Corona-virus - Impact of the Health Situation worldwide

[Andy Hayter]

4 hours ago, Ozexpatriate said:

Our local news has been reporting case and fatality count in Oregon, Washington and the nation to lead off the news. It's starting to feel like the daily casualty bulletin from the front.

 

Far back in this thread I linked to the State of Washington's weekly influenza update. (I'd link to it here, but the whole site appears to be down - it's probably in the middle of a weekly update here in the wee hours of Saturday morning.)

 

I noticed a few days ago that the number of COVID-19 deaths in Washington (now 175 with 3,700 cases), has exceeded influenza deaths over the whole 'flu season which started last October 1 (88* when I last checked) and  influenza cases are declining dramatically.

 

* from memory

 

For me this is quite worrying.

Much has been made about C-19 dying back during the summer months because this is what Coronaviruses and flu viruses do.  This observation might suggest that in Washington at least, while the flu virus is dying back, for the present at least C-19 is still growing strongly.

[phil-b259]

9 minutes ago, Andy Hayter said:

 

For me this is quite worrying.

Much has been made about C-19 dying back during the summer months because this is what Coronaviruses and flu viruses do.  This observation might suggest that in Washington at least, while the flu virus is dying back, for the present at least C-19 is still growing strongly.

 

Given Covid-19 is very much a new Virus (albut similar to the Flu virus in many ways) why shouldn't it behave differently.

 

Arguably if Covid 19 was going to behave like Flu, then we wouldn't have seen it emerge en-mass mid winter - it would have appeared late Autumn.

 

Ultimately we can only make the you cite comparisons when the pandemic has been bought under control and strategies put in place to cope with the permanent presence of Covid-19 within the lists of viruses we must deal with.

 

 

[Andy Hayter]

I agree Phil, bus as I said much has been made that the experts expect that it will behave like  other viruses in the same family.  I have been a little sceptical from the start if only because Spanish flu from 1918/19 also did not behave like a normal flu virus and peaked in August 1918 (first peak).

[EddieB]

Latest figures are seventy deaths from Queensland (I checked because of a friend in hospital there), which suggests that the hoped-for Summer reprieve is becoming unlikely.

[jjb1970]

If the virus was suppressed by to heat we might not have expected to see outbreaks in South East Asia where the temperatures are warm year round (at times very warm).

Edited March 28, 2020 by jjb1970

[Baby Deltic]

[jjb1970]

1 hour ago, Nearholmer said:

Agree.

 

A vanilla model or two, based on slightly different curve-forms (most epidemiologists seem to use a logistic curve, but some slightly different curves), with all variables configurable, plus a couple of curve-fitting tools based on different methods, to allow testing from accumulated real data, would surely be possible .......... in fact I’d assume they exist and are shared between specialists already.

 

Even open sharing of the settings chosen for variables, along with an explanation of the thinking, would be educational.

 

But, maybe the specialist modellers concerned have better things to do at the moment than to open-source their models and assumptions and fend-off the firestorm of debate that would inevitably cause ....... can you imagine trying to debate this sort of stuff sanely, in public, with for instance Christian fundamentalists?

 

I think the reason I would like the models to be public to some degree is to get a sense check of the efficacy of the various models. It seems, for example, that the Imperial and Oxford models use very different assumptions. They can't both be right. Modelling isn't a medical discipline  although some input assumptions depend on medical expertise it tends to be quite straightforward to get a feel for whether the input assumptions are reasonable if you understand numbers and the basis of assumptions is provided. 

[Nearholmer]

I've been playing with spreadsheets again (which probably isn't wise), and I now understand how massively sensitive all this is to the effectiveness of social distancing.

 

If you look at the Italian figures, you can see that it appears that the daily % increase in cases has begun to reduce as a result of SD ........ numbers are still rising, but progressively less steeply, and they will eventually cease to increase, provided that SD remains pretty solid. The same thing happened in China.

