aggressive testing will obviously lead to better visibility. My point merely was that the rationale for not ramping up testing to the wazoo could be attributed to risk/cost analysis. Incidentally, that might even explain why Singapore with a population half the size of Wuhan's would be able to respond more elastically than the US with a ~300M population and high levels of bureaucracy and government fragmentation.
Btw, I should clarify that when I said the word "debatable", I was using an euphemism.
What is this evidence of this “risk/cost analysis” you keep alluding to? Frontline staff are describing dangerous, chaotic circumstances in hospitals because testing is being delayed:
If the US isn’t deploying anywhere near the response of countries with demonstrably curbed spreads in places like Seattle and California, what do you think, explicitly, justifies this? You can’t keep appealing to some greater wisdom without providing some concrete example of it.
I'm not comparing what one country is doing in relation to others. I'm saying that the CDC has their own criteria of what cases qualify for tests. They're not going just wake up one morning and say "yep let's ramp up to 300M test kits because people in the web are up in arms", that's not how it works. They look at the data they have then decide what to do. That's what risk/cost analysis is.
What you seem to be missing from my point is that things take time to do and larger bureaucratic institutions move slower. While the CDC hasn't formally stated the reasons for delays in test ramp up, it's entirely plausible that they're slow to update their analyses, recommendations and action plans because of broken telephones/bureaucracy/politics/etc. If, as the rumors go, the CDC arm needs money to make test kits but the president says "nah can't be that bad", then yeah you can bet things are gonna move very slow.
With all this said, I'm not sure why you are using the word "justify", as if the involved parties are naughty kids to be spanked. I'm not very interested in armchair judgment.
It comes down to the fact that the US is not testing enough people to make ANY sort of assessment, other than that COVID-19 exists here. In South Korea, they have tested enough of their population to make reasonable, even statistically accurate extrapolations. In the US, we may as well not be testing. It does no good at the rate we are doing it. The CDC done fucked up with their initial testing policy, which was likely chosen because they knew that the number of testing kits would bottleneck them to only testing world travellers. This was likely caused by a lack of funding and infrastructure (staff), which is quite clearly caused by our president deciding to fire the people who know how to handle pandemics.
This is almost certainly getting cause and effect backwards. That is, South Korea has been testing a large number of people because there were a large number of likely cases to test, mainly due to that one cult inadvertantly spreading the coronavirus to so many people. You can see this in the number of tests that turn out positive: it's hovering somewhere around 4% in South Korea and slowly dropping now they've got through the really likely targets, but was in the high single digits earlier. Back when the CDC was only testing the most likely cases, their number was around 3%. A lot of the media reporting on this is dubious and might lead people to believe that the US had South Korea-level numbers all along and just wasn't spotting them due to not testing, but that's unlikely.
And yet that's not what you insinuated. There were no cuts no matter how you characterize it-your source confirms that. Certainly no "reaping" what was "sowed".
You'll read of the hundreds of 'confirmed' and 'probsble' cases and dire warnings and the like.
Then, when the dust settles and years pass, the CDC reluctantly admits the following:
------
In the United States, only eight people had laboratory evidence of SARS-CoV infection. All of these people had traveled to other parts of the world where SARS was spreading. SARS did not spread more widely in the community in the United States.
https://www.cdc.gov/sars/about/fs-sars.html#outbreak
----
The market and the current administration both benefit from a low count of confirmed cases. The administration has already been criticized for repeatedly attempting to slash the CDC budget[1] and terminating the epidemic response team[2]. Trump also keeps attempting to downplay the severity of the virus so it would not be a good look if the true spread of the disease was widely known. Knowledge of the spread would also probably trigger more panic selling in the markets which the current administration also tries to avoid as much as possible.
That just doesn’t make sense to me. Uncontained, this disease will grow exponentially until tens of millions are infected at once, and it eventually burns itself out. But by then, the disaster will be obvious and we will have the same result. Only with more casualties.
Certainly anyone who had that sort of ulterior motive would understand this.
I predict Trump administration will underreport the numbers and use the courts to hold up transparency reports and audits until after the election.
They’re already refusing to test people, and I’m guessing they’ll start to blame the flu and/or fake news at some point.
They’ll probably somehow exceed my expectations, and come up with even more cynical tactics than this. For instance, I’ve seen users in other forums blame liberal china lovers for bringing the disease to the US. I wonder if they’re paid trolls or not.
