Coronavirus - potential Black Swan?

[Huggy]

3 minutes ago, Bruce Banner said:

https://www.theguardian.com/world/2020/mar/26/excel-coronavirus-hospital-will-be-by-far-the-largest-in-the-uk

https://www.theguardian.com/world/2020/mar/27/nonchalant-boris-johnson-accused-of-covid-19-complacency

 

As a (mild) prepper, I approve of getting the hospital ready. I wasn't clear that I also believe that this virus is more contageous than the flu and so would overwhelm the NHS, thus causing more deaths due to that.

However, until the death rate does actually hit 5% or even double figures, then my exasperation over any overly-emotional nonsense will continue.

Opinions are of course subject to change on receipt of new and more accurate data.

[Bruce Banner]

1 minute ago, Huggy said:

As a (mild) prepper, I approve of getting the hospital ready. I wasn't clear that I also believe that this virus is more contageous than the flu and so would overwhelm the NHS, thus causing more deaths due to that.

However, until the death rate does actually hit 5% or even double figures, then my exasperation over any overly-emotional nonsense will continue.

Opinions are of course subject to change on receipt of new and more accurate data.

[regprentice]

14 minutes ago, anonguest said:

 

• typically has a high case-fatality rate   - PASS - from what  see we have that at about 5% here in the UK so far

There doesn't seem to be a documented but looking at the way they talk about cases it appears a CFR of 1%, and in this link on cholera 5% is described as very high as opposed to high. 

The issue with a 3% rate is the lack of testing. Masses of people are self isolating due to the illness but but only one has been tested. I know roughly 20 self isolators just now but only one who has had a test. IMHO the real % is probably much lower, say 0.1 to 0.3%.

Wikipedia lists the following CFRs for comparison

Yellow fever 3-7.5%

Legionnaires disease 15%

Bubonic plague 60%

Ebola 90%

[winkie]

Leading by example has never been so important, an opportunity to be an example to us all.... nobody is immune to this, or above the law of science....this virus takes no prisoners.?

[regprentice]

Australian media reporting a reinfection rate in China of 3-14% of cases catching the virus twice. Wide range there. Variability by location sampled in the same way countries are showing very variable figures.

https://7news.com.au/lifestyle/healthmedicine/china-reports-deeply-disturbing-coronavirus-development-c-765460

The assumption behind the numbers is that people cohabiting with the infected person haven't caught the illness. So there must have been a genuine period of non infection in between the two periods of infection for the individual. 

So if 14% of people can be reinfected that may have grave consequences for the hope of a vaccine. 

Could also indicate there are certain people with a 'predisposition' to be seriously affected not necessarily shared even by close family members. 

[rollover]

42 minutes ago, Huggy said:

It's like a bad cold, and I maintain my previous opinion that it's something you don't want to get (especially if you're old or have "underlying etc etc"), and not leaving the house is a good idea, but we seriously need to man up about it. We don't get this emotional about the seasonal flu, and that knocks off quite a few golen oldies every year, with no clapping outside your windows either.

Also, the 5% number you have only looks at people who have been tested, who are supposedly showing symptoms, and so are a week or more into it.

The number of deaths is, I would imagine, pretty accurate.

The number of active cases have to be multiples more, and so the death rate is more like 1-3%. Nothing to get too worries about, no?

• number of active cases have to be multiples more
• 5% number people who have been tested
• The number of deaths is, I would imagine, pretty accurate

I'm feeling a bit slow today, but could you please explain to me how did you get pretty accurate number of deaths?

I'm feeling so jealous right now, your maths skills are dreamlike, simply unreal.

[uro_who]

As a 52 year old surgeon married to a 50 year old anaesthetist none of this feels the slightest bit like over emotional nonsense. Nor does it to our two school age children. We already have multiple colleagues off, some pretty ill and one in his late 40's in intensive care. Obviously many more people we work with will end up very ill or dead. People forget that about 15% of those that contract it require hospitalization for O2 etc and 5-6% ICU to stay alive. It's worth multiplying that by the number of people in the town you live in and then considering the average city of 500,000 would have an ICU of about 25-30 beds and skilled staff to match. Those numbers are very different.

 

For clarification, I don't want clapping, or for health care workers to be called heroes, but I'd like a huge ramping up of PPE, and when the dust has settled it would be nice if our pay could vaguely catch up with inflation, as a 30% pay cut since 2007/8 followed by being surrounded by utter misery at work is an unhappy combination.

 

WRT the downgrading from HCID, it's simply because the huge numbers of cases would make the bio-security requirements impossible to provide especially with the current level of kit and PPE the NHS has.

