Coronavirus - General Chat - No statistics

[ursaminortaur]

CNBC is reporting that scientists are saying that Covid-19 is as bad as the 1918 Spanish Flu especially when taking into account improvements in hygiene, modern medicine and public health since 1918.


https://www.cnbc.com/2020/08/13/scientists-say-the-coronavirus-is-at-least-as-deadly-as-the-1918-flu-pandemic.html

The coronavirus is at least as deadly as the 1918 flu pandemic and the death toll could even be worse if world leaders and public health officials fail to adequately contain it, researchers warned in a study published Thursday in the medical journal JAMA Network Open.

“What we want people to know is that this has 1918 potential,” lead author Dr. Jeremy Faust said in an interview, adding that the outbreak in New York was at least 70% as bad as the one in 1918 when doctors didn’t have ventilators or other advances to help save lives like they do today. “This is not something to just shrug off like the flu.”
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The increase in deaths during the 1918 flu pandemic was higher overall, but comparable to that observed in the first two months of the coronavirus outbreak in New York City, the researchers found. But when taking into account improvements in hygiene, modern medicine and public health, the increase during the early coronavirus outbreak was “substantially greater” than during the peak of the 1918 pandemic, the researchers wrote.

“If insufficiently treated, SARS-CoV-2 infection may have comparable or greater mortality than 1918 H1N1 influenza virus infection,” Faust wrote in the paper.

[tjh290633]

I'm saying that use of the Nightingale Hospitals as Isolation hospitals might have been a better appraoch.

I'll agree with you there! It's a national scandal that so many cancer treatments and scans were being put on hold in main hospitals while the Nightingales were lying completely empty. A massive failure of government policy that simply boggles the mind. (I lost a post-cancer scheduled scan myself, and no date yet for a new appointment.)

Same question, though. What would a Nightingale hospital be able to do for the majority who were asymptomatic (or who had developed no symptoms yet), but many of whom could still be spreaders?

BJ

As those who are asymptomatic have no symptoms, they would not have been hospitalised. Only if you had 100% testing of the population at weekly or daily intervals might they have been discovered. Hence the need for social distancing, hand washing and masking in certain locations. Once found, put them in a requisitioned hotel.

TJH

[johnhemming]

CNBC is reporting that [some] scientists are saying

[scotia]

Without the initial lockdown the NHS would have been over-run, and the fatality rate would have been much higher.

There is in fact evidence both in terms of hospital admissions and in terms of deaths in hospital from Covid-19 that indicates that the date of the peak infection rate was at least a week before the lockdown. That is because admissions tend to occur 13/14 days after infection at the earliest and deaths 21/23 days.

We have had this issue before. There is little reliable information relating to the virus, but the statistics on admissions and deaths in hospital (by date of death) are reliable.

I think you are missing some points. Even if the rate of infection had started to reduce before full lockdown, the NHS would still have been over-run by the volume of new admissions on top of those already admitted. It needed a drastic reduction in the rate of infection to avoid this scenario. Lockdown worked. And just before lockdown hospitals were extremely stressed and were not exactly inviting new patients - indeed they were shipping infected persons off to care homes. So how about some reliable statistics which includes infections and deaths outside hospital during this key period.

[johnhemming]

Even if the rate of infection had started to reduce before full lockdown, the NHS would still have been over-run by the volume of new admissions on top of those already admitted. It needed a drastic reduction in the rate of infection to avoid this scenario. Lockdown worked.

This is where we can compare the chart of deaths/admissions in Sweden to that in the UK.

I would not disagree with the thesis that the rate of infection was further reduced by lockdown, but the primary reduction was something else. I think primarily Herd Immunity. I think this is the same in Sweden.

Avlidna is Swedish for death.
https://experience.arcgis.com/experienc ... 87457ed9aa

English comparison
https://www.england.nhs.uk/statistics/s ... ly-deaths/

My view on a rough consideration is that the number of deaths went down faster in England than Sweden and that was a result of the lockdown. However, this does not point to the lockdown preventing the NHS being overrun.

I may at some time do some calculations to work out what the numerical effect of the lockdown is comparing these two charts, but I don't think it would change my conclusion.

