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How is the COVID virus affecting you?

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Old Wednesday 1st April 2020, 23:01   #201
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Originally Posted by Sancho View Post
Post of the decade. Thanks Owen!
Agreed, an excellent post but, I fear, water off a duck’s back as far as our resident bloviators are concerned.
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Old Thursday 2nd April 2020, 05:23   #202
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Originally Posted by Chosun Juan View Post
Models are just models.They are just a subset of reality. Certainly we should build and test them, and evaluate alternatives, and converge on better and better accuracy. However we should recognize that when assumption is built on assumption upon assumption - the final results are no more accurate than a wild guess.
This is, regretfully, nonsense. Verifiable nonsense. The worst kind of nonsense, spouted in a manner that people often do to sound philosophical and intelligent. It is the exact same tact that flat earthers employ to deny the heliocentric model, by saying "mathematics is just a made up language". It fails, every time, because the person saying this bunk does not understand that models can be tested. When your Google maps tells you that you will reach a destination in time X...it has employed a fairly complex model of speed, distance, road conditions and traffic conditions. You can test it.

If a stellar model tells you there will be an eclipse at time X in your location...you can test that.

Any models concerning this virus are currently being tested... unfortunately in the worst manner possible, a real life and death scenario. And we WANT the worst case scenarios to fail. At the end, we want to be able to say that, because we took action, we never reached those scenarios, and those producing those models are fully aware that there will be idiots out there who will say "pfft, their predictions didn't come true."

Your concern regarding a police state also requires a healthy dose of perspective. The majority of the population is simply being asked to stay home and watch TV.

North Korea is reporting zero cases...which probably means they're curing the infected with bullets.

Perspective.

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Old Thursday 2nd April 2020, 06:55   #203
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Originally Posted by Pariah View Post
This is, regretfully, nonsense. Verifiable nonsense. The worst kind of nonsense, spouted in a manner that people often do to sound philosophical and intelligent. It is the exact same tact that flat earthers employ to deny the heliocentric model, by saying "mathematics is just a made up language". It fails, every time, because the person saying this bunk does not understand that models can be tested. When your Google maps tells you that you will reach a destination in time X...it has employed a fairly complex model of speed, distance, road conditions and traffic conditions. You can test it.

If a stellar model tells you there will be an eclipse at time X in your location...you can test that.

Any models concerning this virus are currently being tested... unfortunately in the worst manner possible, a real life and death scenario. And we WANT the worst case scenarios to fail. At the end, we want to be able to say that, because we took action, we never reached those scenarios, and those producing those models are fully aware that there will be idiots out there who will say "pfft, their predictions didn't come true."

Your concern regarding a police state also requires a healthy dose of perspective. The majority of the population is simply being asked to stay home and watch TV.

North Korea is reporting zero cases...which probably means they're curing the infected with bullets.
Haha. See post #201.

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Old Thursday 2nd April 2020, 07:27   #204
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This is, regretfully, .....
No need for regrets, we can but understand the world from where we find ourselves. If this is your experience of the world it is going to limit us considerably, however even within that, you should be able to quite easily run the numbers for us and prove it.

This gives me quite the chuckle - YMMV
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Old Thursday 2nd April 2020, 08:01   #205
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For a while this discussion seemed a useful inquiry and sharing of views. However, the most vocal and repetitive participants have obviously taken a firm position they intend to adhere to, which entirely defeats the point of asking further questions. So one begins to wonder what they're still doing here, performing some sort of vigilante idea-police patrol?

Right on cue the attempted antediluvian denigration ........
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Agreed, an excellent post but, I fear, water off a duck’s back as far as our resident bloviators are concerned.






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Old Thursday 2nd April 2020, 08:03   #206
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Originally Posted by Chosun Juan View Post
No need for regrets, we can but understand the world from where we find ourselves. If this is your experience of the world it is going to limit us considerably, however even within that, you should be able to quite easily run the numbers for us and prove it.

This gives me quite the chuckle - YMMV
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And this is the second stage tact used by aforementioned flat earthers, that each and every layman should also be able to understand, manipulate and derive values from any given model.

I'm not a virologist or medical expert. I defer to their opinions and interpretation. If I go to a doctor when I'm ill and they send my blood to a lab and get a result, I don't demand to retest that sample myself to confirm a diagnosis. I don't demand to operate the MRI scanner myself.

If an astrophysicist detecting gravitational waves from the collision of two black holes publishes a paper on the subject, another astrophysics expert may choose to challenge that, re-examine the data etc...but I won't, can't and shouldn't attempt to do so.