In Seattle, there are not enough tests to test everyone diagnosed with the disease based on symptoms any more. So some patients are getting diagnosed with COVID-19, but if they are not in severe condition, they just get sent home without testing. These patients also don’t count toward the “confirmed” numbers.
No, people are instructed to self-quarantine merely for being exposed to an infected person. The large majority of those people are not expected to eventually test positive.
From my perspective, if (whoever is in charge) was really in the business of providing accurate numbers, they would test a statistical sample of these 2,300 people to estimate what percentage of them actually have the virus.
Here in Germany a little known tidbit is that the routine sampling system that is already in place to observe influenza has started to check for SARS-CoV-2 as well. It's only a sampling of people sick enough to visit a doctor (not whole population random sampling), but at least this sampling is not limited to people with a known infection path which would completely blindside you to community spread. I don't think that this has been running for long enough to already have meaningful results, but it will eventually put an end to flying blind. Given the value of discovering undiscovered clusters and getting better statistics I think that this is a much much better allocation of testing resources than checking the most likely candidates whom you'd want to quarantine anyways due to the likelihood of false negatives during incubation.
A very similar test allocation might also be running in America without anyone but a few experts taking notice. Here in Germany it has technically been on the news but it was completely drowned out by the pointless shouting match between "it cannot be worse than a cold" (because it would interfere with my precious vacation plans) and "our healthcare wouldbe just as overwhelmed as in Wuhan" (because, I don't know, maybe I'm just not racist enough to assume that it will somehow only be bad in China)
I think the CDC has been rolling SARS-CoV-2 testing out to the US influenza surveillance system. They actually tried to do this in mid-February but ran into problems with the testing kits. Obviously this would have left the US in a much better position to monitor it, though I doubt that'd stop wild theories about how it was everywhere spreading virally.
There are R0 and transmission probability estimates out there. If you sniff around I think you might find the study you're asking for. As usual, media outlets are not scientific, so if you want proactive understanding (as opposed to reactive reporting) you will need to follow the literature yourself. Too bad there is no news service for that.
I think that some of the science adjacent podcasts which provide in depth show note and literature analysis for people willing to pay 10/15 bucks a month are a step in that direction.
I agree that it's probably not a 100% accurate picture, but if you included in the "known cases" every single person who stayed home out of paranoia because they had a stuffy nose, then you'd have the opposite problem of numbers being bloated and overblown. The media is already chomping at the bit to sow fear and paranoia in exchange for views, I'm ok with looking at data with the understanding that it's probably underrepresented versus data that is probably just a complete guess. In an ideal world, yes, every single hospital would have thousands of test kits on hand to test everyone but we aren't there yet.
New York Times? Are they like world-class science researchers like John Hopkin Institute or are they just a bunch of shady journalists with a fantasy narrative that they desperately need to maintain?
At first I thought US numbers were ridiculously wrong out of poor accounting but it is becoming increasingly obvious there is a massive coverup from the top down of the administration.
They are likely waiting for tests to be privatized so then they can claim numbers can't be released because they are private.
Except deaths will be recorded, so this is going to backfire badly, ie. there will only be 1000 tests but 1000+ people will have died. The numbers are going to explode at some point, especially in Washington State
I really dislike these maps that use circles. The circles overlap, are hard to reason about spatially and the size seems to be an arbitrary scale without meaning.
Also only seems to show the cumulative counts, rather than the counts per day, per region, which makes it impossible to tell where the situation is improving or deteriorating.
If they had more detailed locations like at the city level, then a map would be far more useful. But since it's mostly just by country, then it actually gives off the wrong impression.
I wish they also separated European countries by subnational jurisdiction. In the US they do it by cities, surely they should be able to separate Italian provinces, French departments and German states. They are reported like that in the news.
I mention this because it's particularly northern Italy that's hard hit, not southern Italy. I am still planning on travelling to southern France (by car!) around Easter, and I kind of want a more precise map to know which areas to avoid.
(I also think travelling by car is a safer option, both for me and others around me. The plan is to stay at a house in the country, not a hotel.)
Unfortunately, those figures are aggregated by region, which covers a relatively large geographic area. I'm not sure whether more precise information is available somewhere else.
Only Korean levels of surveillance testing and Singaporean levels of contact tracing and quarantine have provided anything like an accurate picture of the disease’s progression.
