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What I would like to know: Given the huge number of infected health workers, are ffp2/ffp3 masks with valve still commonly used in hospitals?
I think you mean: In institutions where health care workers work, which is much more than hospitals. Many of them work in practices or in various kinds of nursing homes. The masks you may see often in an ICU aren't ones you'll see often in a nursing home or a physiotherapist practice.
I think specifically in Spain, there were a particularly high infection rate of frontline hospital staff.

Spain like the majority of European countries does not have issues like lack of staff training or not following state-of-the-art protocols. So it begs the question, are the infection control protocols that we currently have, safe enough to deal with this virus?

An interesting case-study is Cotugno Hospital, an infectious disease hospital in Naples, Italy. It has so far reported zero staff infections. Perhaps their 'over-the-top' protocol is what is required for all Hospitals when dealing with SARS-COV2?

This virus is a strange one. Apparently there's no single symptom that affects even a small majority of the infected patients. That's a strange, unusual problem to handle for a system that assumes that illnesses make people ill.

A hospital is self-selecting, in that it doesn't have 50% patients that feel well and show no symptoms. The people who work at a hospital take the precautions that are considered appropriate for the disease they've diagnosed. This means that to some degree, they're not ambushed by asymptomatic infected people.

What I actually mean is if the standard protocol currently used in hospitals sees the health care workers as potential source of infections or only as potential infection targets.
There are routine protocols to keep health care workers from infecting patients. This is common, because the problem is a very common one. The stuff that lives on a healthy nurses's hands may do no damage there, but would do terrible damage if it could invade a patient who's weak from yesterday's operation. The same applies to the common cold, to whatever the nurse may have picked up while treating another patient half an hour ago, and many, many other varieties of the same hygiene problem.
>Italy, where 12,428 people have now died from COVID-19

with, not from

edit: First downvote after less than 10 seconds, and now [flagged] and will get -4'd. Be proud.

I think you are right, however prepositions are quite tricky for those whom English language is not mother tongue. In Polish we could say "on": eg. "12,428 people have now died on COVID-19".
I don't think that was GP's point. "From" seems absolutely correct. Using "with" would mean that the number refers to people who died while having COVID-19; using "from" means COVID-19 was the cause of death.
Can you not attribute a death to a disease? Covid19 is the name of the disease not the virus.
But we don't know if covid19 was the main cause of death
Sure you could have COVID-19 and then get hit by a car, but in almost all cases pneumonia from COVID-19 is the acute cause of death even if they have some other chronic health problems.
Why would you assume that? There was a comorbidity study from Italy that did not hint at that at all.
If you have cancer and you die from pneumonia then you died from COVID-19 and with cancer. Not the other way around.
That way we agree. However if you have cancer or break your neck and have a positive test, you should not be counted as "died from covid" - yet you are.
These specific deaths are being labelled as the official cause was Covid19. So I think we can know. There are other deaths that didn't occur in hospitals under professionals so those deaths "may" be Covid19.

This is litterally the evidence we're using the justify the lockdowns. Initially I thought it was some grammatical thing you were getting at e.g. a building is evacuated not a person.

The death counts being publicised are the number of confirmed cases that died. In other words, if you test positive for coronavirus and then die, that's +1 for the number of Covid-19 deaths in that country. This is not the way deaths related to any other respiratory infection are recorded.
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Even if it was only contributing - it should be counted.

I've told this story before - my dad has fought cancer for 8 years before he died, he was in paliatative care and one night his heart just couldn't go any longer and he passed away.

What do you think he has officially died "from"? Any sensible person would list his specific cancer as the cause of death, right? Nope, all the hospital wrote in his report was "died of cardiac arrest". So he exists in a statistical report somewhere as a 50 year old who died of...heart problems. That probably leads to some other people somewhere else going "hmmmmm, we have a weirdly large number of people dying from heart problems lately - better increase the cardiology budget!".

Do you see what I'm going at? Even if someone already had ongoing problems when they got covid19, both should be listed as the cause of death.

I read the article - is there anything I should be looking at in particular?
I should have elaborated, sorry. I'm actually trying to make the exact same point you are. People die, and there are sometimes various causes. In your case it was cardiac arrest that "masked" cancer or at least is only half of the whole story.

Now with many sars-cov-2 stories when you dig into individual cases you often find things like in the article: Two people died from a fall. They also had a positive test but I would argue the fall was definitely the major cause of death. They still are in the "died from" number almost all news outlets spew out right now.

Your tweets don't really say anything about the general case.