We train doctors and physicists and chemists and nurses and emergency personnel etc etc for a reason.

May I skip to the next step for you? In general people will accept the need for experts but then retain their flawed view regardless, saying something along the lines of "I don't know what the scenario is but I know it's not scenario X"... possibly adding in something about a mysterious "They" never telling us the truth.

All the best

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Old Thursday 2nd April 2020, 08:38   #207
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Originally Posted by Pariah View Post
This is, regretfully, nonsense. Verifiable nonsense. The worst kind of nonsense, spouted in a manner that people often do to sound philosophical and intelligent. It is the exact same tact that flat earthers employ to deny the heliocentric model, by saying "mathematics is just a made up language". It fails, every time, because the person saying this bunk does not understand that models can be tested. When your Google maps tells you that you will reach a destination in time X...it has employed a fairly complex model of speed, distance, road conditions and traffic conditions. You can test it.

Any models concerning this virus are currently being tested.


Owen

I for one have never doubted the science but how are these models being tested? Simple comparison to other countries and see which graph fits best or the analogous Google map scenario where there are still unknows that cannot be factored in so this would mean that this test would either fail or some factors would have to be guessed / assumed to get a result?
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Old Thursday 2nd April 2020, 08:47   #208
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For anyone unable to read the article and my reproduction of this article does noy imply my agreement but he makes very valid points.


DrJohn Lee is a recently retired professor of pathology and a former NHS consultant pathologist.

in announcing the most far-reaching restrictions on personal freedom in the history of our nation, Boris Johnson resolutely followed the scientific advice that he had been given. The advisers to the government seem calm and collected, with a solid consensus among them. In the face of a new viral threat, with numbers of cases surging daily, I’m not sure that any prime minister would have acted very differently.

But I’d like to raise some perspectives that have hardly been aired in the past weeks, and which point to an interpretation of the figures rather different from that which the government is acting on. I’m a recently-retired Professor of Pathology and NHS consultant pathologist, and have spent most of my adult life in healthcare and science – fields which, all too often, are characterised by doubt rather than certainty. There is room for different interpretations of the current data. If some of these other interpretations are correct, or at least nearer to the truth, then conclusions about the actions required will change correspondingly.

The simplest way to judge whether we have an exceptionally lethal disease is to look at the death rates. Are more people dying than we would expect to die anyway in a given week or month? Statistically, we would expect about 51,000 to die in Britain this month. At the time of writing, 422 deaths are linked to Covid-19 — so 0.8 per cent of that expected total. On a global basis, we’d expect 14 million to die over the first three months of the year. The world’s 18,944 coronavirus deaths represent 0.14 per cent of that total. These figures might shoot up but they are, right now, lower than other infectious diseases that we live with (such as flu). Not figures that would, in and of themselves, cause drastic global reactions.

Initial reported figures from China and Italy suggested a death rate of 5 per cent to 15 per cent, similar to Spanish flu. Given that cases were increasing exponentially, this raised the prospect of death rates that no healthcare system in the world would be able to cope with. The need to avoid this scenario is the justification for measures being implemented: the Spanish flu is believed to have infected about one in four of the world’s population between 1918 and 1920, or roughly 500 million people with 50 million deaths. We developed pandemic emergency plans, ready to snap into action in case this happened again.

At the time of writing, the UK’s 422 deaths and 8,077 known cases give an apparent death rate of 5 per cent. This is often cited as a cause for concern, contrasted with the mortality rate of seasonal flu, which is estimated at about 0.1 per cent. But we ought to look very carefully at the data. Are these figures really comparable?

Most of the UK testing has been in hospitals, where there is a high concentration of patients susceptible to the effects of any infection. As anyone who has worked with sick people will know, any testing regime that is based only in hospitals will over-estimate the virulence of an infection. Also, we’re only dealing with those Covid-19 cases that have made people sick enough or worried enough to get tested. There will be many more unaware that they have the virus, with either no symptoms, or mild ones.

That’s why, when Britain had 590 diagnosed cases, Sir Patrick Vallance, the government’s chief scientific adviser, suggested that the real figure was probably between 5,000 and 10,000 cases, ten to 20 times higher. If he’s right, the headline death rate due to this virus is likely to be ten to 20 times lower, say 0.25 per cent to 0.5 per cent. That puts the Covid-19 mortality rate in the range associated with infections like flu.