Nowhere in Europe is taking these actions at comparable levels, so you’re not going to be able to assess risk using something like this map.
> I also think travelling by car is a safer option, both for me and others around me.
I thought about it because I'll need to drive a long drive in two days (across France). I'm taking throwaway gloves with me...
Inside the car I'll be fine (and people outside the car too) but...
A gas station has to be one of the riskiest place to catch the virus because you are forced to touch the gas pump. And that's the same for everybody who just filled his car. Same with electric chargers for EVs. Anyone with the virus would cough, while driving, and the virus would be on one of his hand. Then that person would fill the car. Then the virus would stay there for hours?
It's a combination of two things: a great many people passing there and all these people being forced to touch something hundreds of people recently touched too. Hence the throwaway gloves.
Not to mention that if anyone in a car has the virus, it's likely that the one driving may have it on its hands (even if he's not infected ?).
I'm very mindful not to touch anything outside the house unless when I'm buying groceries (but at the grocery store when I pick, say, a thuna can, hopefully there haven't been a hundred people touching that on thuna can in the last x hours). At the gas station I know I'll have no choice.
Gas stations are open air (high circulation) with only a small number of people present at a time. Wash/sanitize your hands after using the pump/buttons and there's not much reason to think it's dangerous.
Not throwaway gloves. Carry a pack of disinfecting wipes. Whenever you're about to touch a public surface (gas pump, handrail, door handle, elevator button, touchscreen...) wipe it first. That way you protect yourself, protect the people who come after you, your hands get disinfected many times a day, and anyone who sees you will pick up the idea.
> A gas station has to be one of the riskiest place to catch the virus
When talking about travelling options, the alternatives are trains and buses. In a train or bus station, the volume of people is several orders of magnitude larger, and you have to be in a confined space with many people for a long amount of time.
There is no risk zero option if you need to travel, but I agree with the original comment that travelling by car looks like the safest one.
I think you could get a paper towel and use that to cover your hand while you operate the gas pump. Or your sleeve. Yeah people might look at you like you’re paranoid. Tell them that only the paranoid survive.
Keep a bottle of hand sanitizer in your car. Possibly disinfectant wipes to sanitize your car’s surfaces frequently. Break the habit of flipping through your phone out in public, or start washing your phone frequently. When you touch public objects and then use your phone, your putting germs onto a glass surface where they can last for hours and studies show that phone screens get quite dirty.
Remember: the goal for the majority of people is to help slow the spread of this to protect the vulnerable. Good hygiene goes a long way.
SARS-CoV-2 has a viral envelope, which reduces the transmission possibility via objects[0]:
"The lipid bilayer envelope of these viruses is relatively sensitive to desiccation, heat, and detergents, therefore these viruses are easier to sterilize than non-enveloped viruses, have limited survival outside host environments, and typically must transfer directly from host to host."
This (https://ncov2019.live/map) started as the best, most (practically, conveniently) informative and updated "dashboard" I've found. It was posted to HN several times (where I discovered it), but underwent some curious changes over the last few days. Initially, it showed all known events and included links for additional information. Then, peculiarly, all the cases in Florida disappeared with no trace, and now the southern US seems to have been scrubbed of accounts.
It was produced mostly by a highschool student in WA.
This map seems effectively useless in the US, given absence of meaningful testing. Frontline nurses, treating COVID-19 patients, are having their tests stonewalled and delayed by the CDC:
The problem with wide scale testing is that it makes the CFR incomparable to seasonal flu or previous outbreaks. CFR is by definition deaths/confirmed cases. It's not a measure of infection lethality or mortality rate, even though that's what most of us think it is and what we're most curious about.
For crisis management and planning, you want a CFR that is comparable to something like the seasonal flu or previous outbreaks. "Confirmed" cases of respiratory illnesses are roughly equivalent to the number of people who present to a hospital with severe respiratory symptoms, minus the base rate. We don't go out and run an assay for any person suspected of having the flu, for example, especially not asymptomatic people. If you do that for SARS-CoV-2, the number of "confirmed" cases will sky rocket and the CFR will drop. But that lower CFR can't be meaningfully compared to anything else, and is pretty much useless except as a curiosity.