The death counts record the number of people who died after testing positive for this coronavirus. This isn't how deaths related to any other respiratory infection are recorded. There is upward pressure on the number from people with comorbidity for whom Covid-19 wasn't the primary cause of death, and there is also downward pressure on the number from people who died due to Covid-19's effects but were never tested. The relative magnitude of those different pressures is not known at this point.

> The death counts record the number of people who died after testing positive for this coronavirus

Probably important to point out the large regional variation.

In the UK the doctor has to be able to say to the best of their knowledge and belief that covid-19 was the cause of death before putting it on the death certificate.

We're not testing everyone, not even the ones in hospital for severe respiratory illness. We don't test dead people. So this feels like it's going to under-count, not over-count the deaths.

If this was just people who were going to die anyway we wouldn't have the huge rates of excess mortality. We know we have excess mortality because (again in the UK) we're having to build temporary morgues to hold all the dead bodies, and we're having to change the process to register deaths.

> In the UK the doctor has to be able to say to the best of their knowledge and belief that covid-19 was the cause of death before putting it on the death certificate.

Is "covid-19 on the death certificate" the same thing as "this death is included in covid-19 counts reported by NGOs/media"? Because I've noticed several news outlets in the UK reporting death counts with wording like "deaths of people who tested positive".

In the UK we have two different death counts. There's the numbers from Public Health England. These are more likely to be the numbers you've seen because they are updated daily and there's not much lag between death and reporting. The dashboard is here: https://www.arcgis.com/apps/opsdashboard/index.html#/f94c3c9... (and tucked away in the bottom right there's a link to a PDF for the methods).

The PHE numbers are:

> The figures shown are deaths in NHS-commissioned services of patients who have had a positive test result for COVID-19. These are reported by the services to NHS England. NHS England extracts data at 5pm each day and are reported in the dashboard the following day. Following validation, the total number of deaths in England is published by NHS England. This is combined with death counts provided to DHSC by the devolved administrations to give a UK total which is published by DHSC. The devolved administrations may publish slightly different figures based on different cut-off times. Deaths outside NHS services are not included. Deaths of people who have had a positive test for COVID-19 could in some cases be due to a different cause.

They're talking about NHS England there, but they're taking numbers from Wales, Scotland, and Northern Ireland (the devolved administrations) to give a total for the UK.

These numbers will be higher because, like you've said, they're including people who die with as well as of covid-19. But they'll also be lower because they're not including people who die outside NHS hospitals. That means most people who die in care homes or hospices will not be counted.

The other numbers are from the Office for National Statistics. These are going to be higher because they include all death wherever it happens that a doctor has said is due to covid-19. There's a lag between the death and the reporting of about a week because it uses death certificate data and that takes time.

Here's a blog post from the Office for National Statistics about counting death: https://blog.ons.gov.uk/2020/03/31/counting-deaths-involving...

Are you arguing grammar? Or is it about how those deaths are counted? I heard that some countries will not put COVID-19 as the cause of death if the patient had some other serious condition, like coronary disease, for example. If Italy is doing the opposite that would explain why there are so many COVID-19 deaths on record there.
We know Italy counts "everyone". There was even a study done on comorbidities.
I don't think its about the grammar. It is about how the cause of death is recorded. From what I understand if someone died having been tested positive for the virus in Italy the death is attributed to the virus regardless of any other ailments the deceased might have had. I don't this necessarily applies to other countries.
It does apply to most other countries, as far as I am aware.
The real number (including "from") is most definitely a lot larger than that.
No, this is the "with" number. The "from" number is unknown and is impossible to be larger.
You are write that the from number is unknown, but it can easily be larger. If a person is not tested and dies and is still not tested, they could have died from the disease without it being recorded. Unless every single death is being tested and every single test is 100% accurate, it is possible to be larger. I don't know whether it's plausible, but it's definitely possible.
It can be larger or smaller. People who died from the effects of Covid-19 without having been tested would make the "from" number larger. People who died after testing positive, but whose death was primarily caused by a comorbidity would make the "from" number smaller.
We can say that about almost any natural cause of death, but we don't.
The death tallies publicised for Covid-19 record the number of people who died after testing positive for this coronavirus, without any consideration for how serious their symptoms are or what other health problems contributed to their death. This is different from how basically all other respiratory infections are recorded.
The same isn't actually true of, say, the widely-quoted flu stats that everyone has been comparing the coronavirus to. Flu deaths are generally measured in terms of excess mortality, that is the number of deaths that occur above the normal baseline level due to the flu.
If those people would have survived without COVID-19, does the distinction really matter ?