 

The effect of SD can be 'faked'* by progressively reducing the daily % increase in cases by a factor, which itself increases in size as time goes by. The factor probably ought to increase exponentially, but I set it to increase by simple multiplication of the number of days since "hard" SD was introduced (i.e. last Monday), with a variable time lag.

 

What this illustrates is that tiny changes to the "SD effectiveness factor" make huge differences to the level at which the total number of cases settles-out, and likewise changing the time lag (or the date at which SD is applied) by even one day makes a huge difference.

 

So what? Well, so not a lot really; it just fulfils my obsessive need to have the obvious illustrated by numbers.

 

*The proper way to make the calculation is to work from how many people each infected person passes the bug on to, but that requires all sorts of complex stuff around household sizes and "leakage out of households", the role of asymptomatic carriers etc. to be factored-in, so using a fiddle-factor is a lot easier, if possibly less accurate.

Edited March 28, 2020 by Nearholmer

[Joseph_Pestell]

11 minutes ago, Nearholmer said:

I've been playing with spreadsheets again (which probably isn't wise), and I now understand how massively sensitive all this is to the effectiveness of social distancing.

 

If you look at the Italian figures, you can see that it appears that the daily % increase in cases has begun to reduce as a result of SD ........ numbers are still rising, but progressively less steeply, and they will eventually cease to increase, provided that SD remains pretty solid. The same thing happened in China.

 

The effect of SD can be 'faked'* by progressively reducing the daily % increase in cases by a factor, which itself increases in size as time goes by. The factor probably ought to increase exponentially, but I set it to increase by simple multiplication of the number of days since "hard" SD was introduced (i.e. last Monday), with a variable time lag.

 

What this illustrates is that tiny changes to the "SD effectiveness factor" make huge differences to the level at which the total number of cases settles-out, and likewise changing the time lag (or the date at which SD is applied) by even one day makes a huge difference.

 

So what? Well, so not a lot really; it just makes fulfils my obsessive need to have the obvious illustrated by numbers.

 

*The proper way to make the calculation is to work from how many people each infected person passes the bug on to, but that requires all sorts of complex stuff around household sizes and "leakage out of households", the role of asymptomatic carriers etc. to be factored-in, so using a fiddle-factor is a lot easier, if possibly less accurate.

 

I agree with your basic conclusions.

 

But a lot of research will need to be done (after the emergency) to explain some of the variables. Why are German old people doing better than German middle-aged/young people, the opposite of what we have been led to expect and the situation in Italy and Spain? Why are we three weeks behind Italy when traffic between China and the UK must be at least as heavy as that to Italy? Did it really start in Wuhan or did someone bring it there from somewhere else? And doubtless many other questions.....

[Nearholmer]

JP

 

I haven't attempted to calculate numbers for fatalities, only hospitalised cases (='confirmed cases' the way the UK is testing at the moment).

 

If I'm feeling brave I will expand it to cover fatalities later, using the 'age taper' from the Chinese figures.

 

But, every which way I cut this, I get the NHS running out of capacity to varying extents and for varying durations, soon, and one would expect that to increase the fatality rates while it applies.

 

I'm assuming base capacity =30k, the new field hospitals between them =11k, and co-opted capacity in private healthcare = 11k, which is what I can discern from the deliberately not-joined-up numbers being cited, and that assumes the ability to staff them all, which seems to be in question.

 

what proportion of "beds" are full-on intensive care beds, I really struggle to understand from the figures cited, low numbers of thousands nationwide, I think, and that again will impact fatality rates.

 

I should really leave this alone, and leave it to people who have proper data, and who can still remember the maths that forgot the moment I learned it.

 

K

[spikey]

OK guys ... don't shoot the messenger: I am merely posting this link in case somebody here finds it useful.

 

https://www.fox2detroit.com/news/sanitize-groceries-discard-takeout-containers-immediately-doctor-demonstrates-sterile-technique

[Gilbert]

2 minutes ago, spikey said:

OK guys ... don't shoot the messenger: I am merely posting this link in case somebody here finds it useful.