So it's understandable that the CDC isn't keen on widespread testing; it'll ruin the data, or at least ruin the characteristics of the data most important for crisis management. What matters now from a public health perspective is knowing whether SARS-CoV-2 is circulating. If you know it's circulating in an area, then you should just assume any respiratory illness is a SARS-CoV-2 and quarantine. Test if and only if it becomes severe and you need to know the cause for treatment.[1] You can calculate a more accurate and consistent CFR later by subtracting the base rate of presented respiratory infections from the outbreak rate.
Identifying a local outbreak does request testing, but the major problem there was a temporary problem with getting assay kits out. But going forward, it doesn't help to test people who aren't presenting with severe symptoms. At least, it doesn't help from an epidemiological perspective.
[1] However, SARS-CoV-2 causes primary viral pneumonia. By contrast, severe symptoms from seasonal flu are caused by secondary, bacterial pneumonia. There's not much that can be done for the former; for the latter you can prescribe antibiotics. So for severe cases it might just make sense to prescribe antibiotics, which would be benign for the viral infection (COVID-19) and even possibly a prophylactic for secondary bacterial pneumonia. In other words, in terms of treating a severely ill patient with a clear case of pneumonia, positive or negative COVID-19 identification might not provide any benefit.
Nothing about what the CDC is doing is “understandable.” They’re stonewalling and delaying frontline responders testing puts the healthcare system more at risk of being overwhelmed and we’ve already seen cases of large numbers of nursing staff having to be quarantined once retroactive exposure was determined.
There was also not a “temporary delay” with the kits, there is still nowhere near the necessary testing capacity and they’re throwing out absurd, false numbers like “1 million test kits” that then have to be walked back. And the whole absence of testing is because they rejected the WHO’s test kit and donations of them! We could have began testing immediately.
I’m not sure where you’re getting all this nonsense about the absence of testing being “good for the data”. Every epidemiologist I’ve seen is saying the exact opposite, e.g.:
Michael Mina, Asst Professor of Epidemiology & Immunology & physician @ Harvard School of Public Health/Medicine
> 1 in 6 positive samples in China were asymptomatic and choice was made to not report those. This information is crucial for epidemiological modeling and developing appropriate mitigating strategies. Reporting all positives as symptomatic or not should be standard reporting.
What value does knowing the total number of asymptomatic cases provide today? Such data is doubtlessly invaluable for studying the virus, but it's unnecessary today for managing the outbreak.
Yes, the data can help us more accurately estimate the rate of infections, but that'll take months or years to pin down to the precision that such fine-grained data promises. In the mean time, you can roughly determine the spread of impactful cases by the change in number of presentations of respiratory infections, just as we've done for decades.
You characterize what they're doing as stonewalling, but I'm charactering it as prioritizing. The biggest priority is collecting data on severe cases, and generally following established protocol to minimize unforced errors. The number of asymptomatic cases doesn't help you figure out how many ventilators you might need, at least not in a timely manner. The middle of an epidemic is not the time to revolutionize the practice and science of medicine. If you don't think things through carefully--i.e. the impact of false negatives and false positives of assay kits--you can easily fsck things up.
Researchers want data, but the primary concern right now is juggling medical resources and finding treatments. More data is not always helpful, especially data not directly relevant to the present task.
You're also assuming that hospitals and doctors are itching to run assay kits on every suspected case. Why, because some nurse's complaints went viral on social media? To out-do Singapore? Because "more data"? Doctors not interested in running millions of assay kits aren't going to be the ones complaining, not unless you forced them to run the tests. An assay result won't change the way you treat a patient with characteristic signs of a severe respiratory infection in the middle of a global SARS outbreak.
This is just a series of counterfactuals to everything that’s been reported and said is necessary by frontline healthcare staff, epidemiologists, and even the WHO.
You can keep making these evidence-free, self-justifying claims, but that’s the sum total of what they are.
You can’t even respond to an epidemiologist saying they’re necessary to put in place appropriate mitigating strategies without espousing straw men like “outdoing Singapore” or “one nurse going viral.”
I guess all these other doctors and nurses, describing chaos in California because of the lack of testing, are just trying to “go viral” too?
I personally also look at worldometer dashboard (as it usually gives source link for every count increase) from there and I find Hopkins dashboard to be lagging behind, on some countries for several days.
Deaths / Deaths + Recoveries gives a 5.7% death rate.
Obviously there are mild cases that are never diagnosed, but it seems if you get sick enough for a confirmed diagnosis, your risk is higher than generally reported.
