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Covid-19: the harms of exaggerated information and non‐evidence‐based measures

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Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#171
The acid test for this article will take place towards the end of this week and into next according to the Surgeon General.

Honestly, we're all holding our collective breath and waiting to see whether or not the U.S. begins to approach the same values associated with the Diamond Princess.

So far, the mortality rate of those testing positive, asymptomatic and symtomatic, published by the CDC today, is 0.0119 compared to the DP's 0.013.

The mortality rate as a percentage of all passengers and crew aboard the DP is 0.002 (9/3711).

The infection rate as a percentage of all passengers and crew aboard the DP is 0.192 (712/3711).

Dr. Deborah Brix indicated during today's WH presser that it's possible 70% of the U.S. population will be "exposed" to the virus by the end of 2021.

(327,000,000 * 0.70) * 0.19 = 43,491,000 potential positives if the DP number is used.

To date in the U.S., the reported percentage testing positive of the total number tested is 0.115. I'm not sure where this number keeps coming from.

At the moment, the Diamond Princess represents the best set of data for comparison.

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#172

It's easy to point at others for imperfect data and imperfect science when the situation is evolving so fast and data is so hard to come by. It seems to me that papers being retracted due to inaccurate evidence is not a sign of sensationalism but of sound science. Once can argue that more diligence should be practiced in the review process, but I assume everyone is trying their best to get the information out there A…

I don't believe it being bizarre, nor it being weighing. There's reasonable evidence that there isn't good evidence, with the exception of the cost of being cautious, which has its own life and mortality cost. And if science can't provide good guidance...

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#173

Earlier quoted context omitted.

>Why would we use the Diamond Princess CFR instead of China's, or Italy's, or South Korea's? because everyone on the diamond princess was tested. So we know for sure how many cases we are dealing within the sample. ~0.3 and ~0.9% are also not optimistic guesses but the current numbers for Germany and SK. Italy sits at 9%. So the situation is either that Italy is vastly underestimating cases, or Germany and South Kore…

~0.3 and ~0.9% are also not optimistic guesses but the current numbers for Germany and SK. Fine numbers in the presence of a health system that is not overloaded, or a country that has managed to make effective changes to prevent transmission (how did they do that without science huh?) By John’s numbers (0.3% die and 1% of population) Italy should get a total of 1800 deaths. Yet Italy is at 6000 and rapidly rising -…

Many cases in SK and Germany have not resolved yet. I don’t think you can use those numbers so definitively.

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#174
post #93

Earlier quoted context omitted.

> “If we assume that case fatality rate among individuals infected by SARS-CoV-2 is 0.3% in the general population — a mid-range guess from my Diamond Princess analysis — and that 1% of the U.S. population gets infected (about 3.3 million people), this would translate to about 10,000 deaths.” Why would we use the Diamond Princess CFR instead of China's, or Italy's, or South Korea's? Where does the idea of 1% come fro…

>Why would we use the Diamond Princess CFR instead of China's, or Italy's, or South Korea's? because everyone on the diamond princess was tested. So we know for sure how many cases we are dealing within the sample. ~0.3 and ~0.9% are also not optimistic guesses but the current numbers for Germany and SK. Italy sits at 9%. So the situation is either that Italy is vastly underestimating cases, or Germany and South Kore…

John's analysis is cherry picking in many ways. Death rate in Diamond Princess is 1.1% today and 2% is listed as severe. Assuming 50% of severe make it, final fatality rate for the ship may end up closer to 2%. John then adds a 50% discount factor but it is not clear how he picked that number. Also, the 1% of population infected seems to be another number pulled out of a hat. If we are basing our figures based only on the ship with no other assumptions, we have to go with 20% infection rate. Thus, one reasonable estimate of risk from the ship data is 20%x2%x330M = 1.3M deaths if we wait for "evidence" and did nothing. Clearly, this argues for doing something!

Edit: Also, Germany does not test dead folks for coronavirus while Italy does. Further, SK death rate has gone up to 1.3% (0.9% is an old number) and many more are in severe category. Thus, the sub 1% numbers seem more like the outliers than the above 1% numbers.