 

https://www.fox2detroit.com/news/sanitize-groceries-discard-takeout-containers-immediately-doctor-demonstrates-sterile-technique

Similar to other reports circulating in the UK

https://www.bbc.co.uk/news/science-environment-52040138?at_custom4=16E6D9B8-7014-11EA-B9EB-FCF139982C1E&at_custom2=facebook_page&at_custom1=[post+type]&at_custom3=BBC+News&at_campaign=64&at_medium=custom7&fbclid=IwAR16nNfKXcRY9tgL4fpzJNyzHJCH34RD6w2k8SYKwhGmvd6GQrjhV7bjoNE&fbclid=IwAR3vwgIfhDbyn-0K3YNRGGeuskLN_b4_0AntMMeMe7o2cBGpi8W7LfpA8Qw&fbclid=IwAR2FVH5NMdYPOKERyPHGwcqibM0e9sNfK6IwrQz8R1cZhaXvS-2j3Mq4SmQ&fbclid=IwAR12TOaB0SQRNY9bzRmL6ljrdNItn8cdsXU2lPXMiGlA_6jWQJsYSuXGPW0&fbclid=IwAR0t10IT-0o_PxCCVsv8Z6BvV6dQOH2d6zYW_5Ret7EmqFX_G-7oOdSW6k0&fbclid=IwAR3SjZ7eHia0bRMZMVhFfWRXirKrtm4lFcSnvkfexlC2ck2CevYkRA-_E9U

[Andy Hayter]

Possibly OTT but at least it will not do any harm - unlike some of the other bizarre things being put around.

[spikey]

2 minutes ago, Nearholmer said:

Spikey ... the BBC website (there is so much of it, that I can never find a thing twice!) contains words from Dr James Gill of Warwick Medical school about how effective is can be to sanitise food packaging with a weak solution of bleach, and washing loose fruit and veg under running water.

 

Yes.  I read it this morning.  I merely posted the link in the hope, as i said, that somebody might find it useful - perhaps somebody who doesn't look at the BBC website?

[Fenman]

1 hour ago, jjb1970 said:

...
Modelling isn't a medical discipline  

...

I’m curious what you think epidemiology is? Or how you think public health works?

 

Paul

[Re6/6]

How disgusting can it get?

 

https://news.yahoo.com/coronavirus-council-workers-130349222.html

 

What moronic halfwits.

 

 

[jjb1970]

53 minutes ago, Fenman said:

I’m curious what you think epidemiology is? Or how you think public health works?

 

Paul

 

I'll rephrase, modelling is a mathematical tool used by epidemiologists. The same analytical tools are used in most professions. It's not medicine, it's math, the same as most theoretical engineering and science is essentially math.

[Ozexpatriate]

4 hours ago, Andy Hayter said:

Much has been made about C-19 dying back during the summer months because this is what Coronaviruses and flu viruses do.  This observation might suggest that in Washington at least, while the flu virus is dying back, for the present at least C-19 is still growing strongly.

The weekly State of Washington influenza update document is here. Death count for this season's influenza is 89. COVID-19 is 175 deaths from 3,723 cases.

 

Case rate for COVID-19 is increasing in Washington, though in a television address last week, Governor Jay Inslee was hopeful that a recent decrease in the rate of new cases was a positive sign.

 

The decline in influenza cases could be seasonal, or it could also be helped by "stay at home" orders. Both factors may have contributed.

 

Earlier hopes that the virus may "disappear by April" made by a prominent US politician appear to be quite unfounded.

[Oldddudders]

1 hour ago, Re6/6 said:

What moronic halfwits.

Sadly familiar long before any of us had heard of Covid-19. There are places where ambulance crews will often be attacked, and overt racism has been enjoying a revival since a certain referendum. In every society there will be those who do not accept its values. But even in this thread, people are questioning the Government's right to do this or do that - use of drones for example. For many, life has become such a stroll in the park that anything that impinges on their freedom to do as they wish is regarded with suspicion - and to be resisted if necessary. Entitlement is today's watchword. 