10% of patients require ICU with mechanical ventilators. Yes, it skews to the older population, but that doesn't exclude younger people entirely.
The biggest challenge is we only have ~20 mechanical ventilators per 100k people[0]. That means our entire nation's capacity for mechanical ventiation (excluding overload from regional clusters) is consumed with just 200 infections per 100k - or 660k infections of the US's 330 million.
That doesn't account for baseline ICU/vent usage, which is estimated at at ~70% occupancy rate with 3 in 10 currently needing mechanical vents [1].
A fuzzy summary is 500k infections in the use will utilize all existing mechanical ventilators.
South Korea have been testing more people than anyone else - 10,000 per day, drive-in test centres, results in two hours. If you look at the South Korea numbers here (scroll down a bit) https://www.worldometers.info/coronavirus/ you see 43 deaths and 52 'serious/critical' cases from 6,593 confirmed cases, so about 0.75% for both categories. I'm hoping these South Korea numbers are giving us a more accurate picture of whats going on.
I am also waiting to see a study on the final serious/fatal case rate on the Diamond Princess. Since that was a heavily monitored population given a high standard of care it should be a good indicator of what western countries are in for. Since the ages of the passengers will be known, they can age-weight the statistics to better compare to the general population. 706 infected passengers is a reasonable sample size.
I think people just have to let go of the sense that these numbers are anything other than a snapshot in time. It's not like something gets written down in a book somewhere that the great Covid-19 of 2020 had a case fatality rate of 3.4 / 5.7 / whatever. It's just a ratio between a numerator and a denominator, and both of those numbers are changing at different rates as time passes, as testing increases, as containment practices change, etc.
This is only true if you assume the unresolved cases will resolve in the same ratio as the currently-resolved cases. This ratio has been dropping as more cases are diagnosed.
The problem here is, from what doctors seem to be saying, there's a massive amount of the population that has or has had COVID-19 and will never know - since the symptoms in an otherwise healthy adult are similar to the common Flu.
So that death rate is likely far, far lower than what it seems. The flu kills between 15-60k people in the US every year, and it's around 1% fatality rate (and nobody seems overly concerned about that).
Per CDC numbers [0], in the US the death rate of the flu for the 2018-19 season was roughly 0.1%, an order of magnitude lower than the number quoted above.
That's interesting! Thanks for the link. It only proves my point further. From your link, 34,200 people died from the Flu in the US last year - and not a single person is panicked about those numbers.
I think this is the difference between velocity and acceleration. Flu deaths are known and well studied. Our hospital system has the capacity to treat serious cases. There are existing public health initiatives around vaccination and education. The resources have been allotted and accounted for and flu deaths aren't expect to suddenly 10x or 20x.
This virus is an unknown. It is spreading worldwide very quickly and the growth rate is exponential. Within months, hundreds of millions could be infected without interventions. Today the number of dead is very small. If the virus were to become as common as the flu, it could make infectious disease the leading cause of death, more than heart disease or cancer. We still don't know what the long term health complications are or if you can be re-infected. The science will be in shortly, but in the mean time an abundance of caution would seem to be warranted. I will be washing my hands until then.
> and not a single person is panicked about those numbers.
That's for a very obvious reason. If 40 million people in the US get Covid, as with the flu, it will probably kill between 500k and 1m people.
That's unlikely to happen based on what we know so far. However if two million people get it, that will kill as many as the flu and produce ~200,000 ICU cases. That's far beyond what the US healthcare system can handle on top of routine circumstances.
Along with a drastically higher mortality rate, Covid also produces a far higher rate of ICU outcomes than flu does. It swamps healthcare systems, as we saw so dramatically in China.
> If 40 million people in the US get Covid, as with the flu, it will probably kill between 500k and 1m people.
This is a greatly, greatly exaggerated number based on incomplete reporting.
We cannot yet estimate the number of unconfirmed COVID-19 cases in the US. In healthy adults, the COVID-19 symptoms are no worse than the flu. The CDC uses projections to estimate the fatality rate of the flu every year, since actual hard stats are impossible to generate. Time will tell, but this so far seems nothing more than a media frenzy.
Does anyone remember the Swine Flu? How about the West Nile Virus? What was the outcome of those media frenzies? How'd it turn out for all the people hoarding toilet paper and water bottles back then?
