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Thread: Disease and pandemics thread (because it's science)

  1. #391
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    Quote Originally Posted by profloater View Post
    The uk mag. Private eye points out that the office of national statistics says in 2015 there were 787 UK deaths from falling down stairs plus 250,000 non fatal stair accidents hospitalised, including 58,000 children. And it’s increasing year on year. Where is the outcry? I’ll bet it’s similar in other countries. Perspective required.
    It's not the same. You can't really have an epidemic of stair falling.

    A kind of worst-case scenario for Covid-19 is 60% infection rate and 18% death rate. In the UK that translates to over 7 million deaths. It really is not the same as some drunks falling down stairs.

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    Quote Originally Posted by kzb View Post

    A kind of worst-case scenario for Covid-19 is 60% infection rate and 18% death rate. In the UK that translates to over 7 million deaths.
    What are the assumptions behind a scenario of that nature? No attempts to stop the spread at all? All the population moving in together?
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  3. #393
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    Quote Originally Posted by George View Post
    Yes, but with time, there should be greater accuracy for confirmed and serious cases (1) and the correct number of deaths, hopefully.

    Yes, that's is to be expected, but the lag chart above isn't very revealing, or am I wrong? I thought we would see one of those lag day differences produce a more steady value but I don't see it (2). Perhaps the data is too inaccurate at this point. [Worse would be if it's contrived.]

    This seems likely given the number of cases, especially with a limited number of medical assistance in Wuhan. The number of deaths reported could be just as inaccurate as the number of cases, so then it becomes are they both equally inaccurate, IOW, could we come close to estimating an accuracy of both in a useful way? Probably not. Perhaps with the WHO entering into the picture improved accuracy for the data will come along but I think there's only a handful of personnel being allowed in at this time.

    I would expect most agree that it will be > 2% but it may be well under the SARS value of around 9.5%. The R0 value may prove to be of greater than expected importance.
    (1) Agreed it is easy once it is all over, but what exactly we are trying to do is estimate the death rate NOW. That is the problem we have set ourselves.

    (2) We need to define the cohort, from which a number of deaths results. We have the reported deaths on day X and reported cases on day X-T, where T is the time from being a "reported case" to "dead". We now have evidence that T is 11-21 days.

    The trouble is, this method does indeed give a CFR much greater than 2%, in Hubei at any rate. I don't think people want to know this.

  4. #394
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    Quote Originally Posted by Noclevername View Post
    What are the assumptions behind a scenario of that nature? No attempts to stop the spread at all? All the population moving in together?
    Both percentages are taken from sources, they are not made up.

    https://www.theguardian.com/world/20...lds-population

    The 18% CFR came from Imperial College, I gave the link for that upthread.

    Please note I am not saying that this is "likely". It is a worst case scenario that justifies peoples' fears. With lack of effective action it is something that could happen. It's not like an annual statistic on falling down stairs.

  5. #395
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    Quote Originally Posted by George View Post
    It's a reasonable comparison, but there is a worry difference between the two - scary vs. stupid.
    Quote Originally Posted by kzb View Post
    It really is not the same as some drunks falling down stairs.
    Without wishing to go all Gen Z about this, please lay off the stair-falling thing. You don't need to be stupid or drunk to fall down stairs, and if a person knows (as I do) someone who has died unpleasantly as a result of a stair fall, such characterizations can rather take the shine off their day.
    In a separate observation, since the elevators in many high-rise blocks in Wuhan have been disabled in order to discourage residents from going out, there's a distinct chance of a stair-fall death resulting from the quarantine measures--that was the first thing that occurred to My Wife The Professor when she read the news.

    And in other news, I see that reported daily new infection numbers in Hubei are now falling--back to levels last seen in January.

    Grant Hutchison

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    By the way, the situation with regard to the Ebola outbreak in the DRC continues to be encouraging. Funny how these things drop out of the news cycle just when it becomes clear that there's no justification for headlines reading "WE'RE ALL GOING TO DIE!"
    (I once very, very nearly convinced a newspaper editor that he should have an occasional section in his newspaper devoted to "Good news follow-ups", in which the previous month's diet of catastrophizing could be briefly balanced by news of how these various bad situations had been sorted out or resolved. Unfortunately, he went off the idea the following day, after he'd sobered up.)