[onlooker]

21 minutes ago, regprentice said:

Australian media reporting a reinfection rate in China of 3-14% of cases catching the virus twice. Wide range there. Variability by location sampled in the same way countries are showing very variable figures.

https://7news.com.au/lifestyle/healthmedicine/china-reports-deeply-disturbing-coronavirus-development-c-765460

The assumption behind the numbers is that people cohabiting with the infected person haven't caught the illness. So there must have been a genuine period of non infection in between the two periods of infection for the individual. 

So if 14% of people can be reinfected that may have grave consequences for the hope of a vaccine. 

Could also indicate there are certain people with a 'predisposition' to be seriously affected not necessarily shared even by close family members. 

Would you trust any testing data coming out of China? After the Spanish sent back a load of kits to China because they were not reliable.

[slawek]

17 minutes ago, uro_who said:

As a 52 year old surgeon married to a 50 year old anaesthetist none of this feels the slightest bit like over emotional nonsense. Nor does it to our two school age children. We already have multiple colleagues off, some pretty ill and one in his late 40's in intensive care. Obviously many more people we work with will end up very ill or dead. People forget that about 15% of those that contract it require hospitalization for O2 etc and 5-6% ICU to stay alive. It's worth multiplying that by the number of people in the town you live in and then considering the average city of 500,000 would have an ICU of about 25-30 beds and skilled staff to match. Those numbers are very different.

 

For clarification, I don't want clapping, or for health care workers to be called heroes, but I'd like a huge ramping up of PPE, and when the dust has settled it would be nice if our pay could vaguely catch up with inflation, as a 30% pay cut since 2007/8 followed by being surrounded by utter misery at work is an unhappy combination.

 

WRT the downgrading from HCID, it's simply because the huge numbers of cases would make the bio-security requirements impossible to provide especially with the current level of kit and PPE the NHS has.

Do you know how many people are in ICU in London at the moment?

My estimation based on very limited data is something like 500-1000. That's getting close to the limit. They plan to at least double the capacity next week, which can buy a week. 

Have you noticed any improvement after the lockdown introduced 6 days ago?

Edited March 28, 2020 by slawek

[Huggy]

26 minutes ago, rollover said:

• number of active cases have to be multiples more Of course. It is (almost) a mathematical certainty
• 5% number people who have been tested No, 5% was the 759/14,543 value originally stated as the fatality rate
• The number of deaths is, I would imagine, pretty accurate. I trust the doctors to work out what killed someone

I'm feeling a bit slow today, but could you please explain to me how did you get pretty accurate number of deaths?

I'm feeling so jealous right now, your maths skills are dreamlike, simply unreal.

That's okay, it is quite early and the couple of weeks of housebound slumbering have made your comprehension, and my own explanations, a bit flabby maybe. I shall attempt to clarify

* Worldometers gives 759 deaths and 14,543 cases, a proportion of 5.2%, which was mentioned in the first comment as the fatality rate.

Pretty accurate number of deaths means that the doctors have determined cause of death correctly, and someone who has dies of cancer or something like that, has not been incorrectly labelled as a CV19 death. 759 is close to the number of people who have died from this virus. So pretty accurate even assumng there may be some hidden at home undiscovered maybe?

In the UK, 100k+ people have been tested with 15k found to be positive. I'm assuming, logically, that the 15k number is higher because there will be people who have not been tested who are positive, and I'd say many, many times more. Apparently, most people will have mild symptoms or maybe asymptomatic. That makes the fatality rate certainly a lot lower. 1% maybe? 3%? 0.1%? We'll know in August.

I've used certainly and almost certainly above. I'm happy they're materially correct statements using sensible assumptions. Please do point me in the direction of accurate information if you have it.

Edited March 28, 2020 by Huggy

[rollover]

3 minutes ago, onlooker said:

Would you trust any testing data coming out of China? After the Spanish sent back a load of kits to China because they were not reliable.

Would you trust any other country testing data?

And consider someone else's testing kits more reliable?

[anonguest]

1 hour ago, Huggy said:

It's like a bad cold, and I maintain my previous opinion that it's something you don't want to get (especially if you're old or have "underlying etc etc"), and not leaving the house is a good idea, but we seriously need to man up about it. We don't get this emotional about the seasonal flu, and that knocks off quite a few golen oldies every year, with no clapping outside your windows either.

Also, the 5% number you have only looks at people who have been tested, who are supposedly showing symptoms, and so are a week or more into it.

The number of deaths is, I would imagine, pretty accurate. The number of active cases have to be multiples more, and so the death rate is more like 1-3%. Nothing to get too worries about, no?