> It swamps healthcare systems, as we saw so dramatically in China
I don't think it's even remotely relatable to the US healthcare system, and the general health of the US population.
In an exponentially increasing epidemic, there are 2 factors at work. One, like you say, is that there is an unknown number of undetected cases. The other is that there is a lag time between detection and resolution of up to 6 weeks. Comparing the known cases today to the resolved fatalities from several weeks ago doesn't work.
The undetected case issue can be addressed by intensively studying smaller populations and extrapolating to the general population. The Diamond Princess or other cases where every person in a defined population was tested and monitored would be a good place to start. The exponential growth issue can be solved with cohort analysis, group people by the date of their onset of symptoms and track the resolution for each group.
With a few more weeks of data we should start to see these studies, then we'll know just how serious this is.
Well sure, but we could say that exact thing about the common flu too.
If you're sick enough to go to the doctor and be diagnosed with the flu, there's likely an increased chance of it being fatal (in that your symptoms are extreme or you're already high-risk, ie. elderly or in poor health).
Otherwise, like most folks, you just get better on your own in a few days.
With the flu killing 10's of thousands every year, and nobody bats an eye... I'm not particularly concerned about COVID-19. It's mostly a media PR stunt at this point - designed to whip up fear and clicks. Swine Flu anyone?
A case fatality rate (CFR) is calculated based on confirmed cases. The CFR for the flu[1] or any other disease is roughly based on the number of people who present to the hospital and are diagnosed, with or without serological testing. Therefore, in places with drive-by testing the CFR will be artificially lower. Likewise, using total infected as the denominator makes it a totally useless figure for comparison.
Knowing that, it seems pretty clear that COVID-19 is more-or-less 10x deadlier[2] than seasonal influenza, as the CFR for seasonal flu is ~0.1-0.2%.
[1] It's a little more complicated with the flu because of underreporting. I guess elderly pneumonia is common enough that doctors don't always care why it developed. So apparently the CDC uses a more complex model (e.g. total number of pneumonia cases minus base rate, non-flu season cases). But what they're trying to estimate is the CFR, which is by definition deaths/confirmed.
[2] At least from an epidemiological perspective, regardless of the percentage of symptomatic cases / infections. At the end of the day what matters is how many will die, not how scared someone should be if they're infected.
> A case fatality rate (CFR) is calculated based on confirmed cases.
This is not true[1]. CDC projects the numbers and estimates total number of cases, because almost all of the actual cases are undiagnosed. So no, COVID-19 is not "more-or-less 10x deadlier" than the common Flu.
Let's be clear. The media frenzy around COVID-19 is not grounded in science, and it purely designed to get panic people, resulting in clicks and eye-balls. Nothing more.
South Korea have been testing more people than anyone else - 10,000 per day, drive-in test centres, results in two hours. If you look at the South Korea numbers here (scroll down a bit) https://www.worldometers.info/coronavirus/ you see 43 deaths and 52 'serious/critical' cases from 6,593 confirmed cases, so about 0.75% for both categories. I'm hoping these South Korea numbers are giving us a more accurate picture of whats going on.
I'm fairly confident if we started testing everyone with Flu-like symptoms, we'd show numbers even lower than the 0.75% in South Korea. It's just not as deadly as was initially reported.
I'm not sure this is much superior to Worldometer's tracker. It's been running for weeks and seems to be lighter to load on my slow connection. The graphs are definitely a plus, though.
https://www.worldometers.info/coronavirus/
If you are interested in looking directly at their source-data, CSSE's github repo is also quite interesting. We spent a bunch of time plotting it in various ways last night.
I've found it helpful to view this data as time series (so that trends are more apparent). This site uses this same dataset but shows historical trends per country/region:
Instead of the accumulated total, a better metric for showing trends is the number of daily new cases, it shows whether the infection is accelerating or not.
Of those recovered, what condition are their lungs in? Currently the data isn't capturing this but it's been suggested that covid-19 has a permanent effect on the condition of many who are "recovered."
Something is wrong with the "Plots" tab. Two plots show different data points, without title, but comes with same legends. And the legend does not make much sense either. "Mainland China" and "Other Locations" make sense, but "Total Recovered" as the third group? I don't understand this.
Whoever chose those graph colors (page 2: plots) needs to be taken to accessibility training! WTF. A full 6% of all males are red green colorblind. Who chooses yellow and green as graph colors?! Jeez