[redsturgeon]

Even if the rate of infection had started to reduce before full lockdown, the NHS would still have been over-run by the volume of new admissions on top of those already admitted. It needed a drastic reduction in the rate of infection to avoid this scenario. Lockdown worked.

This is where we can compare the chart of deaths/admissions in Sweden to that in the UK.

I would not disagree with the thesis that the rate of infection was further reduced by lockdown, but the primary reduction was something else. I think primarily Herd Immunity. I think this is the same in Sweden.

Avlidna is Swedish for death.
https://experience.arcgis.com/experienc ... 87457ed9aa

English comparison
https://www.england.nhs.uk/statistics/s ... ly-deaths/

My view on a rough consideration is that the number of deaths went down faster in England than Sweden and that was a result of the lockdown. However, this does not point to the lockdown preventing the NHS being overrun.

I may at some time do some calculations to work out what the numerical effect of the lockdown is comparing these two charts, but I don't think it would change my conclusion.

Although Sweden did not lockdown in the same way as the UK the population certainly adopted social distancing methods voluntarily.

Sweden has largely relied on voluntary social distancing guidelines since the start of the pandemic, including working from home where possible and avoiding public transport.
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There's also been a ban on gatherings of more than 50 people, restrictions on visiting care homes, and a shift to table-only service in bars and restaurants. The government has repeatedly described the pandemic as "a marathon not a sprint", arguing that its measures are designed to last in the long term

[johnhemming]

I had a go at superimposing one image on the other to see the effects of the lockdown.


I accept that this is not as well done as it could be, but you can see how the number of deaths in England reduced more quickly than in Sweden. That is where the lockdown had an effect.

[johnhemming]

Although Sweden did not lockdown in the same way as the UK the population certainly adopted social distancing methods voluntarily.

I don't think anyone is saying that Sweden did not respond in any way. The arguments are about the compulsory lockdown and the rather stupid things the government is doing with local lockdowns and badly substantiated international quarantines.

[redsturgeon]

Although Sweden did not lockdown in the same way as the UK the population certainly adopted social distancing methods voluntarily.

I don't think anyone is saying that Sweden did not respond in any way. The arguments are about the compulsory lockdown and the rather stupid things the government is doing with local lockdowns and badly substantiated international quarantines.

I'd agree with your last two points but I think the evidence is pretty strong that the main problem with the initial lockdown is not that it happened at all but that it was at least a week too late.

There seems to be a consensus among scientists that locking down a week earlier would have cut deaths by around 50% and reduced the peak of infections such that the lockdown could then have ended earlier, win-win.

I have also read reports that SAGE and other scientists were recommending lockdown 10 days before it finally happened.

John

[johnhemming]

The question about whether the lockdown was a good idea has to take into account things like the effect on a year cohort of 6th form students. It cannot be entirely measured on whether or not it delayed a number of deaths from covid-19.

I thought I would do a bit more work on the Sweden vs England comparison. So I have got the raw data from published sources and produced my own chart.

[88V8]

I thought I would do a bit more work on the Sweden vs England comparison. So I have got the raw data from published sources and produced my own chart.

OK with a magnifying glass the red is Sweden, the blue is the UK, then there's a line labelled variance, what we're looking for is the inclination of the curve rather than the absolute numbers. Also depends how deaths are reported of course, ref my earlier point about PHE's over-reporting.

One thing you can be sure of, if lockdown had been a week earlier the govt would have been accused of over-reaction. And without the demonstrable and visible problem, would the lockdown have been as effective anyway? People more likely to comply if they are scared.

V8

[redsturgeon]

The question about whether the lockdown was a good idea has to take into account things like the effect on a year cohort of 6th form students. It cannot be entirely measured on whether or not it delayed a number of deaths from covid-19.

As I said, if you lock down earlier then you don't have to lock down for so long, therefore mitigating some of the adverse effects of a long lockdown.

As for deaths vs a six form student getting an "A" grade vs and "A star" then I'm not sure they are equivalent. Heard one poor A level student complaining Thursday that she had been awarded 2 A*s and one A vs the three A*s offered for Oxford. They still accepted her on the lower award but she still did not seem happy.

John

[johnhemming]

My argument is that the lockdown was a mistake. We only know that now, but could see it in early April, probably late March (on hospital admissions) an earlier lockdown would have left us subject to further waves and hence cause problems over a longer period.