But there’s another, potentially even more serious problem: the way that deaths are recorded. If someone dies of a respiratory infection in the UK, the specific cause of the infection is not usually recorded, unless the illness is a rare ‘notifiable disease’. So the vast majority of respiratory deaths in the UK are recorded as bronchopneumonia, pneumonia, old age or a similar designation. We don’t really test for flu, or other seasonal infections. If the patient has, say, cancer, motor neurone disease or another serious disease, this will be recorded as the cause of death, even if the final illness was a respiratory infection. This means UK certifications normally under-record deaths due to respiratory infections.

Now look at what has happened since the emergence of Covid-19. The list of notifiable diseases has been updated. This list — as well as containing smallpox (which has been extinct for many years) and conditions such as anthrax, brucellosis, plague and rabies (which most UK doctors will never see in their entire careers) — has now been amended to include Covid-19. But not flu. That means every positive test for Covid-19 must be notified, in a way that it just would not be for flu or most other infections.

In the current climate, anyone with a positive test for Covid-19 will certainly be known to clinical staff looking after them: if any of these patients dies, staff will have to record the Covid-19 designation on the death certificate — contrary to usual practice for most infections of this kind. There is a big difference between Covid-19 causing death, and Covid-19 being found in someone who died of other causes. Making Covid-19 notifiable might give the appearance of it causing increasing numbers of deaths, whether this is true or not. It might appear far more of a killer than flu, simply because of the way deaths are recorded.

If we take drastic measures to reduce the incidence of Covid-19, it follows that the deaths will also go down. We risk being convinced that we have averted something that was never really going to be as severe as we feared. This unusual way of reporting Covid-19 deaths explains the clear finding that most of its victims have underlying conditions — and would normally be susceptible to other seasonal viruses, which are virtually never recorded as a specific cause of death.

Let us also consider the Covid-19 graphs, showing an exponential rise in cases — and deaths. They can look alarming. But if we tracked flu or other seasonal viruses in the same way, we would also see an exponential increase. We would also see some countries behind others, and striking fatality rates. The United States Centers for Disease Control, for example, publishes weekly estimates of flu cases. The latest figures show that since September, flu has infected 38 million Americans, hospitalised 390,000 and killed 23,000. This does not cause public alarm because flu is familiar.

The data on Covid-19 differs wildly from country to country. Look at the figures for Italy and Germany. At the time of writing, Italy has 69,176 recorded cases and 6,820 deaths, a rate of 9.9 per cent. Germany has 32,986 cases and 157 deaths, a rate of 0.5 per cent. Do we think that the strain of virus is so different in these nearby countries as to virtually represent different diseases? Or that the populations are so different in their susceptibility to the virus that the death rate can vary more than twentyfold? If not, we ought to suspect systematic error, that the Covid-19 data we are seeing from different countries is not directly comparable.

Look at other rates: Spain 7.1 per cent, US 1.3 per cent, Switzerland 1.3 per cent, France 4.3 per cent, South Korea 1.3 per cent, Iran 7.8 per cent. We may very well be comparing apples with oranges. Recording cases where there was a positive test for the virus is a very different thing to recording the virus as the main cause of death.

Early evidence from Iceland, a country with a very strong organisation for wide testing within the population, suggests that as many as 50 per cent of infections are almost completely asymptomatic. Most of the rest are relatively minor. In fact, Iceland’s figures, 648 cases and two attributed deaths, give a death rate of 0.3 per cent. As population testing becomes more widespread elsewhere in the world, we will find a greater and greater proportion of cases where infections have already occurred and caused only mild effects. In fact, as time goes on, this will become generally truer too, because most infections tend to decrease in virulence as an epidemic progresses.

One pretty clear indicator is death. If a new infection is causing many extra people to die (as opposed to an infection present in people who would have died anyway) then it will cause an increase in the overall death rate. But we have yet to see any statistical evidence for excess deaths, in any part of the world.

Covid-19 can clearly cause serious respiratory tract compromise in some patients, especially those with chest issues, and in smokers. The elderly are probably more at risk, as they are for infections of any kind. The average age of those dying in Italy is 78.5 years, with almost nine in ten fatalities among the over-70s. The life expectancy in Italy — that is, the number of years you can expect to live to from birth, all things being equal — is 82.5 years. But all things are not equal when a new seasonal virus goes around.

It certainly seems reasonable, now, that a degree of social distancing should be maintained for a while, especially for the elderly and the immune-suppressed. But when drastic measures are introduced, they should be based on clear evidence. In the case of Covid-19, the evidence is not clear. The UK’s lockdown has been informed by modelling of what might happen. More needs to be known about these models. Do they correct for age, pre-existing conditions, changing virulence, the effects of death certification and other factors? Tweak any of these assumptions and the outcome (and predicted death toll) can change radically.

