Corona Virus Numbers???

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tspear said:
Salty,

You are completely missing the point. The flatten the curve and social distancing is not about containment. It is not about stopping the disease. It is about slowing the rate of infection to a point where the healthcare system can handle the load. If the healthcare system can handle the load, there is a fairly good survival rate for those hospitalized. When the healthcare system cannot handle the load, the survival rate goes down significantly.

Tim
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I get it. It’s not going to make a difference in the real world. We aren’t going to let people die due to lack of care. Not any more than will any way. There are better ways to Deal with the logistics than the feeble attempt to delay the inevitable by unemploying half the population.
 
Salty said:
I get it. It’s not going to make a difference in the real world. We aren’t going to let people die due to lack of care. Not any more than will any way. There are better ways to Deal with the logistics than the feeble attempt to delay the inevitable by unemploying half the population.
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How do you propose we're going to suddenly have 10-100 times the number of ventilators, ICU beds, doctors, and nurses that we have now?

If we don't flatten the curve, the health care system will be completely and totally overwhelmed, and triage is going to have to start deciding who lives and who dies. You're a healthy 60-year-old and you come to the ER experiencing respiratory distress at the same severity as a healthy 35-year-old, but there's only one ventilator left? Sorry, you're gonna die, when you wouldn't have if you hadn't gotten sick until after the other guy was recovered.

Or, let's say you are an otherwise young and healthy person who happens to have the bad luck of getting in a car accident while the system is overwhelmed. They're already short of blood right now, and maybe you have an arm severed in a way that they can't put a tourniquet on it in the field. They rush you to the hospital, but because they didn't have the blood units available on the ambulance, by the time you get to the hospital you've already bled out to the point where you sustain severe brain damage or die. Oh well...

It's not just people who get the virus who will die needlessly if we get to the point where the system is overwhelmed, and MANY MORE people who get the virus will die if it all happens at once than if we can spread it out...

And make no mistake, there is an economic cost to all of those deaths as well.
 
Matthew said:
Among the sites I've been looking at is the CDC.

I see one of their charts labeled COVID-19 cases in the United States by date of illness onset. It seems to show a drop in the number of new cases based on when the illness was detected(?) (unless I'm not reading it correctly). Data is still coming in for the most recent days, so don't pay too much attention to the far end of the chart. You have to scroll down towards the bottom of the page.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html

I'm not really sure what it means, other than it seems a lot of newly sick people were found about 2 weeks ago and it's been trending down for a few days in a row.
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3/11 was the day when a whole crap-ton of stuff started happening to contain the spread. The good news is, that chart appears to indicate that it's working so far.
 
flyingcheesehead said:
3/11 was the day when a whole crap-ton of stuff started happening to contain the spread. The good news is, that chart appears to indicate that it's working so far.
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3/11 (Wed) was the first day of the Big 12 tournament (that’s how I measure time).

The first two games were played, and because the doors had already been opened, they played in front of a crowd. An announcement was made that the 3/12 games would be played in an empty arena. On 3/12 (Thursday) the tournament was canceled, as were all other NCAA league tournaments. By mid-day Thursday Kansas and Duke, maybe others, announced cancellation of all athletic department travel and pretty much took themselves out of the NCAA tournament. Later that same day the NCAA basketball tournament was canceled. Thursday 3/12 was when I noticed the run on grocery stores. Friday 3/13, our local schools closed a day early for spring break. Friday, Saturday, and Sunday, 3/13-14-15, more places and events started shutting down. MLB, NBA, MLS, and pretty much all other pro sports started announcing postponing their schedules and seasons. By Monday 3/16 gyms started closing, schools started spring break early and spring breaks were extended.

I’ve been calling that “week 1”, it had a soft start, but I consider today, Monday 3/23, the beginning of week 2.

What I understand is that the infection takes approx 6 days, it’s a curve that seems to peak heavily at day 6, between infection and symptoms. If I take last Monday to be day 1, then today is either day 7 or 8 depending on how you count. Maybe the curve starts to slow this week because we’ve managed to slow the spread, or it doesn’t.

I’m not sure a lot of the charts we look
at are all that helpful. Someone upstream in this thread said they show data, not information. There is little context. Different localities have different testing methodologies so test and result numbers, in many cases, are just numbers.