[scotia]

My argument is that the lockdown was a mistake. We only know that now, but could see it in early April, probably late March (on hospital admissions) an earlier lockdown would have left us subject to further waves and hence cause problems over a longer period.

You keep coming back to that dubious statistic -the hospital admissions just before lockdown. The hospitals were being over-run, so they were trying to ration admissions for any but essential cases (read the Sage minutes for predictions from London hospitals). And they were returning to care homes patients which they clearly should not have returned. So any minor slackening in admissions immediately before lockdown was simply a measure of the panic predictions that there soon would be no available beds. Fortunately lockdown quickly reduced the reproduction ratio to less than one and a major crisis was avoided.
As for numbers of deaths and when they occurred - the only reliable number is the total number of deaths recorded, with a multi-year average subtracted . This has shown to be significantly higher than the number recorded as due to Covid-19.
Finally returning to your other postulate that it was herd immunity which triumphed - you should not be surprised that I believe that there is no evidence of such an event. Random sampling has consistently shown that around 6 to 7% of the UK populace has antibodies from a Covid-19 infection, Herd immunity is generally required to work only when there is greater than 70% immunity. Consequently you seem to be proposing that only around 10% of those who have been infected by by Covid-19 will display antibodies, but will be immune. Do you have any scientific evidence to support such a proposition?

[johnhemming]

I have repeatedly provided the evidence relating to t cells and the fading of antibodies in this forum. I do not think you can claim that the NHS stats on admissions and deaths are dubious.

[sg31]

I have repeatedly provided the evidence relating to t cells and the fading of antibodies in this forum. I do not think you can claim that the NHS stats on admissions and deaths are dubious.

Would you like to direct me to the relevant scientific paper. I only ask because very, very few of the ones I've read have stated they are sure of anything. The most common point they make is that further research is required.

It's still very early in scientific research terms and this is a virus that produces very complex issues nobody fully understands at this stage. Anyone saying they are sure of anything surprises me.

I've just found the main paper on the subject.

https://science.sciencemag.org/content/ ... ce.abc8511

It's a complex paper it takes a lot of understanding by the layman like me but this stands out.

"The T and B cell response to SARS-CoV2 infection remains poorly understood."

[scotia]

I have repeatedly provided the evidence relating to t cells and the fading of antibodies in this forum. I do not think you can claim that the NHS stats on admissions and deaths are dubious.

Can you list any published refereed work in a reputable journal that has shown that only about 10% of persons experiencing a viral infection will show any antibodies to that virus? (OK - before submitting this I note that sg31 has made a similar request.)
Yes - I believe that your interpretation of selective NHS statistics is dubious. You claim that a lowering of hospital admissions shortly before lockdown is a measure of a decreasing infection rate. I think I have made my interpretation clear, but I'll repeat it again. In a crisis situation where major hospitals are projecting (see Sage notes) being over-run by new admissions, these hospitals will make sure that any admissions that can possibly be deferred, will be deferred. And as to selecting only hospital deaths in your analysis - this number is utterly irrelevant when not added to deaths outside hospitals.
So the relevant statistic which you should have used is the total number of deaths due to Covid-19. There is only one reliable method of obtaining this - it is to look at the excess mortality compared to an average over several past years. This has shown that the number recorded through death certificates(from all sources) has been a substantial underestimate of the true death rate.
So perhaps you may like to take a look at this more reliable source.

[redsturgeon]

My argument is that the lockdown was a mistake. We only know that now, but could see it in early April, probably late March (on hospital admissions) an earlier lockdown would have left us subject to further waves and hence cause problems over a longer period.

You have clearly looked into this theory of yours in detail, if this is the case then I am sure you must have read this article from Tomas Pueyo

https://medium.com/@tomaspueyo/coronavi ... de3348e88b

He looks in detail at the Swedish situation and argues against their stance. It is a very detailed argument and IMHO very persuasive.