Much of the response to Covid-19 seems explained by the fact that we are watching this virus in a way that no virus has been watched before. The scenes from the Italian hospitals have been shocking, and make for grim television. But television is not science.

Clearly, the various lockdowns will slow the spread of Covid-19 so there will be fewer cases. When we relax the measures, there will be more cases again. But this need not be a reason to keep the lockdown: the spread of cases is only something to fear if we are dealing with an unusually lethal virus. That’s why the way we record data will be hugely important. Unless we tighten criteria for recording death due only to the virus (as opposed to it being present in those who died from other conditions), the official figures may show a lot more deaths apparently caused by the virus than is actually the case. What then? How do we measure the health consequences of taking people’s lives, jobs, leisure and purpose away from them to protect them from an anticipated threat? Which causes least harm?

The moral debate is not lives vs money. It is lives vs lives. It will take months, perhaps years, if ever, before we can assess the wider implications of what we are doing. The damage to children’s education, the excess suicides, the increase in mental health problems, the taking away of resources from other health problems that we were dealing with effectively. Those who need medical help now but won’t seek it, or might not be offered it. And what about the effects on food production and global commerce, that will have unquantifiable consequences for people of all ages, perhaps especially in developing economies?

Governments everywhere say they are responding to the science. The policies in the UK are not the government’s fault. They are trying to act responsibly based on the scientific advice given. But governments must remember that rushed science is almost always bad science. We have decided on policies of extraordinary magnitude without concrete evidence of excess harm already occurring, and without proper scrutiny of the science used to justify them.

In the next few days and weeks, we must continue to look critically and dispassionately at the Covid-19 evidence as it comes in. Above all else, we must keep an open mind — and look for what is, not for what we fear might be.


Written by Dr John Lee
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Old Thursday 2nd April 2020, 10:45   #209
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I inhabit a couple of other forums and came across this graph. It was posted to try and support the idea that the reaction by some governments to this outbreak, has been unneccessarily extreme, by comparing death rates across the World, of other significant, causes of death.

I have no idea where this graph was sourced or it's accuracy but you'd hope that COVID-19, stops short of the number killed annually by the HIV virus so at c48,000 deaths so far, in a global sense, it seems to be relatively minor compared to say diabetes?

The BBC stated the other day that so far, 1 in 10 hospital beds are being occupied by a COVID patient, it doesn't say what % that is of critical care beds.
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Old Thursday 2nd April 2020, 11:13   #210
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And this is the second stage tact used by aforementioned flat earthers, .....
Look, the forum already has it's resident Dymo - it's a club of 1 that I wouldn't recommend anyone be in a rush to join - I'd suggest avoiding such banausic peremptorism, swifter and more surely than v*mit on the sidewalk .....

Bad science is bad science.

I suppose now that former professor of pathology Dr.John Lee (quoted in post#208) has also said the same thing, and also questioned the same assumptions, that I, and others have raised, that we can put the childish persecution of 'the other' to bed, and open our minds to the very real ramifications of blindly following the resultant models.

All I was really asking is for a simple calculation of how many assumptions out by what order of magnitude, corrupted by data inaccurate by what order of magnitude, need to be compounded before the model becomes no more accurate than a wild guess ......

I would have thought any science graduate at least capable, and likely many high school students (I myself will bow out of the running since apparently my qualifications are obtainable by mail order and suitable for nothing more elaborate than a pie chart ! :)

Anyone wishing to go to snarkytown is really going to need a different travelling companion ......

I would really like to know what the plan is - how long are these 'isolation' measures (with all their very real deleterious impacts) envisaged to continue ? ....... and then what ?

Without either sufficient herd immunity and/or a vaccine - what is the plan ? It greatly concerns me that Parliament is suspended in this country.

No plan is no plan ........






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Old Thursday 2nd April 2020, 12:08   #211
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Bad science is bad science.

I suppose now that former professor of pathology Dr.John Lee (quoted in post#208) has also said the same thing, and also questioned the same assumptions, that I, and others have raised, that we can put the childish persecution of 'the other' to bed, and open our minds to the very real ramifications of blindly following the resultant models.


Chosun
Where was it published?

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Old Thursday 2nd April 2020, 13:05   #212
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Where was it published?

Owen
The Spectator was where I saw it. It's an opinion piece, not a peer reviewed paper.

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Old Thursday 2nd April 2020, 13:20   #213
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The Spectator was where I saw it. It's an opinion piece, not a peer reviewed paper.

John
Well he's a lot better placed to have that opinion than a great many others, including and especially, those here!