Is there a graph, chart, table, or other source that shows “information”?
 
FastEddieB said:
Congratulations!

I’ve read countless inane posts on the topic of this virus, but this is clearly the dumbest I can recall to date.

Good job!
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Apparently it needed to be said because someone was implying that might actually be the case.

We are all tense, but lighten up. Being snarky here doesn’t make anyone feel
better, including you.

What I keep remembering about this disease is that we don’t have good data. You can’t look at a chart of numbers and know what they mean until after the fact. We are still catching up on data and by the time we’ve caught up, we’ll already be flattening. The flattening is going to happen fast
 
bflynn said:
We are all tense, but lighten up.
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No thanks. I’ll point out idiotic statements when I see them.

“We aren’t going to let people die due to lack of care.” is one such. People already die in the US every day from lack of care. Increased need for ICU beds beyond what is available will lead to folks dying on gurneys in hallways without access to respirators or proper care. It’s happening already in Italy, hardly a third world country.
 
flyingcheesehead said:
You're a healthy 60-year-old and you come to the ER experiencing respiratory distress at the same severity as a healthy 35-year-old, but there's only one ventilator left? Sorry, you're gonna die, when you wouldn't have if you hadn't gotten sick until after the other guy was recovered.
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OR,
You are a healthy 60 year old millionaire needing that ventilator and there is another guy, a 35 year old homeless crackhead. THEN who gets the ventilator?
Personally I am hoping it is the 60 year old millionaire.
 
Matthew said:
3/11 (Wed) was the first day of the Big 12 tournament (that’s how I measure time).

The first two games were played, and because the doors had already been opened, they played in front of a crowd. An announcement was made that the 3/12 games would be played in an empty arena. On 3/12 (Thursday) the tournament was canceled, as were all other NCAA league tournaments.

.....

I’m not sure a lot of the charts we look
at are all that helpful. Someone upstream in this thread said they show data, not information. There is little context. Different localities have different testing methodologies so test and result numbers, in many cases, are just numbers.

Is there a graph, chart, table, or other source that shows “information”?
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My son who goes to OSU claims they should be declared Big XII champions because of their tourney win.

Reuters show deaths by country over time. https://graphics.reuters.com/CHINA-HEALTH-MAP/0100B59S39E/index.html
 
FastEddieB said:
No thanks. I’ll point out idiotic statements when I see them.
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So stating the obvious is idiotic to you. Glad that you're aware, I just wish you were aware that not everyone else is as smart as you.

Relax, we're going to be ok.
 
FastEddieB said:
No thanks. I’ll point out idiotic statements when I see them.

“We aren’t going to let people die due to lack of care.” is one such. People already die in the US every day from lack of care. Increased need for ICU beds beyond what is available will lead to folks dying on gurneys in hallways without access to respirators or proper care. It’s happening already in Italy, hardly a third world country.
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I dont anticipate the same situation happening. While we have a lower number of hospital beds per capita, we have about 3 times the number of ICU beds, much of that the result of our high cardiac surgery volumes. You need to be careful not to extrapolate from a local overload to a health system in a different country to the situation we have in the US. Ventilated patients can be transported and I expect that local ICU capacity issues in NY/NJ will be addressed by transferring patients out of the most affected hospitals to open vent spots for new incoming patients.

In this entire thing, it is important not to stare at the 'shiny object' and predict doom and gloom based on an outlier case. While a region in northern Italy did experience a capacity problem in their healthcare system, the great majority of other countries that the virus went through did not.
 
weilke said:
I dont anticipate the same situation happening. While we have a lower number of hospital beds per capita, we have about 3 times the number of ICU beds, much of that the result of our high cardiac surgery volumes. You need to be careful not to extrapolate from a local overload to a health system in a different country to the situation we have in the US. Ventilated patients can be transported and I expect that local ICU capacity issues in NY/NJ will be addressed by transferring patients out of the most affected hospitals to open vent spots for new incoming patients.

In this entire thing, it is important not to stare at the 'shiny object' and predict doom and gloom based on an outlier case. While a region in northern Italy did experience a capacity problem in their healthcare system, the great majority of other countries that the virus went through did not.
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Most of the stuff I have read talks about a shortage of ventilators and medical staff; on a national scale not local/regional. This has been a major part of the issue in Italy.

