2019 Novel Coronavirus Covid-19 Discussion

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#2461700 15-Apr-2020 10:48

frankv:

Depending on what you mean by a covid-19 death, I don't think that will give you an accurate answer. In Europe where hospitals and ICUs have been swamped, death rates from non-covid-19 causes have increased to about match the covid-19 death rate. I assume that's because the hospitals and ICUs are full of covid-19 cases, so accident and other disease victims are unable to get optimal treatment.

Is a car crash victim who dies because he can't get an operation because the ICU is full of covid-19 patients also a covid-19 victim? He is, in he sense that he wouldn't have died if there was no covid-19 outbreak, but he isn't in the sense that he never had the disease himself.

I agree - but I still think that excess deaths over seasonal average is a better indicator of the impact of a lethal pandemic when it's at the scale it is in badly affected countries, and "official" counts aren't to be trusted because of political interference etc. In the third world, there's going to be very little to go off at all. We're only going to see approximations, various "experts" with political affiliation will data dredge to score points.

Here's a graphic representation from towns in Lombardy:

This means that with a subset of 56.48% of the population, the figures show 5067 excess deaths (i.e. 891.8 deaths per 1M pop) which are greater than 3072 (305.4 deaths per 1M pop), the official COVID-19 deaths toll across the whole of Lombardy

https://towardsdatascience.com/covid-19-excess-mortality-figures-in-italy-d9640f411691

The revision of numbers from NY is consistent with what's reported above from Lombardy. I see that some websites that tally cases/deaths by country and region have not included the additional NYC deaths in their running tallies. According to some reports, NYC hasn't run out of ICU beds. The number of patients with eg cardiac symptoms who don't call for an ambulance and die at home when they might have been able to be saved is unknown and probably unknowable.

Fred99

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#2461705 15-Apr-2020 10:55

Sideface:

BBC News - Trump halts funding to WHO

breaking

"I am directing my administration to halt funding while a review is conducted to access the World Health Organisation's role in severely mismanaging and covering up the spread of the coronavirus," says Trump.

"The WHO failed in its basic duty and it must be held accountable" ... "So much death has been caused by their mistakes," he says.

Deny. Discredit. Deflect.

At the press conference / campaign rally where he appointed his VP - a religious anti-science zealot - to oversee the US pandemic response, he was waving a report from Johns Hopkins, and bragging that the US was "best prepared". So how come using the same data as other countries (including from WHO) and being "best prepared" - his administration managed to F$%# it up so badly?

(apologies if this is political - but "policy" seems to have a major impact on epidemic spread).

nzkiwiman

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#2461706 15-Apr-2020 10:56

Fred99:

nzkiwiman:

Found this in the ODT:

From yesterday, "suspect case definition" was changed and now any acute respiratory infection with at least one of the following symptoms: cough, sore throat, shortness of breath, head cold (runny nose, sneezing, post-nasal drip) or loss of sense of smell with or without fever should be tested.

https://www.odt.co.nz/news/dunedin/aged-care-facilities-focus-deaths-rise

Not quite as bad as I thought it was, but considering you need to have breathing issues to get tested when there are people out there with basically no symptoms, who knows how many people out there are have the virus and don't know it or have one of the symptoms but not breathing issues, so can't get tested.

Bold selection to show that what you conclude from what was written isn't correct. OTOH I don't like how they used "any acute respiratory infection with..." as it's easy to read that the wrong way.

Hrm, I still can't read it any other way; you can be tested if you have acute respiratory infection AND one of the other following issues

health.govt seems to back this up
https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-novel-coronavirus-information-specific-audiences/covid-19-novel-coronavirus-resources-health-professionals/case-definition-covid-19-infection

The case definition has been amended to de-couple respiratory symptoms from a history of travel. Testing is available to people with respiratory symptoms suggestive of COVID-19 infection (including the acute onset of cough with or without fever). This is regardless of travel history or known contact with a confirmed or probable case of COVID-19. Priority groups for testing have been included in the case definitions.

Sidestep

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#2461707 15-Apr-2020 10:56

frankv:
Fred99:

There will never be an accurate tally of Covid-18 deaths. The best indication will be the tally of increased overall deaths over seasonal average.

Depending on what you mean by a covid-19 death, I don't think that will give you an accurate answer. In Europe where hospitals and ICUs have been swamped, death rates from non-covid-19 causes have increased to about match the covid-19 death rate. I assume that's because the hospitals and ICUs are full of covid-19 cases, so accident and other disease victims are unable to get optimal treatment.

Is a car crash victim who dies because he can't get an operation because the ICU is full of covid-19 patients also a covid-19 victim? He is, in he sense that he wouldn't have died if there was no covid-19 outbreak, but he isn't in the sense that he never had the disease himself.