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#175

The acid test for this article will take place towards the end of this week and into next according to the Surgeon General. Honestly, we're all holding our collective breath and waiting to see whether or not the U.S. begins to approach the same values associated with the Diamond Princess. So far, the mortality rate of those testing positive, asymptomatic and symtomatic, published by the CDC today, is 0.0119 compared…

Why do we expect to get better mortality data in the US than other countries?

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#176
post #167

Earlier quoted context omitted.

he seems to advocate individual hygiene and avoiding the public when sick, which also btw seems to be the response that countries like Japan, Taiwan and Singapore have taken, where complete lockdowns or closures have largely been avoided. Together with tracing they seem to have handled the situation just fine.

> together with tracing This is key — these countries were able to avoid lockdown by testing and tracing early, before the case load became unmanageable. In the US, we’ve missed that opportunity

But US still needs to develop that capacity as quickly as it can, because once quarantine brings the virus under approximate control, testing and contact-tracing are what can eliminate it.

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#177

Earlier quoted context omitted.

Risk management is the correct way to go when uncertainty is high. Containment was the correct approach at the time. When evidence starts coming in, then you can start applying evidence based approaches. > Mortality rate: Mortality and morbidity rates are also downward biased, due to the lag between identified cases, deaths and reporting of those deaths [1] > Among 3,711 Diamond Princess passengers and crew, 712 (19.…

Whereas, if you compare fatality rates reported by Germany, SK, HK, Singapore and other high testers vs China, Italy and Spain, it's pretty clear the latter are under-diagnosing mild/asymptomatic cases, which increase their fatality rate by a factor of 10 or more. South Korea has 1% fatality rate at the end of their epidemic, they showed .5% in the middle of this. Germany has .2% rate but it has crept up to .4% and I…

> You quote 10% of the infected on the Diamond Princess as requiring hospitalization.

10% of symptomatic cases, not all cases, and definitely not all infected.

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#178
http://www.euromomo.eu/

Mortality across Europe has drastically declined in the past few months. Seems like everyone sitting at home is saving a ton of lives. Fewer accidents, fewer sicknesses, maybe even people eating a bit healthier.

Why stop locking yourselves indoors when so many lives are being saved by not leaving home?

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#179

Earlier quoted context omitted.

>Why would we use the Diamond Princess CFR instead of China's, or Italy's, or South Korea's? because everyone on the diamond princess was tested. So we know for sure how many cases we are dealing within the sample. ~0.3 and ~0.9% are also not optimistic guesses but the current numbers for Germany and SK. Italy sits at 9%. So the situation is either that Italy is vastly underestimating cases, or Germany and South Kore…

That's a false dichotomy. The situation could also be that access to treatment is a huge factor in mortality, and that Italy and Wuhan faced a large enough caseload that people were unable to get healthcare, which drove up mortality significantly. This is a much more likely factor than the idea that Germany and South Korea are somehow 10x-30x more effective in testing their population than Italy.

I'm not sure about Germany, but South Korea was and is extremely effective at testing their population. They also did and are doing a fantastic job tracing infections (although part of this is due to being able to mostly focus on a single super-spreader rather than many simultaneous outbreaks. I think that South Korea probably confirmed 70-80% of their actual number of cases, while Italy probably has at least 2-3 actual cases for each confirmed case. Testing and tracing en masse is really, really hard, and is basically impossible if you don't catch it soon enough. I think that hospital overloading is definitely able to double or triple the death rate, though.

Re: Covid-19: the harms of exaggerated information and non‐evidence‐based measures

#180

The acid test for this article will take place towards the end of this week and into next according to the Surgeon General. Honestly, we're all holding our collective breath and waiting to see whether or not the U.S. begins to approach the same values associated with the Diamond Princess. So far, the mortality rate of those testing positive, asymptomatic and symtomatic, published by the CDC today, is 0.0119 compared…

Why do we expect to get better mortality data in the US than other countries?

Social distancing and hygiene hopefully contribute to fewer exposures and therefore fewer fatalities. Especially those 65+ with underlying conditions such as hypertension and diabetes.
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