He was also interviewed by Adam Boulton on Sky news a couple of days ago, making the same points in a calm, rational manner, especially when AB was trying to lead him.
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Old Thursday 2nd April 2020, 13:21   #214
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The Spectator was where I saw it. It's an opinion piece, not a peer reviewed paper.

John
Yes, the Spectator was were I sourced it to also. ��

I think that's me done. Like the Daily Heil, I wouldn't wipe my hole with the Spectator...Brendan O'Neill's massive shiny forehead just has zero absorbancy.

I'll stick with the WHO.

Owen

P.s but I did love Chosuns flat earther meme. ��
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Old Thursday 2nd April 2020, 14:31   #215
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There's a growing number of news articles regarding theft of, amongst other things, hand sanitiser from UK hopitals.
I have now, just become personally aware of an individual who works for the NHS, in what role I know not, who has actually 'liberated', a number of supplies for her family, hand sanitiser and face masks.
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Old Thursday 2nd April 2020, 16:17   #216
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. . .I would have thought any science graduate at least capable, and likely many high school students (I myself will bow out of the running since apparently my qualifications are obtainable by mail order and suitable for nothing more elaborate than a pie chart. . .
My goodness you have a long memory. . ..

How about it, Pariah (anybody?) can you summarize your views in a pie chart or 2? If so, it would be a great kindness to our poor friend here.

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Old Thursday 2nd April 2020, 18:18   #217
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But thanks for posting this link to a report I hadn't seen:
https://www.reuters.com/article/us-c...-idUSKCN20M124
This is very much worth following up on, whether it turns out to be only testing error (initial false negative) or a real phenomenon. (Of course that was a month ago, years in normal human time... perhaps it's been settled.)
A few days ago I commented thus on an article Deb Burhinus posted. I haven't heard anything further about this issue of allegedly recurring(?) infection, but I did just run across a report that coronavirus tests do have a disturbingly high false negative rate, 30% or more:
https://www.nytimes.com/2020/04/01/w...-negative.html
It's quite likely then that there is no "reinfection", just faulty testing. Also this means that there are even more mild to asymptomatic cases of C-19 out there than testing seems to indicate, and the disease is even less deadly than thought.

Of course that will come as cold comfort to those unlucky enough to live in densely populated areas or large multigenerational families, where infection at home will be worst. (Not only New York City for example, but it now appears in particular postal codes within it.)
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Old Thursday 2nd April 2020, 18:24   #218
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For anyone unable to read the article and my reproduction of this article does noy imply my agreement but he makes very valid points.


DrJohn Lee is a recently retired professor of pathology and a former NHS consultant pathologist.

in announcing the most far-reaching restrictions on personal freedom in the history of our nation, Boris Johnson resolutely followed the scientific advice that he had been given. The advisers to the government seem calm and collected, with a solid consensus among them. In the face of a new viral threat, with numbers of cases surging daily, I’m not sure that any prime minister would have acted very differently.

But I’d like to raise some perspectives that have hardly been aired in the past weeks, and which point to an interpretation of the figures rather different from that which the government is acting on. I’m a recently-retired Professor of Pathology and NHS consultant pathologist, and have spent most of my adult life in healthcare and science – fields which, all too often, are characterised by doubt rather than certainty. There is room for different interpretations of the current data. If some of these other interpretations are correct, or at least nearer to the truth, then conclusions about the actions required will change correspondingly.

The simplest way to judge whether we have an exceptionally lethal disease is to look at the death rates. Are more people dying than we would expect to die anyway in a given week or month? Statistically, we would expect about 51,000 to die in Britain this month. At the time of writing, 422 deaths are linked to Covid-19 — so 0.8 per cent of that expected total. On a global basis, we’d expect 14 million to die over the first three months of the year. The world’s 18,944 coronavirus deaths represent 0.14 per cent of that total. These figures might shoot up but they are, right now, lower than other infectious diseases that we live with (such as flu). Not figures that would, in and of themselves, cause drastic global reactions.

Initial reported figures from China and Italy suggested a death rate of 5 per cent to 15 per cent, similar to Spanish flu. Given that cases were increasing exponentially, this raised the prospect of death rates that no healthcare system in the world would be able to cope with. The need to avoid this scenario is the justification for measures being implemented: the Spanish flu is believed to have infected about one in four of the world’s population between 1918 and 1920, or roughly 500 million people with 50 million deaths. We developed pandemic emergency plans, ready to snap into action in case this happened again.