In any case I am convinced that the number of victims is probably much higher.

There was an article where number of deaths was compared with previous years in towns around Bergamo. I cannot find the link now, so the numbers my be a bit wrong, but for example I remember that in a town of ~11k inhabitants, they had 150 deaths this March compared to the usual 20-30 of the previous years. This means that COVID-19 could have caused about 100 deaths while the official numbers say little more than 20.

EDIT: Found the article [1]:

"We checked the average of the previous years, in the January-March timeframe. In Nembro it should have been - in normal conditions - about 35 deaths. This years the municipality registered 158 deaths. 123 more than the average. Not 31 more, as it should have been according to the official numbers."

[1] https://www.tpi.it/cronaca/studio-nembro-numero-morti-superi...

If those people would have survived without COVID-19, does the distinction really matter ?

Yes, it matters. No stat records whether they would or wouldn't have survived without COVID-19. That's the problem with them: they just record the presence of the virus, not whether it caused death (which is at any rate a rather nuanced judgement, presumably).

The idea this virus is hyper-dangerous is coming from comparisons between these figures and other viruses which aren't recorded in the same way. Incomparable statistics being compared can lead to completely false conclusions.

they had 150 deaths this March compared to the usual 20-30 of the previous years

But they had far fewer deaths in December compared to the December of previous years:

http://www.salute.gov.it/portale/caldo/SISMG_sintesi_ULTIMO....

You would expect deaths to be higher in March than in prior years even if the virus was exactly as dangerous as flu, but pushed forwards by some months, because lots of people survived the winter who in prior years would not have done. So excess deaths will appear higher for now, but if you look at the areas under the graph, it looks a bit like it's just the normal winter surge delayed (so far ... it'll probably end up a fair bit higher, but we don't know that).

It seems to me that literally every number being used to support the notion that this is a very dangerous disease is statistically invalid in some way.

There is a huge difference countries in between in Europe. On one hand, you have Spain/Italy and on another, you have Denmark which is starting to plan a controlled opening in the coming weeks [1]. Denmark being the second European country to impose lockdown after Italy. But did so much earlier in the curve than Italy.

Going forward it will be very interesting to compare the 3 Scandinavian countries Denmark/Norway and Sweden. Very similar countries cultural, political, and economical but have chosen two very different paths. With Sweden being the last European country holding out against lockdown.

Edit: While the countries have very different population/area ratio their capitals Copenhagen/Oslo/Stockholm are comparable. And I'm not only talking about the actual number of cases/deaths. But also how the economy is going to be effected in the long run.

[1] https://www.reuters.com/article/us-health-coronavirus-denmar...

When comparing responses of each nation we really out to give consideration to the population of each as well as the land area.

When one nation has less population that a large city in another there really is no good comparison.

It might also be the case the the Italy (the north in particular) suffered from a larger influx of people with the virus from China or elsewhere to begin with. This means that they're starting with a significant handicap. I think this also adds to the difficulties of direct comparisons between countries.
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> But did so much earlier in the curve than Italy.

Things could have been better for Italy if they had imposed a total lockdown a little earlier for the Bergamo industrial region. The fact is that the industrialists in that area were against it and nothing happened, apart from the whole region of Lombardy being put in a looser lockdown a few days after things had started going bad in the Bergamo region. That "helped" the virus spread around Bergamo and in the whole province of Lombardy, so that Bergamo together with neighbouring Brescia were the most heavily hit regions both in number of cases and deaths.

Denmark had it "easier", so to speak, because if you lockdown Copenhagen I guess you've already lockdown-ed half of the country already.

This is an article in Italian [1] about what went wrong in the Bergamo industrial region.

[1] https://www.ilpost.it/2020/04/01/disastro-alzano-lombardo-ne...

As the other comment already said you're comparing apples and oranges. If you take some regions of Spain that has around the same population of Denmark for example they're more or less at the same level of Denmark. Most of the contagions in Spain are in Madrid.
Germany also does better than Italy and Spain and it has a bigger population.
Germany started later, wait a few weeks and we will talk then. Spain was pretty good too when Italy was already in the hundreds of deaths.

England is looking far better than Spain and Italy NOW, but I will bet that the contagions and deaths are going to be higher ( proportionally speaking ) in a couple of months.

The infections in Germany were the same as Italy after the same period.

Italy is getting better now but it was already a hard hit when being at the same level as Germany is now.

If the numbers are right, things are already at its worst in Germany while still being much better than Italy at its worst.