Isn't that the definition of CASE FATALITY RATE?  i.e. the number of people who test  positive for it AND die?

IF i am wrong then please correct me.

Unles I am right but you thnk 5% fatality rate is nothing special and we should all just 'man up' over it?

Edited March 28, 2020 by anonguest

[regprentice]

Just now, onlooker said:

Would you trust any testing data coming out of China? After the Spanish sent back a load of kits to China because they were not reliable.

Lots of crap made in China. Lots of cutting edge stuff too. Wouldn't put it past China to rush tests for themselves, the produce better tests as time went on, and then offload the earlier, less good, tests to someone else for a profit. Communists in name only. 

In a country like China I'd imagine the desire would be to suppress issues like this, not overstate them. 

The only political decision they could be making is to use this as evidence to support their renewed border closures to foreigners... But the evidence here doesn't really support that case. 

[onlooker]

2 minutes ago, rollover said:

Would you trust any other country testing data?

And consider someone else's testing kits more reliable?

Would I trust data out of China?:

https://www.telegraph.co.uk/news/2020/03/27/doubts-surface-chinese-virus-death-toll-thousands-urns-spotted/

 

Chinese testing kits:

https://www.theguardian.com/world/2020/mar/27/coronavirus-test-kits-withdrawn-spain-poor-accuracy-rate

[rollover]

2 minutes ago, anonguest said:

Isn't that the definition of CASE FATALITY RATE?  i.e. the number of people who test  positive for it AND die?

IF i am wrong then please correct me.

Unles I am right but you thnk 5% fatality rate is nothing special and we should all just 'man up' over it?

I have problem to follow you, give an example what you mean?

[uro_who]

It'll be at least 3-4 weeks before the lock down has an effect on ICU admissions due to incubation and disease course. My guess is we have probably baked in significantly more deaths than Italy. It's hard to say though as testing regimes are so different. I'd suggest that a well observed lock down is essential. I'd also suggest that catching it at any age is Russian roulette, although clearly the odds are worst if you get it on the way to collect your pension!

[rollover]

8 minutes ago, onlooker said:

Would I trust data out of China?:

https://www.telegraph.co.uk/news/2020/03/27/doubts-surface-chinese-virus-death-toll-thousands-urns-spotted/

 

Chinese testing kits:

https://www.theguardian.com/world/2020/mar/27/coronavirus-test-kits-withdrawn-spain-poor-accuracy-rate

China's testing kits are probably not accurate.

You dodged my questions.

[winkie]

8 minutes ago, anonguest said:

Isn't that the definition of CASE FATALITY RATE?  i.e. the number of people who test  positive for it AND die?

IF i am wrong then please correct me.

Unles I am right but you thnk 5% fatality rate is nothing special and we should all just 'man up' over it?

Fatality rate is all those who catch the virus to the percentage rate who die......many will catch it and recover without anyone ever knowing, they should be included in the fatality statistics.

Then of course you could break it down into age groups.....higher fatalities older people.

Then you could break it down to those with certain underlying health issues.....higher fatalities for those in already poor health.?

 

[Grayphil]

Just now, uro_who said:

As a 52 year old surgeon married to a 50 year old anaesthetist none of this feels the slightest bit like over emotional nonsense. Nor does it to our two school age children. We already have multiple colleagues off, some pretty ill and one in his late 40's in intensive care. Obviously many more people we work with will end up very ill or dead. People forget that about 15% of those that contract it require hospitalization for O2 etc and 5-6% ICU to stay alive. It's worth multiplying that by the number of people in the town you live in and then considering the average city of 500,000 would have an ICU of about 25-30 beds and skilled staff to match. Those numbers are very different.

 

For clarification, I don't want clapping, or for health care workers to be called heroes, but I'd like a huge ramping up of PPE, and when the dust has settled it would be nice if our pay could vaguely catch up with inflation, as a 30% pay cut since 2007/8 followed by being surrounded by utter misery at work is an unhappy combination.

 

WRT the downgrading from HCID, it's simply because the huge numbers of cases would make the bio-security requirements impossible to provide especially with the current level of kit and PPE the NHS has.

Yeah I can completely understand that point of view, I spend a lot of my time on the ships talking with the doctors and nurses who have become so jaded with the NHS system since the GFC, 

What is ridiculous is that on the ships cabin stewards and waiters are actually paid more onboard than the nurses. I couldn't believe it at first, but apparently the nurses are so desperate to look for something else there is almost a waiting list of nurses waiting to join ships. 

Its a very sad state of affairs, let's hope for a silver lining, that the UK realises the value of the NHS and renumerates the workers properly. 