Tim
 
weilke said:
I dont anticipate the same situation happening. While we have a lower number of hospital beds per capita, we have about 3 times the number of ICU beds, much of that the result of our high cardiac surgery volumes. You need to be careful not to extrapolate from a local overload to a health system in a different country to the situation we have in the US. Ventilated patients can be transported and I expect that local ICU capacity issues in NY/NJ will be addressed by transferring patients out of the most affected hospitals to open vent spots for new incoming patients.

In this entire thing, it is important not to stare at the 'shiny object' and predict doom and gloom based on an outlier case. While a region in northern Italy did experience a capacity problem in their healthcare system, the great majority of other countries that the virus went through did not.
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What's the end of that argument though? If the argument is, yeah, if we also peak at a 0.1% overall infection rate like Italy did, we can deal with it better than Italy, then sure. That implies we cap out at 360'000 infections, which we can handle better than Italy. But Italy had to institute something pretty close to Martial Law in order to actually peak at 0.1%.

But we're not doing anywhere close to what Italy did, and people in the US are talking about doing even less and letting it run lose and just braving a 40% to 60% infection rate - which is 500 times higher than Italy. At that point 3 times the number of ICU beds does nothing.
 
Italy just reported 5249 more cases and 743 more deaths today. I guess they aren't past the hump just yet.
 
tspear said:
Most of the stuff I have read talks about a shortage of ventilators and medical staff; on a national scale not local/regional. This has been a major part of the issue in Italy.
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Below is a link to the esri site for Italy. I am far less confident about their data than about the data on the german or dutch sites, but as that is what the italian civil defense reports, I'll go with it for now:

https://www.arcgis.com/apps/opsdashboard/index.html#/b0c68bce2cce478eaac82fe38d4138b1

There is a claim that italy is seeing high death numbers because their healthcare system 'capped out' and that they are now leaving everyone over 60 out to die. I dont see that in the data. Their death rate followed the total number of cases without any sudden jump as you would expect with a capacity effect. Other regions in italy have case counts of 1500 (with only a minority hospitalized), if this caused a shortage 'nationwide' there is something independent from the virus going on.
 
Salty said:
Just extend your pretty picture further to the right and all the lines end up red anyway.

In the meantime, let's cause a recession, or even worse. Those that live through this panic are going to suffer for a decade or more from rash actions borne from irrational fears.
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40% of those hospitalized (with SARS, which this virus causes) are under 50. Nothing in your lifetime spreads as quickly and easily as this. Irrational my ass; things just seem crappy because we were essentially unprepared.
 
midwestpa24 said:
Italy just reported 5249 more cases and 743 more deaths today. I guess they aren't past the hump just yet.
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Their new case count ('Incremento giornaliero degli attualmente positivi' in the site referenced above) is trending down for the past few days. The number of total current cases ('Attualmente positivi') will continue to climb until that the number of recovered (guariti) + deaths (Deceduti) exceeds the number of new cases. The number of deaths lags the number of new infections by a somewhat variable period. Some patients have a quick deterioration towards an ARDS picture and die, others are on the vent for a while and interestingly die from what appears to be a direct effect of the virus on the heart.

So even if their new case number went to 0 tomorrow, the number of deaths would continue to mount for a few weeks. But once the 'hump' is reached, there is at least light at the end of the tunnel.

https://www.arcgis.com/apps/opsdashboard/index.html#/b0c68bce2cce478eaac82fe38d4138b1
 
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Kenny Phillips said:
40% of those hospitalized (with SARS, which this virus causes) are under 50. Nothing in your lifetime spreads as quickly and easily as this. Irrational my ass; things just seem crappy because we were essentially unprepared.
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Just as a point of order. The virus for the current outbreak is called SARS-CoV2, the disease it causes is called Covid-19.
SARS was a disease caused by a virus calld SARS-CoV and happend around the 2003 timeframe. That one had a case fatality rate that was multiples of what we see with Covid-19.
 