It's interesting that less than half COVID-19 deaths are actually happening in ICU's

Apart from people dying at home (up to 10% in some estimates) - in Italy, Spain, France, Ireland and Belgium between 42% and 57% of deaths from the virus have been happening in care homes.

The ratio is similar - or higher - in the US, Canada and many other places.
And deaths (up to 15-20% of them in Canada) in care facilities that 'involve' COVID-19 are not being reported as 'caused' by coronavirus.

Many older or frail residents - who are seen as less likely to benefit from life-saving treatment so instead would receive only palliative care no matter the result - are not even being tested for coronavirus.

This is, and will continue to be, the most reported on global health issue in history.

Studies, papers will be written about this years to come. With hindsight and research the truth about actual death rates will become clearer, likely showing a 'bump' in non COVID-19 attributed deaths of older people over these few months - some of which will be due to lack of care of pre-existing conditions, but many due to coronavirus..

Fred99

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#2461715 15-Apr-2020 11:18

nzkiwiman:

Hrm, I still can't read it any other way; you can be tested if you have acute respiratory infection AND one of the other following issues

health.govt seems to back this up
https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-novel-coronavirus-information-specific-audiences/covid-19-novel-coronavirus-resources-health-professionals/case-definition-covid-19-infection

The case definition has been amended to de-couple respiratory symptoms from a history of travel. Testing is available to people with respiratory symptoms suggestive of COVID-19 infection (including the acute onset of cough with or without fever). This is regardless of travel history or known contact with a confirmed or probable case of COVID-19. Priority groups for testing have been included in the case definitions.

Any acute respiratory infection with at least one of the following symptoms: cough, sore throat,
shortness of breath, coryza, anosmia, with or without fever.

A sore throat, cough etc are symptoms of acute respiratory infection. A common cold is an acute respiratory infection.

Batman

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#2461760 15-Apr-2020 11:32

Tinkerisk:
Doesn't sound good to me ... https://www.bbc.com/news/uk-52275823

You're in Germany, do you know what they do (not) include in their statistics? The rates are much lower for Germany then say France & Italy.

tdgeek

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#2461761 15-Apr-2020 11:34

Fred99:

nzkiwiman:

Hrm, I still can't read it any other way; you can be tested if you have acute respiratory infection AND one of the other following issues

health.govt seems to back this up
https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-novel-coronavirus-information-specific-audiences/covid-19-novel-coronavirus-resources-health-professionals/case-definition-covid-19-infection

The case definition has been amended to de-couple respiratory symptoms from a history of travel. Testing is available to people with respiratory symptoms suggestive of COVID-19 infection (including the acute onset of cough with or without fever). This is regardless of travel history or known contact with a confirmed or probable case of COVID-19. Priority groups for testing have been included in the case definitions.

Any acute respiratory infection with at least one of the following symptoms: cough, sore throat,
shortness of breath, coryza, anosmia, with or without fever.

A sore throat, cough etc are symptoms of acute respiratory infection. A common cold is an acute respiratory infection.

The DG and PM said yesterday, if you have a runny nose, get a test. That's the level of the plan now. I think thats part of surveillance testing, just right for the likely upcoming Level 3

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Fred99

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#2461776 15-Apr-2020 11:47

tdgeek:

The DG and PM said yesterday, if you have a runny nose, get a test. That's the level of the plan now. I think thats part of surveillance testing, just right for the likely upcoming Level 3

And that's what the guidelines are saying (coryza as one of the qualifying symptoms for testing).
Also noted that it's expected that due to lockdown/social isolation, the number of cases of flu/colds should be very low, so every case presenting with cold/flu symptoms should be suspected as C-19.
Will be interesting to see the test numbers and cases today. They should have both probably jumped, as people with mild symptoms over the long weekend prone to delay seeking medical attention until yesterday. I expect confirmed/probably cases to rise for a few days - it will be a very pleasant surprise if they don't.

tdgeek

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#2461781 15-Apr-2020 11:54

Fred99:

And that's what the guidelines are saying (coryza as one of the qualifying symptoms for testing).
Also noted that it's expected that due to lockdown/social isolation, the number of cases of flu/colds should be very low, so every case presenting with cold/flu symptoms should be suspected as C-19.
Will be interesting to see the test numbers and cases today. They should have both probably jumped, as people with mild symptoms over the long weekend prone to delay seeking medical attention until yesterday. I expect confirmed/probably cases to rise for a few days - it will be a very pleasant surprise if they don't.

Im going to go the other way, I am feeling that the low tests are low demand, due to lower numbers of symptoms. If I had worrying symptoms over Easter, I'd get a test, I wouldn't make that decision any different to any other day. If it was 2018, and flu symptoms, I'd live with it till Tuesday, I just feel that many wouldn't right now.

