COVID-19 Pandemic

[emax]

8 minutes ago, kold weather said:

Totally agree with your post matty, the only question I do have is this part.

The key with mortality is having good hospital procedures as noted, however once we are getting into the Italy situation and the capacity is maxed out, then surely the mortality rate is going to skyrocket as effectively you are having to choose who lives and dies based on best chances, and obviously those with bad chances are less likely to survive in the first place even without the removal of help. 

So whilst the normal mortality is 0.5%, you could easily shoot it back upto 3% average because the care quality degrades as the NHS crumbles under the strain of thousands needing extra care.

I know the idea is to not get to that point, but its kind of feeling inevitable at this point given what has been said this evening.

 

I cant remember now, so I might be wrong, but wasnt the initial 3% CFR (Wuhan era) during the Wuhan crisis, so that 3% CFR does at least partially take into account a struggling health system?

[BornFromTheVoid]

1 minute ago, emax said:

I'm not downplaying, but over what time frame? Thats the key to all this

The UK population is roughly 68 million. Herd immunity requires at least 80% resistance. That equals 54 million people getting infected. With a death rate, taking a very low value, of 0.2%, that's 108K deaths. The plan is to take the pain early to avoid a theoretical second wave (no social isolation, no banning of large crowds, etc), so we can expect this over the next 6 months. However, those 100k fatalities will only be a small proportion of the total number that require ICU treatment (think closer 2 million), and they will be a small proportion that require general hospitalisation (growing close to 5 million). Given the fact (not opinion) that the NHS struggles when seasonal flu is bad, and only has a total of around 4,000 ICU beds, of which more than 3,000 are occupied at any one time... how can it possibly cope? The estimates here are low, best case stuff. 

[kold weather]

Just now, emax said:

I cant remember now, so I might be wrong, but wasnt the initial 3% CFR (Wuhan era) during the Wuhan crisis, so that 3% CFR does at least partially take into account a struggling health system?

Yes, its clearly not the normal CFR in a normal functioning health services, but many countries will have not have normal functioning health service. Italy is struggling with 1300 extra people in critical care...and certainly you could conceive a situation where a country could get orders of magnitude more than that if it were to really take off.

What maybe should be worth remembering is that out of 75,000 resolved cases, the CFR is still hoovering around 6% as an average, as it has done now for the last 2 weeks (within a range of 5.5-6.5, its actually gone above that range yesterday and today) which suggests that countries are clearly struggling to keep the numbers down once it really takes off in a country. I was hoping to see that average drop away somewhat, but if anything its increasing.

[weirpig]

1 minute ago, kold weather said:

It certainly doesn't, 2% of global population mortality is 154 million deaths! I think you'd notice that given its more than WW1 and WW2 combined!

Not that I'm saying that will happen, but 2% mortality rates are ultra rare in terms of infectious diseases, to give you an example, the Spanish Flu pandemic had a mortality rate of 2% and thats widely regarded as one of the most dangerous pandemics ever along with the Black Death and possibly a few plagues that hit the Roman Empire.

Even 1% fatality rate at 20% of the population is over 15 million deaths worldwide, which would rank it 2nd highest killed world wide behind Cardiovascular disease over a year period.

My arguement is  that if the government  released a daily total  of  flu  or measles  and a mortality rate  it would blow our mind   I just dont get why this virus is any different?   It seems that everyone waits on the daily totals   then panic    the world is lockdown  and I dont know why 

[matty007]

1 minute ago, emax said:

I cant remember now, so I might be wrong, but wasnt the initial 3% CFR (Wuhan era) during the Wuhan crisis, so that 3% CFR does at least partially take into account a struggling health system?

Partially, but it mostly due to the very fact that the only cases that were documented were those that were severe enough to require hospitalization, and intensive care. CFR is always highest at the start of a outbreak due to to this. The first cases weren't documented until the end of January as Covid. We now know that the virus indeed started at the beginning of December. So, how many contracted it and were mild cases that nobody knew about?

The CFR is still quite inflated due to so few being tested in comparsion to the actual cases. There are so many that have this, but are simply carrying on, or are at home.