For instance he states: (he uses the term "hammer" for "lockdown")

Yet some people have claimed that the peak and drop of coronavirus cases were not due to the Hammer. They say it doesn’t have any effect. Instead, they argue that outbreaks happen in all countries sooner or later and that, like clockwork, the epidemic dies down after a few weeks, whether there were lockdowns or not. In science, if you want to prove a theory, you make predictions based on it and you see if they turn out to be true. Here are some predictions from this theory:
1. Since all countries have a similar case curve going up and down independent from any Hammer, there should be an outbreak in all countries. Countries without a heavy outbreak are impossible.
2. Conversely, since all countries have a similar case curve going up and down independent from any Hammer, all countries should be seeing their caseload go down.
3. Countries with similar initial conditions should see similar outbreaks, regardless of whether they applied Hammers.
4. Conversely, countries with different initial situations should see different outbreaks, regardless of whether they applied Hammers.

He then goes on to show how all these predictions have not happened in reality.

He also is very clear on what needs to happen from now, since the time for lockdowns is past. (he calls this "the dance")

Many measures can be taken to stop the coronavirus, including testing, contact tracing, isolations, quarantines, universal masks, hygiene, physical distancing, public education, sewage testing, travel restrictions and crowds restrictions. All countries should apply these measures, since they’re mostly proven, much cheaper, and can dramatically reduce the epidemic

All of this was set out in his original paper back in March and he has been remarkably prescient.

https://medium.com/@tomaspueyo/coronavi ... d3d9cd99ca

John

[johnhemming]

In a crisis situation where major hospitals are projecting (see Sage notes) being over-run by new admissions, these hospitals will make sure that any admissions that can possibly be deferred, will be deferred.

These admissions were, however, for Covid-19. Hence they were not the admissions that could be deferred. Furthermore the idea that the hospitals were deferring deaths (which points to the same conclusion) is absurd. We also know that the Nightingale hospitals were not used in any substantial way. Hence the argument of a limit on admissions is nonsense.

And as to selecting only hospital deaths in your analysis - this number is utterly irrelevant when not added to deaths outside hospitals.

Rather obviously it is not. There are two sets of data. The one set is consistently prepared and reported on by date of death (which is a key aspect). There is another set of data which is unclear and I have not seen a reliable analysis.

As the two sets of data which is admissions and also deaths from infections in the community are consistently prepared they provide one of the more reliable sources of this information. It is also to be noted that they are consistent.

Can you list any published refereed work in a reputable journal that has shown that only about 10% of persons experiencing a viral infection will show any antibodies to that virus? (OK - before submitting this I note that sg31 has made a similar request.)

This is not what I have said. What I have said is that there is evidence both
a) That people defeat the virus without generating antibodies ... and
b) That people who do generate antibodies also end up with the level of antibodies fading and hence tests coming back negative rather than positive.

For example on 14th and 17th July I posted two links to this particular thread:
viewtopic.php?f=83&t=22737&p=325765&hilit=antibodies#p325765

There really are rather a lot of papers which demonstrate this. I would really be surprised, however, if anyone wrote a paper which said that everything is known about Covid-19 and no more research is required.

[johnhemming]

You have clearly looked into this theory of yours in detail, if this is the case then I am sure you must have read this article from Tomas Pueyo

https://medium.com/@tomaspueyo/coronavi ... de3348e88b

I had not read his article. It is not an academic article and his academical qualifications for this are actually quite weak. Indeed it is more like a polemic with charts. I may have glanced at it at some stage, but it is not a primary source in any way.

This is a dreadful way of writing an article:

Here’s what you’re going to learn:
Sweden is suffering tremendously in cases and deaths. Yet few people have been infected yet. They are a long way from Herd Immunity.
Between 0.5% to 1.5% of infected die from the coronavirus.
Left uncontrolled, it can kill between 0.4% and 1% of the entire population.
Many more suffer conditions we don’t yet understand.
Unfortunately, that death and sickness toll is far from having bought us Herd Immunity anywhere in the world.
Only protecting those most at risk sounds great. It’s a fantasy today.
Even if Sweden’s economy has remained mostly open, it has still suffered as much as others.
From now on, it might start doing worse.
Sweden now has regrets. But not enough. It can control the virus without a lockdown if it acknowledges its mistakes and takes the right measures.
Other countries, like the US or the Netherlands, are toying with a Herd Immunity strategy. It will only cause more economic loss and death.
Alright, let’s do this.