[jjb1970]

Government should always be challenged if it seeks to extend powers and limit basic freedom. That isn't entitlement,  it's an essential part of the checks and balances of a functioning democracy. It is for government to demonstrate the necessity of such measures. I think it's fair to say most accept the need for restrictions at the current time, the issue that should be of concern is ensuring government doesn't introduce measures under a cloak of responding to a pandemic.  I am still not sure that allowing a single doctor to section someone under the mental health act is a justified response to COVID 19.

[jcredfer]

27 minutes ago, Ozexpatriate said:

The weekly State of Washington influenza update document is here. Death count for this season's influenza is 89. COVID-19 is 175 deaths from 3,723 cases.

 

Case rate for COVID-19 is increasing in Washington, though in a television address last week, Governor Jay Inslee was hopeful that a recent decrease in the rate of new cases was a positive sign.

 

The decline in influenza cases could be seasonal, or it could also be helped by "stay at home" orders. Both factors may have contributed.

 

Earlier hopes that the virus may "disappear by April" made by a prominent US politician appear to be quite unfounded.

 

All seems relevant, but there are other factors which will also impinge.  One important factor is that the population has had Flu to deal with for a very long time, so immunity, plus vaccinations are a strong human defence.  Covid-19 has no {identified} historical immunity and no vaccine which are therefore not available to the current human population.  Climate may assist, but the other two factors and isolation may well account for rather more influence, at this stage.

 

Julian

 

[Ozexpatriate]

2 minutes ago, jcredfer said:

One important factor is that the population has had Flu to deal with for a very long time, so immunity, plus vaccinations are a strong human defence.  Covid-19 has no {identified} historical immunity and no vaccine which are therefore not available to the current human population.

Even this week a prominent politician in a large US state, made observations along the lines of "we don't shut the country down for the 'flu" with implications that "the 'flu kills more people than COVID-19". His state is not (yet) one of the COVID-19 hot spots.

 

Washington data indicates that (at least there), and even with drastic "stay home" measures in place COVID-19 is likely to cause significantly more early deaths than seasonal influenza. I had my 'flu shot this year. As you state there's no 'COVID-19 shot'.

[jcredfer]

7 minutes ago, Ozexpatriate said:

Even this week a prominent politician in a large US state, made observations along the lines of "we don't shut the country down for the 'flu" with implications that "the 'flu kills more people than COVID-19". His state is not (yet) one of the COVID-19 hot spots.

 

Washington data indicates that (at least there), and even with drastic "stay home" measures in place COVID-19 is likely to cause significantly more early deaths than seasonal influenza. I had my 'flu shot this year. As you state there's no 'COVID-19 shot'.

 

What surprises me is the  sheer number, of those elected to support / protect their electorate, who manage to miss / avoid the clear known facts, in preference to attempting to imagine that keeping those facts quiet, might make them go away.....  at the cost of blood on their hands!!

 

Other polite comment is beyond my capabilities of self control.

 

Julian

 

[Neil]

15 minutes ago, jjb1970 said:

.....  I am still not sure that allowing a single doctor to section someone under the mental health act is a justified response to COVID 19.

 

My brother is a mental health social worker, my wife worked in the system for many years until retirement and I know well several individuals who have been sectioned to protect themselves from themselves. Sectioning isn't undertaken lightly, it comes at great cost to the care system due to the increased provision it entails. Though it may seem worrying that it may only take one person rather than the current three to section someone, I believe that this is done with the best of intentions, ensuring timely care when doctors may be very thin on the ground. When a person has been sectioned it's for a specified time, the person has the right to appeal against their section and during the period of the section they will be receiving care from professionals who would soon realise if something was wrong. It is not ideal but it is aimed at protecting the individual and society.

[black and decker boy]

Germany have suggested their unusual statistics and low death rate are a result of very widespread community testing which started quite early too

 

they seem to be controlling spread by early detection. Presumably their excellent healthcare system helps too though they, like everyone else, are trying to increase capacity & buy more ventilators and expect their mortality rate to rise over coming weeks.