[emax]

1 minute ago, matty007 said:

Partially, but it mostly due to the very fact that the only cases that were documented were those that were severe enough to require hospitalization, and intensive care. CFR is always highest at the start of a outbreak due to to this. The first cases weren't documented until the end of January as Covid. We now know that the virus indeed started at the beginning of December. So, how many contracted it and were mild cases that nobody knew about?

The CFR is still quite inflated due to so few being tested in comparsion to the actual cases. There are so many that have this, but are simply carrying on, or are at home.

Oh yeh, I totally get all that. I was just replying to kold because he suggested the CFR would go back up again with a struggling health service, so I was saying that is already factored in to your point, so as you say, the CFR is still probably much lower.

[kold weather]

8 minutes ago, weirpig said:

My arguement is  that if the government  released a daily total  of  flu  or measles  and a mortality rate  it would blow our mind   I just dont get why this virus is any different?   It seems that everyone waits on the daily totals   then panic    the world is lockdown  and I dont know why 

According to a report I've seen from WHO, Measles in 2017 killed roughly 250 people a day world wide, normal flu about 1000 a day world wide (rough figures of course). Yesterday world total was 400 for Covid-19, but remember we are going to continue to see that death rate rise as more countries start to max out their max capacity in hospital system.

My best guess is by the end of the month we will be north of a 1000 deaths a day from this thing worldwide.

Emax- I don't think Wuhan was anywhere near as bad a collapse of a health system like I think some countries will see in the coming months, some poorer countries are going to have to basically make very strict number calls and will lose far more than they save. Even in this country they are suggesting care maybe limited to those below 65 at the peak from a report from this evening.

Edited March 15, 2020 by kold weather

[BornFromTheVoid]

1 minute ago, weirpig said:

My arguement is  that if the government  released a daily total  of  flu  or measles  and a mortality rate  it would blow our mind   I just dont get why this virus is any different?   It seems that everyone waits on the daily totals   then panic    the world is lockdown  and I dont know why 

Flu, measles, cancer, car accidents... all what the health system are designed to cope with because they are common, predictable, and just enough funding is allocated to deal with them, but only barely. COVID-19 is throwing way more on top of all that, way beyond the capacity that the NHS and others were designed for. Everything now is streamlined and efficient, but not built to cope with sudden additional influxes of serious cases.

[weirpig]

Just now, BornFromTheVoid said:

Flu, measles, cancer, car accidents... all what the health system are designed to cope with because they are common, predictable, and just enough funding is allocated to deal with them, but only barely. COVID-19 is throwing way more on top of all that, way beyond the capacity that the NHS and others were designed for. Everything now is streamlined and efficient, but not built to cope with sudden additional influxes of serious cases.

And ?  What's that got to do with my comment? 

[matty007]

In my opinion, the CFR of Germany (0.25%), South Korea (1.2%) and Switzerland (0.9%) is probably around the actual accurate figure of this virus CFR. I would estimate the final CFR to be around 0.75%. Worse than Flu, yes, but not massively so.

If you look at most of the countries affected, indeed, the mortality is rather low (under 1% in many). We have to remember that Italy's population has a much higher percentage of elderly citiziens than average.

[weirpig]

 

4 minutes ago, kold weather said:

According to a report I've seen from WHO, Measles in 2017 killed roughly 247 people a day world wide, normal flu about 1000 a day (rough figures of course). Yesterday world total was 400 for Covid-19, but remember we are going to continue to see that death rate rise as more countries start to max out their max capacity in hospital system.

My best guess is by the end of the month we will be north of a 1000 deaths a day from this thing worldwide.

Emax- I don't think Wuhan was anywhere near as bad a collapse of a health system like I think some countries will see in the coming months, some poorer countries are going to have to basically make very strict number calls and will lose far more than they save. Even in this country they are suggesting care maybe limited to those below 65 at the peak from a report from this evening.

 

[weirpig]

5 minutes ago, kold weather said:

According to a report I've seen from WHO, Measles in 2017 killed roughly 247 people a day world wide, normal flu about 1000 a day (rough figures of course). Yesterday world total was 400 for Covid-19, but remember we are going to continue to see that death rate rise as more countries start to max out their max capacity in hospital system.

My best guess is by the end of the month we will be north of a 1000 deaths a day from this thing worldwide.