Fred99

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#2461786 15-Apr-2020 11:58

tdgeek:

I am feeling that the low tests are low demand, due to lower numbers of symptoms.

Hope you're right. We'll find out in an hour.

frankv

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#2461789 15-Apr-2020 12:01

Sidestep:
Apart from people dying at home (up to 10% in some estimates) - in Italy, Spain, France, Ireland and Belgium between 42% and 57% of deaths from the virus have been happening in care homes.

I'll go out on a limb here and talk about something that the doctors and politicians appear to be desperate to avoid; that many of these patients are being allowed to die.

For background, my mother died in a care home a couple of years ago of Alzheimers. Earlier in her life, before the onset of Alzheimers, she had seen the effects of it, and was very clear that she didn't want to live like that. So she had a "Do not resuscitate" order, and when the time came, was allowed to die. I, and the rest of my family, were 100% ok with this. So, I expect that many of the Rosewood cases, and many of the cases in care homes elsewhere would also have had "Do not resuscitate" orders. And, when covid-19 hit them, they too were allowed to die. I want to be quite clear here, that I am NOT saying "left to die". They are being cared for, to minimize suffering, with compassion and kindness.

And that is why covid-19 is so devastating when it gets into a residential care home.

Sidestep

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#2461795 15-Apr-2020 12:15

frankv:
I'll go out on a limb here and talk about something that the doctors and politicians appear to be desperate to avoid; that many of these patients are being allowed to die.

For background, my mother died in a care home a couple of years ago of Alzheimers. Earlier in her life, before the onset of Alzheimers, she had seen the effects of it, and was very clear that she didn't want to live like that. So she had a "Do not resuscitate" order, and when the time came, was allowed to die. I, and the rest of my family, were 100% ok with this. So, I expect that many of the Rosewood cases, and many of the cases in care homes elsewhere would also have had "Do not resuscitate" orders. And, when covid-19 hit them, they too were allowed to die. I want to be quite clear here, that I am NOT saying "left to die". They are being cared for, to minimize suffering, with compassion and kindness.

And that is why covid-19 is so devastating when it gets into a residential care home.

The actual wording of that - sent out to families of people in Canadian long term care facilities, where half of all deaths have occurred:

We have "no plans to transport residents who become ill with COVID-19, the disease caused by the novel coronavirus, to hospital."

"She would be denied access to an ICU. She would be kept in the care facility and treated to the best of their abilities there."

"Doctors have learned there is no benefit for seniors with COVID-19 to go to the hospital, and they would not survive intensive care,"

"If a senior or an individual with existing medical conditions does get sick … we know now there is a very high chance that they will die from it, possibly in just a few days,"

"treated like a hospice, end of life care and comfort"

Fred99

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#2461875 15-Apr-2020 13:25

Fred99:

tdgeek:

I am feeling that the low tests are low demand, due to lower numbers of symptoms.

Hope you're right. We'll find out in an hour.

Hmmm - guess it was a draw.

Not good, not bad.

kingdragonfly

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#2461878 15-Apr-2020 13:28

The Guardian, sports news: Helmut Marko wanted Red Bull's F1 drivers to deliberately catch coronavirus

Season break is ‘ideal time’ to get virus, says Marko
Idea ‘has not been well received’ by officials at Red Bull

Helmut Marko, Red Bull’s head of driver development, has revealed he suggested the team’s drivers should try to become infected with coronavirus as it is the “ideal time”, with the season on hold.

The F1 season has been decimated by the global pandemic, with the opening six races of the year either cancelled or postponed. As things stand, the first grand prix of a truncated season will be in Canada on 14 June but that will almost certainly change in the coming days.

In the meantime, Marko told the Austrian television station ORF that he came up with a plan in which his driver pairing of Max Verstappen and Alexander Albon – as well as the AlphaTauri duo Pierre Gasly and Daniil Kvyat – contract Covid-19 in an attempt to have them fit and healthy when the season finally begins.

“We have four Formula One drivers and eight or 10 juniors,” he said. “The idea was to organise a camp where we could bridge this mentally and physically somewhat dead time and that would be the ideal time for the infection to come.

“These are all strong young men in really good health. That way they would be prepared whenever the action starts. And you can be ready for what will probably be a very tough championship once it starts.”

Asked how his vision was taken by Red Bull officials, he added: “Let’s put it this way, it has not been well received.”
...

vexxxboy

4243 posts

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#2461882 15-Apr-2020 13:37

Hope you're right. We'll find out in an hour.

Hmmm - guess it was a draw.

Not good, not bad.

i dont know , is this the first time that confirmed cases are lower than Probable

Common sense is not as common as you think.

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