Wish they could find a way to use the million volunteers (I did volunteer) to do something constructive like helping in factories to make the ppe.. I know it's not as simple as that.. But if only. 

[uro_who]

1 minute ago, winkie said:

Fatality rate is all those who catch the virus to the percentage rate who die......many will catch it and recover without anyone ever knowing, they should be included in the fatality statistics.

Then of course you could break it down into age groups.....higher fatalities older people.

Then you could break it down to those with certain underlying health issues.....higher fatalities for those in already poor health.?

 

We've just changed the rules to only count those who are tested and die in hospitals. Community deaths excluded. So those who are very elderly, infirm, who are very unlikely to get to ICU or improve in hospital, many in nursing homes will not even be counted.

[onlooker]

19 minutes ago, rollover said:

Would you trust any other country testing data?

And consider someone else's testing kits more reliable?

I believe most Western testing data to be basically honest, though there are different methodologies apparent for instance in the cause of death recorded in statistics which partly account for the different fatality rates in Italy vs Germany.

I would rely on the NHS to institute more reliable testing.

[anonguest]

1 hour ago, regprentice said:

There doesn't seem to be a documented but looking at the way they talk about cases it appears a CFR of 1%, and in this link on cholera 5% is described as very high as opposed to high. 

The issue with a 3% rate is the lack of testing. Masses of people are self isolating due to the illness but but only one has been tested. I know roughly 20 self isolators just now but only one who has had a test. IMHO the real % is probably much lower, say 0.1 to 0.3%.

Wikipedia lists the following CFRs for comparison

Yellow fever 3-7.5%

Legionnaires disease 15%

Bubonic plague 60%

Ebola 90%

Two points here.....

First, 1% is still pretty horrendous IF it ultimately ends up infecting, say, about 3/4 of the population - as TPTB seem to think will happen.  A 1% fatality rate for the UK would then translate into about 1/2 million dead!

Second, all those other diseases, as horrible as they may be, are by comparison relatively easy to avoid.  This coronavirus, with it also very likely being airborne, is vastly harder to avoid - and so the greate rnumbers of inevtiably infected will more than make up for its lower fatality rate compared with, say, Ebola (which by the way we know, so I undertsand it, have a vaccine/treatment?)

[regprentice]

6 minutes ago, anonguest said:

Isn't that the definition of CASE FATALITY RATE?  i.e. the number of people who test  positive for it AND die?

The govt isn't following WHO guidelines on testing so the numbers aren't comparable. Countries also aren't testing consistently. In retrospect you are going to need to compare results, availability of tests, reported volumes of self isolation by region and try and reach an overall figure for CFR. 

CFR is a measure of infections vs deaths. If you aren't making an attempt to correctly identify the number of infections then you CFR is worthless 

https://www.bbc.com/news/health-51943612

Before the announcement on testing of NHS staff, only seriously ill patients in hospital with flu-like symptoms were being routinely tested for the virus.

----

There are two main reasons for testing people - to diagnose them individually, and to try to understand the spread of the virus. This is called surveillance testing, but is not being done by the UK at present.

[rollover]

28 minutes ago, Huggy said:

That's okay, it is quite early and the couple of weeks of housebound slumbering have made your comprehension, and my own explanations, a bit flabby maybe. I shall attempt to clarify

* Worldometers gives 759 deaths and 14,543 cases, a proportion of 5.2%, which was mentioned in the first comment as the fatality rate.

Pretty accurate number of deaths means that the doctors have determined cause of death correctly, and someone who has dies of cancer or something like that, has not been incorrectly labelled as a CV19 death. 759 is close to the number of people who have died from this virus. So pretty accurate even assumng there may be some hidden at home undiscovered maybe?

In the UK, 100k+ people have been tested with 15k found to be positive. I'm assuming, logically, that the 15k number is higher because there will be people who have not been tested who are positive, and I'd say many, many times more. Apparently, most people will have mild symptoms or maybe asymptomatic. That makes the fatality rate certainly a lot lower. 1% maybe? 3%? 0.1%? We'll know in August.

I've used certainly and almost certainly above. I'm happy they're materially correct statements using sensible assumptions. Please do point me in the direction of accurate information if you have it.

I don't think the information are accurate.

 

[winkie]

7 minutes ago, uro_who said:

We've just changed the rules to only count those who are tested and die in hospitals. Community deaths excluded. So those who are very elderly, infirm, who are very unlikely to get to ICU or improve in hospital, many in nursing homes will not even be counted.

I would say that is a distortion of the real figures, but they have no other choice because of the failure/ lack of testing...?