    Grant Hutchison

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    Quote Originally Posted by grant hutchison View Post
    … In a separate observation, since the elevators in many high-rise blocks in Wuhan have been disabled in order to discourage residents from going out ...

    And in other news, I see that reported daily new infection numbers in Hubei are now falling--back to levels last seen in January.
    Is it possible those two items are related?

    "Well, I don't feel good at all. But I'm on the sixth floor with no elevator (or otherwise isolated) so I can't make it to the doctor. So I'll stay here and either get well or die … without being included in the statistics for now either way."
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  8. #398
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    Quote Originally Posted by Jim View Post
    Is it possible those two items are related?

    "Well, I don't feel good at all. But I'm on the sixth floor with no elevator (or otherwise isolated) so I can't make it to the doctor. So I'll stay here and either get well or die … without being included in the statistics for now either way."
    Yeah, hence my use of the adjective "reported", since lots of things can lead to a fall in reporting.
    But given that there have been house-to-house temperature checks going on in Hubei for a while now, so that people can be carted off to quarantine facilities, it seems unlikely that sort of shut-in situation would have a big impact on the figures.

    Grant Hutchison

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    Quote Originally Posted by grant hutchison View Post
    Without wishing to go all Gen Z about this, please lay off the stair-falling thing. You don't need to be stupid or drunk to fall down stairs, and if a person knows (as I do) someone who has died unpleasantly as a result of a stair fall, such characterizations can rather take the shine off their day.
    In a separate observation, since the elevators in many high-rise blocks in Wuhan have been disabled in order to discourage residents from going out, there's a distinct chance of a stair-fall death resulting from the quarantine measures--that was the first thing that occurred to My Wife The Professor when she read the news.

    And in other news, I see that reported daily new infection numbers in Hubei are now falling--back to levels last seen in January.

    Grant Hutchison
    For the sake of argument, 90% of the population is "a case". i.e they use stairs.

    90% of the UK population is 60 million. If you have a stair-using lifetime of 80 years the CFR is about 0.1%. That's after being "a case" for your whole life.

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    Quote Originally Posted by Jim View Post
    "Well, I don't feel good at all. But I'm on the sixth floor with no elevator (or otherwise isolated) so I can't make it to the doctor. So I'll stay here and either get well or die … without being included in the statistics for now either way."
    I meant to add that this sort of self-isolating behaviour is presumably one of the things that shutting down the lifts was intended to encourage. It's a much better way of getting R0<1 than having people roaming the streets in ineffective masks, and then sitting in a crowded waiting room waiting to be seen. The proviso, of course, is that once self-isolated you should get in contact with a medical practitioner or health authority. (I've no idea how easy that is to do in Hubei right now, but the door-to-door checks are presumably compensating for that to some extent.)
    Our local medical practice already has a big sign outside, in English and (I presume) Mandarin, giving advice to the effect that, if you feel unwell and believe you may have been exposed to the coronavirus, you should not enter the building but go directly home and phone the practice from there. And a small proportion of the British media have been publicizing this as the correct behaviour, running positive reports on one of the UK coronavirus patients who self-isolated as soon as he felt unwell.

    Grant Hutchison

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    Quote Originally Posted by kzb View Post
    For the sake of argument, 90% of the population is "a case". i.e they use stairs.

    90% of the UK population is 60 million. If you have a stair-using lifetime of 80 years the CFR is about 0.1%. That's after being "a case" for your whole life.
    Surely a lot lower than that. A "case" occurs each time a person uses stairs (just as a person will be "a case of the flu" each time they develop the disease). So billions of cases of stair-use in the UK annually result in a death toll of around 1000 annually. The whole-population case-fatality rate must be well under one in a million (though much higher in at-risk subgroups, who account for most of the deaths).

    Not sure why you'd address that remark to me, though, since I was hardly championing the whole "falling down stairs" analogy.

    Grant Hutchison
    Last edited by grant hutchison; 2020-Feb-12 at 04:08 PM.

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    Quote Originally Posted by grant hutchison View Post
    Without wishing to go all Gen Z about this, please lay off the stair-falling thing. You don't need to be stupid or drunk to fall down stairs, and if a person knows (as I do) someone who has died unpleasantly as a result of a stair fall, such characterizations can rather take the shine off their day.
    My apologies. The "stupid" part was more hyperbole and a self-reference as I used to slide rapidly down carpeted stairs with only touching the toe of each step. I strongly advise against it.