At the time of writing, the UK’s 422 deaths and 8,077 known cases give an apparent death rate of 5 per cent. This is often cited as a cause for concern, contrasted with the mortality rate of seasonal flu, which is estimated at about 0.1 per cent. But we ought to look very carefully at the data. Are these figures really comparable?

Most of the UK testing has been in hospitals, where there is a high concentration of patients susceptible to the effects of any infection. As anyone who has worked with sick people will know, any testing regime that is based only in hospitals will over-estimate the virulence of an infection. Also, we’re only dealing with those Covid-19 cases that have made people sick enough or worried enough to get tested. There will be many more unaware that they have the virus, with either no symptoms, or mild ones.

That’s why, when Britain had 590 diagnosed cases, Sir Patrick Vallance, the government’s chief scientific adviser, suggested that the real figure was probably between 5,000 and 10,000 cases, ten to 20 times higher. If he’s right, the headline death rate due to this virus is likely to be ten to 20 times lower, say 0.25 per cent to 0.5 per cent. That puts the Covid-19 mortality rate in the range associated with infections like flu.

But there’s another, potentially even more serious problem: the way that deaths are recorded. If someone dies of a respiratory infection in the UK, the specific cause of the infection is not usually recorded, unless the illness is a rare ‘notifiable disease’. So the vast majority of respiratory deaths in the UK are recorded as bronchopneumonia, pneumonia, old age or a similar designation. We don’t really test for flu, or other seasonal infections. If the patient has, say, cancer, motor neurone disease or another serious disease, this will be recorded as the cause of death, even if the final illness was a respiratory infection. This means UK certifications normally under-record deaths due to respiratory infections.

Now look at what has happened since the emergence of Covid-19. The list of notifiable diseases has been updated. This list — as well as containing smallpox (which has been extinct for many years) and conditions such as anthrax, brucellosis, plague and rabies (which most UK doctors will never see in their entire careers) — has now been amended to include Covid-19. But not flu. That means every positive test for Covid-19 must be notified, in a way that it just would not be for flu or most other infections.

In the current climate, anyone with a positive test for Covid-19 will certainly be known to clinical staff looking after them: if any of these patients dies, staff will have to record the Covid-19 designation on the death certificate — contrary to usual practice for most infections of this kind. There is a big difference between Covid-19 causing death, and Covid-19 being found in someone who died of other causes. Making Covid-19 notifiable might give the appearance of it causing increasing numbers of deaths, whether this is true or not. It might appear far more of a killer than flu, simply because of the way deaths are recorded.

If we take drastic measures to reduce the incidence of Covid-19, it follows that the deaths will also go down. We risk being convinced that we have averted something that was never really going to be as severe as we feared. This unusual way of reporting Covid-19 deaths explains the clear finding that most of its victims have underlying conditions — and would normally be susceptible to other seasonal viruses, which are virtually never recorded as a specific cause of death.

Let us also consider the Covid-19 graphs, showing an exponential rise in cases — and deaths. They can look alarming. But if we tracked flu or other seasonal viruses in the same way, we would also see an exponential increase. We would also see some countries behind others, and striking fatality rates. The United States Centers for Disease Control, for example, publishes weekly estimates of flu cases. The latest figures show that since September, flu has infected 38 million Americans, hospitalised 390,000 and killed 23,000. This does not cause public alarm because flu is familiar.

The data on Covid-19 differs wildly from country to country. Look at the figures for Italy and Germany. At the time of writing, Italy has 69,176 recorded cases and 6,820 deaths, a rate of 9.9 per cent. Germany has 32,986 cases and 157 deaths, a rate of 0.5 per cent. Do we think that the strain of virus is so different in these nearby countries as to virtually represent different diseases? Or that the populations are so different in their susceptibility to the virus that the death rate can vary more than twentyfold? If not, we ought to suspect systematic error, that the Covid-19 data we are seeing from different countries is not directly comparable.

Look at other rates: Spain 7.1 per cent, US 1.3 per cent, Switzerland 1.3 per cent, France 4.3 per cent, South Korea 1.3 per cent, Iran 7.8 per cent. We may very well be comparing apples with oranges. Recording cases where there was a positive test for the virus is a very different thing to recording the virus as the main cause of death.

Early evidence from Iceland, a country with a very strong organisation for wide testing within the population, suggests that as many as 50 per cent of infections are almost completely asymptomatic. Most of the rest are relatively minor. In fact, Iceland’s figures, 648 cases and two attributed deaths, give a death rate of 0.3 per cent. As population testing becomes more widespread elsewhere in the world, we will find a greater and greater proportion of cases where infections have already occurred and caused only mild effects. In fact, as time goes on, this will become generally truer too, because most infections tend to decrease in virulence as an epidemic progresses.