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weilke said:
Just as a point of order. The virus for the current outbreak is called SARS-CoV2, the disease it causes is called Covid-19.
SARS was a disease caused by a virus calld SARS-CoV and happend around the 2003 timeframe. That one had a case fatality rate that was multiples of what we see with Covid-19.
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One more point. The NIH and CDC is now officially referring to SARS-CoV as SARS-CoV-1.
 
bflynn said:
So stating the obvious is idiotic to you. Glad that you're aware, I just wish you were aware that not everyone else is as smart as you.

Relax, we're going to be ok.
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Not if we open the floodgates. If we just go back to business as usual, people WILL die because we are unable to provide them care.
 
flyingcheesehead said:
Not if we open the floodgates. If we just go back to business as usual, people WILL die because we are unable to provide them care.
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And if we allow the economy to crash, then we WILL see thousands, if not more, suicides. But I suppose if you ("you" in general, not "you @flyingcheesehead ) want to rationalize it, suicides are by choice, so there is that.
 
Van Johnston said:
My son who goes to OSU claims they should be declared Big XII champions because of their tourney win.

Reuters show deaths by country over time. https://graphics.reuters.com/CHINA-HEALTH-MAP/0100B59S39E/index.html
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Given OSU's season, I'm not even sure they should have been eligible for the Big XII tournament. They should have abstained due to shame alone, lol. *Note: OU was only marginally better, lol. KU and BU get the nod, the conference really fell off after those two teams.
 
JOhnH said:
And if we allow the economy to crash, then we WILL see thousands, if not more, suicides.
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Thousands of suicides that otherwise would not have happened caused directly by a crash of the economy. You seem pretty confident of that claim. I'm fascinated to know how you can prove it.
 
JOhnH said:
And if we allow the economy to crash, then we WILL see thousands, if not more, suicides. But I suppose if you ("you" in general, not "you @flyingcheesehead ) want to rationalize it, suicides are by choice, so there is that.
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Not sure about the suicides, but a huge amount of hardship. So we have a true Sophie's choice. But this is where we're at because of complacency and incompetence.
 
JOhnH said:
And if we allow the economy to crash, then we WILL see thousands, if not more, suicides. But I suppose if you ("you" in general, not "you @flyingcheesehead ) want to rationalize it, suicides are by choice, so there is that.
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Or we can bail out people as well as businesses instead of wall street with our endless money printer, allowing people to keep their homes, and businesses to reopen after this thing blows over. For some reason we are the only country having this discussion.
 
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Juliet Hotel said:
Thousands of suicides that otherwise would not have happened caused directly by a crash of the economy. You seem pretty confident of that claim. I'm fascinated to know how you can prove it.
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Are you really asking for proof? Huh?

Don't make me resort to name calling. Of course I can't offer proof of what will happen, but financial disasters often result in suicides. Do you remember the pictures of people jumping out of windows in 1929?

Just search for "suicide" and "financial loss" and see what you get.
 
azure said:
But this is where we're at because of complacency and incompetence.
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Can you offer proof of that?

I don't suppose it has anything to do with a never seen before virus.
 
JOhnH said:
Can you offer proof of that?

I don't suppose it has anything to do with a never seen before virus.
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The point is: we were not prepared to deal with ANY truly global pandemic of a lethal illness. And: South Korea never dealt with this particular virus before either (as you said, it is a new virus), and yet they were able to stem their outbreak without shutting down the country. By their standards, we were incompetent.

As to complacency, I don't think we can discuss this here without violating the TOS...
 
azure said:
South Korea never dealt with this particular virus before either (as you said, it is a new virus), and yet they were able to stem their outbreak without shutting down the country. By their standards, we were incompetent.
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South Korea is right next door to China, where the outbreak originated. Of course they reacted quickly. If it originated in Canada, we would have reacted faster too. Of course though, if it originated in Mexico . . .

azure said:
As to complacency, I don't think we can discuss this here without violating the TOS...
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Ok. You are right about this. So I'll stop here.
 
JOhnH said:
South Korea is right next door to China, where the outbreak originated. Of course they reacted quickly. If it originated in Canada, we would have reacted faster too. Of course though, if it originated in Mexico . . .
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I don't think we were in any position to react as quickly as they did, regardless of where the virus originated. The most important thing they did differently from us was widespread testing. There is still not enough testing availability here to meet the need, even several weeks later.