Emax- I don't think Wuhan was anywhere near as bad a collapse of a health system like I think some countries will see in the coming months, some poorer countries are going to have to basically make very strict number calls and will lose far more than they save. Even in this country they are suggesting care maybe limited to those below 65 at the peak from a report from this evening.

But are they in the same scrutiny    as coronavirus ?

[kold weather]

1 minute ago, matty007 said:

In my opinion, the CFR of Germany (0.25%), South Korea (1.2%) and Switzerland (0.9%) is probably around the actual accurate figure of this virus CFR. I would estimate the final CFR to be around 0.75%. Worse than Flu, yes, but not massively so.

If you look at most of the countries affected, indeed, the mortality is rather low (under 1% in many). We have to remember that Italy's population has a much higher percentage of elderly citiziens than average.

Again though, that is in a functioning health service, in countries and places where that stopped working or has become sub-optimal (Iran, Wuhan and N.Italy) the average CFR seems to be getting into the 3-4% range at least. I don't doubt your right about the normal range being in the 0.5-0.75%, that may indeed be on the higher side again due to unreported cases.

You have to assume that if it does blow up like expected, the vast majority of European health systems are going to go the same way as the countries mentioned above, therefore the CFR is going to rise as a consequences of people not getting the help that would normally save them.

Or am I way off base here? Be interesting to know!

[emax]

7 minutes ago, kold weather said:

 

Emax- I don't think Wuhan was anywhere near as bad a collapse of a health system like I think some countries will see in the coming months, some poorer countries are going to have to basically make very strict number calls and will lose far more than they save. Even in this country they are suggesting care maybe limited to those below 65 at the peak from a report from this evening.

I dunno, but from reports at least, you could definitely compare Wuhan to Italy. Yes many other poorer countries will struggle if it takes off for them, but I'm solely talking about UK at the moment.

[kold weather]

1 minute ago, weirpig said:

But are they in the same scrutiny    as coronavirus ?

I highly doubt it, but they are not going to massively far off. Of course there is also seasonal variation, some flu seasons for example can be quite rough. For example a severe flu season for China ended up getting a CFR of 0.19% in 2017-2018 for some parts of China. However those figures at least give you a reasonable framework to work from.

[emax]

2 minutes ago, kold weather said:

Again though, that is in a functioning health service, in countries and places where that stopped working or has become sub-optimal (Iran, Wuhan and N.Italy) the average CFR seems to be getting into the 3-4% range at least. I don't doubt your right about the normal range being in the 0.5-0.75%, that may indeed be on the higher side again due to unreported cases.

You have to assume that if it does blow up like expected, the vast majority of European health systems are going to go the same way as the countries mentioned above, therefore the CFR is going to rise as a consequences of people not getting the help that would normally save them.

Or am I way off base here? Be interesting to know!

Oh dont get me wrong, you could sadly be right. I just think that we just really dont know for sure yet. Best to plan for the worst obviously, and I'm sure there are lots of people scurrying away increasing the NHS's capacity as we speak, and I guess the advantage is that we are at least (even if only a few days) behind other countries, rather than being at the front like Italy.

[weirpig]

4 minutes ago, kold weather said:

I highly doubt it, but they are not going to massively far off. Of course there is also seasonal variation, some flu seasons for example can be quite rough. For example a severe flu season for China ended up getting a CFR of 0.19% in 2017-2018 for some parts of China. However those figures at least give you a reasonable framework to work from.

In your opinion  do you believe  this virus should result in such mass panic ?    As I said earlier  no different here  pubs rammed  and chinese restaurants rammed    for me  just carry on 

Edited March 15, 2020 by weirpig

[kold weather]

7 minutes ago, emax said:

I dunno, but from reports at least, you could definitely compare Wuhan to Italy. Yes many other poorer countries will struggle if it takes off for them, but I'm solely talking about UK at the moment.

Then I tend to agree, all my figures I've done has been based off 0.5% CFR for the UK, and a rough scaling up based on what we have seen from other countries averages from there. 

In answer to your time question, in an unmitigated peak, 95% of cases would occur in a 6-8 week period around the peak from a graph I saw on Thursday linked to the press briefing. Obviously that would be a total disaster, and obviously that is not going to happen because even the most minimal social distancing should drag that down by 25% or so without any of the more drastic measures.