One pretty clear indicator is death. If a new infection is causing many extra people to die (as opposed to an infection present in people who would have died anyway) then it will cause an increase in the overall death rate. But we have yet to see any statistical evidence for excess deaths, in any part of the world.

Covid-19 can clearly cause serious respiratory tract compromise in some patients, especially those with chest issues, and in smokers. The elderly are probably more at risk, as they are for infections of any kind. The average age of those dying in Italy is 78.5 years, with almost nine in ten fatalities among the over-70s. The life expectancy in Italy — that is, the number of years you can expect to live to from birth, all things being equal — is 82.5 years. But all things are not equal when a new seasonal virus goes around.

It certainly seems reasonable, now, that a degree of social distancing should be maintained for a while, especially for the elderly and the immune-suppressed. But when drastic measures are introduced, they should be based on clear evidence. In the case of Covid-19, the evidence is not clear. The UK’s lockdown has been informed by modelling of what might happen. More needs to be known about these models. Do they correct for age, pre-existing conditions, changing virulence, the effects of death certification and other factors? Tweak any of these assumptions and the outcome (and predicted death toll) can change radically.

Much of the response to Covid-19 seems explained by the fact that we are watching this virus in a way that no virus has been watched before. The scenes from the Italian hospitals have been shocking, and make for grim television. But television is not science.

Clearly, the various lockdowns will slow the spread of Covid-19 so there will be fewer cases. When we relax the measures, there will be more cases again. But this need not be a reason to keep the lockdown: the spread of cases is only something to fear if we are dealing with an unusually lethal virus. That’s why the way we record data will be hugely important. Unless we tighten criteria for recording death due only to the virus (as opposed to it being present in those who died from other conditions), the official figures may show a lot more deaths apparently caused by the virus than is actually the case. What then? How do we measure the health consequences of taking people’s lives, jobs, leisure and purpose away from them to protect them from an anticipated threat? Which causes least harm?

The moral debate is not lives vs money. It is lives vs lives. It will take months, perhaps years, if ever, before we can assess the wider implications of what we are doing. The damage to children’s education, the excess suicides, the increase in mental health problems, the taking away of resources from other health problems that we were dealing with effectively. Those who need medical help now but won’t seek it, or might not be offered it. And what about the effects on food production and global commerce, that will have unquantifiable consequences for people of all ages, perhaps especially in developing economies?

Governments everywhere say they are responding to the science. The policies in the UK are not the government’s fault. They are trying to act responsibly based on the scientific advice given. But governments must remember that rushed science is almost always bad science. We have decided on policies of extraordinary magnitude without concrete evidence of excess harm already occurring, and without proper scrutiny of the science used to justify them.

In the next few days and weeks, we must continue to look critically and dispassionately at the Covid-19 evidence as it comes in. Above all else, we must keep an open mind — and look for what is, not for what we fear might be.


Written by Dr John Lee
Andy,

Many thanks for posting this very fine article. Dr. Lee thinks and speaks like a true scientist, which as he says, "[is] all too often, characterised by doubt rather than certainty."

This one is a keeper.

Ed
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Old Thursday 2nd April 2020, 18:55   #219
tenex
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I have no idea where this graph was sourced or it's accuracy but you'd hope that COVID-19, stops short of the number killed annually by the HIV virus so at c48,000 deaths so far, in a global sense, it seems to be relatively minor compared to say diabetes?
No use, "water off a duck's back" as fugl says. There seem to be a lot of unbudgable opinions here. Such is life. Let's just wait and see, shall we. (As long as the doomsayers don't claim that their draconian measures were all that saved us!)

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If you believe any of the above, then you don't understand science.
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If an astrophysicist detecting gravitational waves from the collision of two black holes publishes a paper on the subject, another astrophysics expert may choose to challenge that, re-examine the data etc...but I won't, can't and shouldn't attempt to do so.
As you obviously know, none of that affects life on earth. In fact from my background in physics I'm accustomed to models that are actuallly accurate, getting the first-order effects right and perhaps many of the second order as well. What we wind up debating are details. These models in comparison are ridiculous, not even getting within an order of magnitude. Models from previous viruses (like SARS) have been applied to a new one that behaves much differently in the population, with large numbers of mild to asymptomatic infections not previously seen. And we're supposed to decide the world's fate based on that? Wake up to how serious this is, billions of lives and livelihoods, not whether I can go to a bloody pub. What kind of crude slur is that meant to be? Think of all the people who worked there, and in other "nonessential" businesses. I could say "I'm not sure you understand science yourself, or what you actually do understand" but I can see that not leading anywhere useful.