    In a separate observation, since the elevators in many high-rise blocks in Wuhan have been disabled in order to discourage residents from going out, there's a distinct chance of a stair-fall death resulting from the quarantine measures--that was the first thing that occurred to My Wife The Professor when she read the news.
    The amount of non-viral misery the folks in Wuhan must be going through must be considerable, compounding the problems in no small way.
    We know time flies, we just can't see its wings.

  13. 2020-Feb-12, 05:45 PM

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    Quote Originally Posted by kzb View Post
    (2) We need to define the cohort, from which a number of deaths results. We have the reported deaths on day X and reported cases on day X-T, where T is the time from being a "reported case" to "dead". We now have evidence that T is 11-21 days.
    Perhaps these may help. The extrapolation is more of a hint of the time lag than something quite quantitative, but I thought it might be worth a try anyway...

    Cases vs deaths.jpg
    Rate compare 8 day lag.jpg
    Rate compare 11 day lag.jpg
    We know time flies, we just can't see its wings.

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    Quote Originally Posted by George View Post
    The amount of non-viral misery the folks in Wuhan must be going through must be considerable, compounding the problems in no small way.
    Indeed. If and when this outbreak comes under control, we'll all owe a debt of gratitude to millions of Chinese citizens.

    Grant Hutchison

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    by no chance, the BBC rebroadcast their experiment, the "BBC Pandemic" in which an epidemic was simulated using one patient zero and thousands of volunteers using an app on mobile phones. The demonstration showed how the spread, with various assumptions, was faster than the standard vaccine preparation. But also the model showed how vaccinating certain people, those who are likely to be close to many others, dramatically reduced the spread, and similarly universal hand washing slowed the epidemic down so that vaccine preparation became feasible. The data set took account of age distribution too. It produced a scary death toll at 2% death rate but not dissimilar to the numbers expected to die in general every year. The important effect of course is having a large proportion of the population sick and the remainder avoiding contact thus closing down the economy. This must raise the strategic question of how many people to isolate or indeed instruct when the epidemic starts. If detected within a few days as a new virus, a shut down town might slow the spread enough to develop the vaccine and distribute it to prevent country wide shut down. Social media now probably makes this strategy obsolete. Equally being slow to detect it means it spreads effectively out of control within a territory.
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    Quote Originally Posted by kzb View Post
    Both percentages are taken from sources, they are not made up.

    https://www.theguardian.com/world/20...lds-population

    The 18% CFR came from Imperial College, I gave the link for that upthread.

    Please note I am not saying that this is "likely". It is a worst case scenario that justifies peoples' fears. With lack of effective action it is something that could happen. It's not like an annual statistic on falling down stairs.

    I never said your numbers were "made up". That's your addition to the conversation.
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    Quote Originally Posted by Noclevername View Post
    I never said your numbers were "made up". That's your addition to the conversation.
    The story just gets stranger.
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    I’m not sure if this has been mentioned yet, but here is a world wide tracker for the disease:

    https://gisanddata.maps.arcgis.com/a...23467b48e9ecf6

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    Quote Originally Posted by grant hutchison View Post
    Without wishing to go all Gen Z about this, please lay off the stair-falling thing. You don't need to be stupid or drunk to fall down stairs, and if a person knows (as I do) someone who has died unpleasantly as a result of a stair fall, such characterizations can rather take the shine off their day.
    Yes, years ago when I definitely was not drunk (I very rarely drink in any case) I took a tumble down stairs and fractured five ribs. Also was temporary dazed. It was extremely painful for a fair amount of time, and recovery was unpleasant. It took a very long time for the aching in my chest to stop completely. At that, it could have been much worse.

    For some time after that I avoided stairs and if I use them now, I make a point of being careful. On the positive side, I don’t have any particular fear or bad memories about it, I am just more cautious.

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    Quote Originally Posted by kzb View Post
    It really is not the same as some drunks falling down stairs.
    I think it is probably increasing not because more people are drinking but rather that the number of the elderly is increasing.
    As above, so below

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    A cruise ship, with no cases aboard, has been rejected by five ports.