Lets take these then:

Sweden is suffering tremendously in cases and deaths. Yet few people have been infected yet. They are a long way from Herd Immunity.

Here is the uptodate set of Swedish stats:
https://experience.arcgis.com/experienc ... 87457ed9aa

If they are a long way from Herd Immunity when why are the numbers of infections going down? Schools have been kept open. Bars and restaurants didn't shut.

Between 0.5% to 1.5% of infected die from the coronavirus.
Left uncontrolled, it can kill between 0.4% and 1% of the entire population.

This is the IFR figure.

Lets look at Wikipedia

https://en.wikipedia.org/wiki/Coronavirus_disease_2019
Infection fatality rate
Infection fatality rate or infection fatality ratio (IFR) is distinguished from case fatality rate (CFR). The CFR for a disease is the proportion of deaths from the disease compared to the total number of people diagnosed with the disease (within a certain period of time). The IFR, in contrast, is the proportion of deaths among all the infected individuals. IFR, unlike CFR, attempts to account for all asymptomatic and undiagnosed infections.

Our World in Data states that, as of 25 March 2020, the IFR for coronavirus cannot be accurately calculated.[283] In February, the World Health Organization reported estimates of IFR between 0.33% and 1%.[284][285] On 2 July, The WHO's Chief Scientist reported that the average IFR estimate presented at a two-day WHO expert forum was about 0.6%.[286][287]

The CDC estimates for planning purposes that the IFR is 0.65% and that 40% of infected individuals are asymptomatic, suggesting a fatality rate among those who are symptomatic of 1.08% (.65/60) (as of 10 July).[288][289] According to the University of Oxford Centre for Evidence-Based Medicine (CEBM), random antibody testing in Germany suggested a national IFR of 0.37% (0.12% to 0.87%).[290][291][292] To get a better view on the number of people infected, as of April 2020, initial antibody testing had been carried out, but peer-reviewed scientific analyses had not yet been published.[293][294] On 1 May antibody testing in New York City suggested an IFR of 0.86%.[295]

Firm lower limits of IFRs have been established in a number of locations such as New York City and Bergamo in Italy since the IFR cannot be less than the population fatality rate. As of 10 July, in New York City, with a population of 8.4 million, 23,377 individuals (18,758 confirmed and 4,619 probable) have died with COVID‑19 (0.28% of the population).[296] In Bergamo province, 0.57% of the population has died.[297]

Personally I think the IFR will end up as being as 0.2-0.3% taking into account that about half of people are not susceptible. The viral load is the reason for more deaths in places like Northern Italy and New Yorks.

However, it is obvious that Tomas Pueyo is exaggerating the figures using the value of 1.5%. Although that is an ad hominem attack it demonstrates a lack of concern for accuracy which is relevant when considering other claims.

Unfortunately, that death and sickness toll is far from having bought us Herd Immunity anywhere in the world.
Only protecting those most at risk sounds great. It’s a fantasy today.

Perhaps the biggest mistake was not protecting care homes. Sweden recognised that they also made this mistake. This is sadly still going on with the mistake in Spain of redistributing asymptomatic sufferers from one home to others than happened recently.

I think New York and Northern Italy have also hit the HIT. It is pretty obvious that this is the only final destination that is practical in the short term. Vaccines may help, of course.

Even if Sweden’s economy has remained mostly open, it has still suffered as much as others.
From now on, it might start doing worse.

This is just garbage.

There is a table of effects on annual GDP in this
https://en.wikipedia.org/wiki/COVID-19_recession

https://www.bbc.co.uk/news/business-53664354

The flash estimate from the Swedish statistics office indicated that the country had fared better than other EU nations which took stricter measures.

Sweden now has regrets.

https://www.dailymail.co.uk/news/articl ... laugh.html

Yet when I asked this affable couple about Anders Tegnell, the state epidemiologist steering their country’s strategy for tackling this crisis, their reply was instant. ‘He’s a hero,’ said Carolinne, 35.

‘It is such a huge responsibility to take these decisions that affect the whole country and I like the way he sticks to his guns even if he gets a lot of criticism.’

Such adulation for a scientist – echoed in less adulatory terms by other day-trippers I met on the islands of Fjaderholmarna last week – might seem strange to outsiders. Sweden has one of the highest global death rates from coronavirus.