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Johns Hopkins CSSE Covid-19 Global Case Dashboard

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Re: Johns Hopkins CSSE Covid-19 Global Case Dashboard

#91

Post by dougmwne »

Alupis wrote: post #65
DennisP wrote: post #40

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.

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 concerne…

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.

Re: Johns Hopkins CSSE Covid-19 Global Case Dashboard

#92

Post by wahern »

Alupis wrote: post #71
DennisP wrote: post #67

Earlier quoted context omitted.

That's what I mean by the "mild cases that are never diagnosed."

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, a…

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.

Re: Johns Hopkins CSSE Covid-19 Global Case Dashboard

#93

Post by alexandercrohde »

usrusr wrote: post #70
alexandercrohde wrote: post #47

Earlier quoted context omitted.

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 th…

Fascinating. I'd love to see a system like that in America.

Re: Johns Hopkins CSSE Covid-19 Global Case Dashboard

#94

Post by kickopotomus »

marvin wrote: post #86
alexandercrohde wrote: post #76

Earlier quoted context omitted.

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." 1. https://www1.nyc.gov/site/doh/hea…

CDC’s lackluster response is absolutely confounding. One could suspect political involvement, but I can’t see who would stand to benefit.

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.

[1]: https://abcnews.go.com/Politics/trump-cut-cdcs-budget-democr...

[2]: https://www.washingtonpost.com/news/to-your-health/wp/2018/0...

Re: Johns Hopkins CSSE Covid-19 Global Case Dashboard

#95

Post by claudeganon »

lhorie wrote: post #90
alexandercrohde wrote: post #76

Earlier quoted context omitted.

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." 1. https://www1.nyc.gov/site/doh/hea…

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 re…

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.

Re: Johns Hopkins CSSE Covid-19 Global Case Dashboard

#96

Post by davidw »

yreg wrote: post #73
alexandercrohde wrote: post #27

Unfortunately garbage-in -> garbage-out. That chart shows US at 233 confirmed cases. 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. 1. https://www.nytimes.com/2020/03/05/nyr…

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).

What's garbage is the US response to it.

Italy is running 2500 tests a day.

Oregon has the capacity to run a total of about 40.

Re: Johns Hopkins CSSE Covid-19 Global Case Dashboard

#97

Post by futureshock »

Alupis wrote: post #87
pieix wrote: post #83

Earlier quoted context omitted.

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. [0] https://www.cdc.gov/flu/about/burden/past-seasons.html

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.

Re: Johns Hopkins CSSE Covid-19 Global Case Dashboard

#98

Post by addandsubtract »

TacticalCoder wrote: post #26
Svip wrote: post #16

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…

> 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…

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."

[0] https://en.wikipedia.org/wiki/Viral_envelope

Re: Johns Hopkins CSSE Covid-19 Global Case Dashboard

#100

Post by dougmwne »

codeulike wrote: post #85
dougmwne wrote: post #84

Earlier quoted context omitted.

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.

They would be mostly be old though. I would imagine very few people under 50 were on that ship. And the virus is known to be worse the older you are.

Yes, they will be able to age-weight the sample population in order to adjust for that.
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