    My opinion of humanity has just dropped a notch.

    https://www.bbc.com/news/world-asia-51484625


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    It is estimated that 500 million people died from small pox in the 20th century. https://en.wikipedia.org/wiki/History_of_smallpox This just shocks me. Perhaps there was an average of 6 billion people who lived and died in the 20th century. That is an incredible fraction of the deaths.
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    Quote Originally Posted by Van Rijn View Post
    Iím not sure if this has been mentioned yet, but here is a world wide tracker for the disease:

    https://gisanddata.maps.arcgis.com/a...23467b48e9ecf6
    Yes.

    Quote Originally Posted by Jim View Post
    Ö Latest developments:
    * Confirmed infections and fatalities continue to increase. Thus far the virus has reportedly infected 40,195 people in China with 908 fatalities. Outside of China 378 cases with 2 fatalities have been reported in 27 countries: Australia, Belgium, Cambodia, Canada, Finland, France, Germany, Hong Kong, India, Italy, Japan, Macau, Malaysia, Nepal, the Philippines, Russia, Singapore, South Korea, Spain, Sri Lanka, Sweden, Taiwan, Thailand, the UAE, United Kingdom, the United States and Vietnam. Updated figures can be found on Johns Hopkins University's coronavirus tracking map. ...
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    The Swiss Medical Weekly has a good article on the futility of trying to estimate CFR at present.
    Diagnosis of viral infection will precede recovery or death by days to weeks and the number of deaths should therefore be compared to the past case counts – accounting for this delay increasing the estimate of the case fatality rate. On the other hand, cases in official statistics are likely a severe underestimate of the total – accounting for this underestimate will decrease the case fatality rate. The time between diagnosis and death/recovery and the degree of underreporting will vary over time as well as between cities and countries. A precise estimate of the case fatality rate is therefore impossible at present. Figure 1 illustrates how these uncertainties manifest themselves using currently available data.
    Their Figure 1 is of interest, and the whole text worth reading.

    (There was a step increase in reported cases yesterday, reportedly due to a broadening of the diagnostic criteria, further muddying the waters.)

    Grant Hutchison

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    Ah, thanks Jim. I do recall that post, but the link was pretty deep in the text and I missed it.

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    Quote Originally Posted by grant hutchison View Post
    The Swiss Medical Weekly has a good article on the futility of trying to estimate CFR at present.Their Figure 1 is of interest, and the whole text worth reading.

    (There was a step increase in reported cases yesterday, reportedly due to a broadening of the diagnostic criteria, further muddying the waters.)

    Grant Hutchison
    Agreed.
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    The big jump in the numbers may be explained in part by these excerpts taken from here.


    "Hubei’s health commission said it was now including in its confirmed tally those people diagnosed via CT scans as well as via testing kits. Previously, the authorities had included only those cases confirmed by the diagnostic testing kits, which are in short supply.

    The shortage of the testing kits has meant that many sick residents have been unable to seek treatment, with hospital admission contingent on the test result.

    The political fallout from the outbreak also escalated on Thursday with the firing of party chief of Hubei province, the party chief of Wuhan and the head of China’s Hong Kong and Macau Affairs office.

    Thursday’s jump in infections may have been another impetus for the purges
    ."

    My hunch is that the last one could be restated as the purges were more easily justified by giving the jump in the numbers, so they may be overstated (more hope than reason, admittedly). The next few days may say a lot.
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    Quote Originally Posted by Copernicus View Post
    To me it looks like the fatality rate for those tested and treated and have had the virus awhile is high, probably 10 percent or higher, but there could be 80 percent in the mild category that will never be tested. It may bring the mortality down to two percent again. Then again many may have damage to the lungs that may make them more vulnerable to congestive heart failure COPD or pneumonia of a different sort. Too many unknowns yet.
    Still too many unknowns!
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    Quote Originally Posted by Copernicus View Post
    I would think every country would have a vested interest in keeping people from panicking. 400 million quarantined seems like desperation.
    I still think every country has a vested interest in preventing panic.
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    Quote Originally Posted by Copernicus View Post
    I still think every country has a vested interest in preventing panic.
    Unfortunately calm does not promote subscription to NY-Times or advertising revenues.
    Regurgitating same old news with ever more shocking headlines on the other hand ...

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