I had a terrible thought this morning. If Trump does another turnaround and starts tweeting to all those out of work (most of whom haven't even been able to get benefits yet, some not even eligible) about having been misled by "fake science", he could absolutely get himself re-elected. And the worst thing is he'll be right.

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And so the questions you or anyone like you, whining about the economy or that they can't go to the pub, is what number of dead people is acceptable to you so your life can go on as normal, and how exactly will you have them die? In hospitals, overwhelming medical staff? At home with their distressed families? Or at home alone and unknown?

How does that play out in your head?
OK, I'm up for that, big guy. Nothing we can do totally avoids deaths. A modest number of dead people is acceptable to me, a number like those who die every year of the flu (or its impact on other conditions) or careless driving or smoking or any of a dozen other things that happen in life, some or many of whom would have died soon anyway for one reason or another. All this self-righteous dudgeon about "death" gets tiresome. We all die. Maybe you're watching too much Italian TV. In the statistics of mortality around the world this is going to be a blip, barely noticeable.

(Oh, and poor people are going to start starving soon in places like India or Africa from the shutdown... have you done all the math, even in terms of deaths?)

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Old Thursday 2nd April 2020, 19:23   #220
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. . .A modest number of dead people is acceptable to me, a number like those who die every year of the flu (or its impact on other conditions) or careless driving or smoking or any of a dozen other things that happen in life, some or many of whom would have died soon anyway for one reason or another. All this self-righteous dudgeon about "death" gets tiresome. We all die. Maybe you're watching too much Italian TV. In the statistics of mortality around the world this is going to be a blip, barely noticeable.

(Oh, and poor people are going to start starving soon in places like India or Africa from the shutdown... have you done all the math, even in terms of deaths?)
You’re a hard man, tenex, a hard man. . ..
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Old Thursday 2nd April 2020, 19:51   #221
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These interactive daily updated graphs are un-nerving if you like that kind of thing
https://91-divoc.com/pages/covid-visualization/

Set the first graph to linear scale & the US curve looks pretty sinister.
This is a nice article on modelling. No idea why Trump is on the front and the title is stupid too.
https://www.msn.com/en-us/news/opini...BoUo_UArYqNtck

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Old Thursday 2nd April 2020, 20:32   #222
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A modest number of dead people is acceptable to me, a number like those who die every year of the flu (or its impact on other conditions) or careless driving or smoking or any of a dozen other things that happen in life, some or many of whom would have died soon anyway for one reason or another. All this self-righteous dudgeon about "death" gets tiresome. We all die. Maybe you're watching too much Italian TV. In the statistics of mortality around the world this is going to be a blip, barely noticeable.
That does it. Congratulations, you're the first person who made it onto my ignore list.

*plonk*

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Old Thursday 2nd April 2020, 20:40   #223
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You’re a hard man, tenex, a hard man. . ..
Apparently someone finally needed to just say it. But it's not me that's hard, it's life. And death. (Oh, and you somehow edited out the sentence Nothing we can do totally avoids deaths.)
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Old Thursday 2nd April 2020, 20:55   #224
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Set the first graph to linear scale & the US curve looks pretty sinister.
This is a nice article on modelling. No idea why Trump is on the front and the title is stupid too.
https://www.msn.com/en-us/news/opini...BoUo_UArYqNtck
Graphs of infections are bound to look sinister with a virus most of the population is expected to contract. Attention should be paid instead to hospitalizations and deaths.

You're right about the oddness of the title (Don't Believe The Models), the article's point seems to be quite the opposite. The author is a "writer" and "academic" not a scientist or doctor, and the argument she's making is the one I've been expecting and dreading to start hearing: the world is not going to end after all because people heeded the predictions of the models and took action, never mind whether they were remotely accurate or not. (She also seems confused as to whether we're trying to "stop" the spread, as many people are.)

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Old Thursday 2nd April 2020, 21:04   #225
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Apparently someone finally needed to just say it. But it's not me that's hard, it's life. And death. (Oh, and you somehow edited out the sentence Nothing we can do totally avoids deaths.)
Not “somehow” but deliberately to cut down on the verbiage a bit. And besides: “nothing we can do totally avoids death”. Who needs their faces rubbed in that!

And here’s a friendly tip. Your ideas would find a less hostile reception if you learned to express yourself less brutally. I know, I know, I’m being soft and sentimental but that's the state to which most of us humans devolve when confronted with such dreadful choices. You must have been human yourself once so surely you’re not unaware of that?

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