I don't want to assign blame here (again, the TOS...), but I don't see how we can escape that conclusion.
 
Deelee said:
Correct. And by keeping the people who are at higher risk for severe or fatal illness isolated, you do a good thing. By keeping people isolated that may be infected, but not suffer severe or fatal illness isolated you only tax the rest of the country's resources and do more lasting harm. Getting the people who are at higher risk of dying isloated = good. F'ing up the rest of the world by isolating everyone who may get infected = bad. Read the article. The Dr. does a better job of explaining it that I can.
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This approach only works if (1) the resulting disease expansion rate does not exceed capacity to care for those that must be hospitalized, which is about 15% of those diagnosed, and (2) we can do expansive testing to identify those who are sick, and those who have achieved immunity. It would also help if (3) we had proven therapeutics that could shorten the length and intensity of the disease, thereby shortening hospital stays and freeing up capacity. None of these conditions is met yet, and the result is that the current epidemic is still in the rapid, exponential growth phase. The only way to slow it down in the absence of the above is temporary isolation. Because we are unable to do any widespread testing, we can't get ourselves easily out of this kind of dumb noose because we don't know who we can release back into the economy without fanning the flames. Lack of testing capacity is the biggest current failing.

When you turn everyone loose without testing, even the "low-risk" individuals, they will still get sick, make their co-workers sick, and the neighbors and family sick. About 1-2% of those will die, including many in the "low-risk" category. And when the critically ill flood the healthcare system, it will collapse and the case fatality rate will above that 1-2% because not all critical cases will be able to be treated. If we can ramp up testing, we can be a lot smarter about how to release individuals back into the general population. That's what Korea did, and they got out underneath their epidemic in about a month. China did it the hard way (because they were the first) and it took 4 months to gain control. Europe is going to be somewhere in between China and Korea, at a dear cost in terms of mortality. Where will the U.S. be? Depends on how smart or dumb we are.

The purpose of isolation is not to "stop" the disease, it is to spread out the impact over time. That time will be temporary, only a few months. The shorter that period is, ironically, the more painful it will be in terms of mortality rates. New York is going to have a very bad time in the next month. Other states at the beginning of their exponential growth will be next, a few weeks behind. We need testing and therapeutics, then we can start climbing out of this mess. When the vaccine eventually comes, we can declare total victory, but that is more than a year off.
 
chemgeek said:
This approach only works if (1) the resulting disease expansion rate does not exceed capacity to care for those that must be hospitalized, which is about 15% of those diagnosed, and (2) we can do expansive testing to identify those who are sick, and those who have achieved immunity. It would also help if (3) we had proven therapeutics that could shorten the length and intensity of the disease, thereby shortening hospital stays and freeing up capacity. None of these conditions is met yet, and the result is that the current epidemic is still in the rapid, exponential growth phase. The only way to slow it down in the absence of the above is temporary isolation. Because we are unable to do any widespread testing, we can't get ourselves easily out of this kind of dumb noose because we don't know who we can release back into the economy without fanning the flames. Lack of testing capacity is the biggest current failing.
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Precisely.
 
azure said:
I don't think we were in any position to react as quickly as they did, regardless of where the virus originated. The most important thing they did differently from us was widespread testing. There is still not enough testing availability to meet the need, even several weeks later.

I don't want to assign blame here (again, the TOS...), but I don't see how we can escape that conclusion.
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Correct about Korea and the role of testing, and to be honest I don't think any administration would have been particularly well prepared for what has transpired, just because the federal government is not that nimble. (I've worked at NIH in the past...so I know how the bureaucracy works.) But we did squander some time when the experts did see this train wreck coming. We were not alone. Europe was caught flat-footed, too. This should be a good lesson for the future.
 
FormerHangie said:
Italy passed 6000 total deaths today. The number of new cases per day is starting to trend downward, so maybe they can keep it under 10,000. The U. S has about 5.5 times as many people, so if we do as well as the Italians do, we'd be looking at 50,000 deaths. If we did nothing, then who knows how many deaths.
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When you reach the inflection point of the logistic curve (the function that describes limited exponential growth events like epidemics) you are only half-way home. So if Italy has actually passed the peak, they can expect about twice the current number of deaths. The good news is that they will start to gain hospital capacity for here on out.
 
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