The 2nd wave of the Spanish Flu was killing something like 20,000 a week at the peak, 1st wave killed about 5k a week at peak, and the 3rd peak was something between the two. Even a peak rate of the 1st wave of the Spanish flu is several times more severe than what Italy has at the moment, which you've got to think would be too much for our health system to take.

PS- I'm no doctor or anything like that, however my background is history based, so I'm pretty decent when it comes to statistical analysis and looking for trends. Its why I'm wondering about Matty's views on what I said as well, because I don't want to be talking out my backside!!

Edited March 15, 2020 by kold weather

[kold weather]

3 minutes ago, weirpig said:

In your opinion  do you believe  this virus should result in such mass panic ?    As I said earlier  no different here  pubs rammed  and chinese restaurants rammed    for me  just carry on 

No, but I think you've kind of answered your own point, the pubs are busy, and resturants full. So clearly there is no mass panic there. Concern and anxiety, for sure, especially for the older population, but I see no signs of mass panic yet (other than toilet rolls!!!) The media will always look for a story, and this is the no.1 story on the planet so they will focus so much attention on it, but the situation from country to country is shifting so rapidly.

[emax]

23 minutes ago, BornFromTheVoid said:

The UK population is roughly 68 million. Herd immunity requires at least 80% resistance. That equals 54 million people getting infected. With a death rate, taking a very low value, of 0.2%, that's 108K deaths. The plan is to take the pain early to avoid a theoretical second wave (no social isolation, no banning of large crowds, etc), so we can expect this over the next 6 months. However, those 100k fatalities will only be a small proportion of the total number that require ICU treatment (think closer 2 million), and they will be a small proportion that require general hospitalisation (growing close to 5 million). Given the fact (not opinion) that the NHS struggles when seasonal flu is bad, and only has a total of around 4,000 ICU beds, of which more than 3,000 are occupied at any one time... how can it possibly cope? The estimates here are low, best case stuff. 

I totally get your point, and I'm not for one minute saying the NHS will sail through this if even the best case figures end up being accurate.

Its just you've based this on there being no lockdowns, crowd banning, or social isolation, when quite clearly that is and always will be planned to happen, so I dont get how you can accurately say this is all over a 6 month duration?

 

[emax]

4 minutes ago, matty007 said:

 Alas, we are actually one of the prime candiate countires for this virus to really get a foothold. Our increase in daily cases is who of the highest in Europe.

All I would say on that point, is that our testing rates per million are still fairly high compared to most European countries, not the best by any means, but its fairly good. The daily testing has been gradually going up too, so although you may still be right, I dont think you can solely rely on the daily case increase, and probably not compare most of Europe at least.

[northwestsnow]

Increasing signs the Government is trying to free up as many beds as possible, including from private hospitals and trying to source as many ventilators as it can.

The war is coming ,in contrast to China we have had a little time to prepare, let us all hope (and in my case pray) as many people can be saved as possible.

 

[snefnug]

5 hours ago, Bristle boy said:

Well, i know they do extra tests to try and find cause of pneumonia, so one would expect any unknown detected would've been investigated. My point is that pneumonia is investigated to find cause of pneumonia; so during heart of Winter if an 'unknown' had shown up further investigation may have detected COVID-19.

You.gov publish weekly flu updates, where it is tracked in hospitals, care homes and schools, so I guess anomalies  would have been picked up if there were any.  

[Weather-history]

Look at the contrast between Spain and Portugal

Spain: 6391 known cases and 191 deaths

Portugal: 169 cases and 0 deaths.

 

Edited March 15, 2020 by Weather-history

[Robbie Garrett]

3 hours ago, emax said:

Oh dont get me wrong, you could sadly be right. I just think that we just really dont know for sure yet. Best to plan for the worst obviously, and I'm sure there are lots of people scurrying away increasing the NHS's capacity as we speak, and I guess the advantage is that we are at least (even if only a few days) behind other countries, rather than being at the front like Italy.

NHS is doing well from what my friend told me.  He did say check back in two weeks. And that's from a London Trauma hospital.

Maybe our systems are used to being overworked and stressed?

Meanwhilst another day travelling in London,  another day of filthy people sneezing and coughing without covering.  Probably the same tools who stockpile bog role.