I keep hearing from friends in Germany that the death numbers reported are completely bollocks. They say the people who die with pre-existing conditions aggravated with the coronavirus are not counted, nor the people who are not tested after deceasing. Whereas in Italy seems everything that dies in the medical system these days is being counted.

Would love to see someone confirming or disproving this...

I read this the other way around.

The death numbers from Italy were completly insane, because they counted in people who would have died anyway and just happened to be infected by the virus at the time of death.

Don't know which is true.

Both countries are counting all infected.

https://swprs.org/rki-relativiert-corona-todesfaelle/

The President of the German Robert Koch Institute confirmed on March 20, 2020 that test-positive deceased are counted as "corona deaths" regardless of the real cause of death: "We consider a corona death to be someone who has been diagnosed with a coronavirus infection was, «said the RKI President when asked a journalist (see video below).

According to experts, the number of deaths is severely relativized, since the patients die in many cases from their previous illnesses and not from the virus. Data from Italy show that over 99% of the deceased had one or more chronic medical conditions, including cancer and heart problems, and only 12% mentioned the coronavirus on the death certificate as a cofactor.

A look at the statistics of the German test-positive deaths shows that the median age of the deceased, similar to Italy, is over 80 years and that there were usually one or more serious previous illnesses.

But there's only so much you can do to hide an influx of dead bodies; whatever the explanations are, people would notice at least this.
It's like the numbers in China. Who the fu--- believes that a country with 1.4 billion people and that had no previous knowledge of the virus ( like the rest of the countries ) has less contagions and deaths than USA, EU or any other country.
Yes, I don't really know what's true.

I can just have assumptions on what is reported.

To me it seems that the US is spiraling out of control, Italy and Spain had shitty health systems so they didn't do well and Germany doing okay.

But yeah, could be totally wrong reporting.

The absolute population should only start to play a role once a significant part of the population is or has been infected. In all other cases the population density should be the only invariant factor that matters for the different infection rates.
Denmark has 18 deads per 1M people, on the european situation I would it's on the average. Infections started much earlier in Italy and Spain, most of the other countries had the advantage of learning from these 2 and having the time to prepare.
If you look at death per capita situation in Nethetlands, Belgium, Luxemburg, Switzerland and recently also in Sweden and UK is on par with France..

BE 87 per milion, NL 68, France 62, Switzerland 58, Luxemburg 46, UK 35, Sweden 24.

also Andora and San Marino, Monaco

https://www.worldometers.info/coronavirus/

"While the countries have very different population/area ratio their capitals Copenhagen/Oslo/Stockholm are comparable."

I would say not even close....

Population:

Oslo .. 673,469 -- Barcelona .. 5.515 million -- Madrid 6.55 million --

Population density:

Oslo .. 3,500 people per square kilometer -- Barcelona .. 16,000 people per square kilometer -- Madrid .. 5,400 people per square kilometer -- `

How did you get from Copenhagen/Oslo/Stockholm to Oslo/Barcelona/Marid?
Copenhagen : 602,481 Stockholm : 974,073

Still no comparable, but whatever, it seems you got your own opinion.

You mean: how Europe & USA sleepwalked into the coronavirus crisis.
This article doesn't mention the USA at all. Actually read the article. It is explaining how things happened, rather than just accusations.
I guess "why" is the interesting question. This article shows that they sleepwalked into it, describing some of the events or documents that accompanied that. But it doesn't actually say why.

After there were more than a dozen cases discovered at one workplace in Bavaria, a consequence of one apparently healthy woman travelling from China to a training session, it is incredible that they didn't say "this is a highly contagious disease and given its consequences in China, we must be prepared" instead they said "we're prepared".

But why? What motivated the collective dropping of the ball? A commenter says of Denmark above, that they did well. But again, Denmark responded late - they locked down after Italy when coronavirus was spreading like hotcakes in Europe. It's just that they seem to have been lucky that it wasn't spreading in Denmark before they acted. In February it seems like all governments were saying "We'll be fine, nothing to worry about".

Why did Europe drop the ball? Are there lockdowns in China regularly that I'm not aware of, so this was a case of the boy crying wolf? Did the WHO need to say "this is a pandemic" before anyone was prepared to take it seriously?

So, the short story here would be: EU proposed to help & coordinate action but individual governments failed to acknowledge/assess how unprepared they were (going to be), as they did not assess the threat properly. And their joint reports provided a false sense of security to the whole.

That there's a deep coordination/collaboration failure here is clear.

But how could several many governments/states all assess that much wrongly on their own capacity to face the epidemics?

China did its best to keep the epidemic secret for at least several weeks, while buying medical supplies from Europe and other areas, draining them of their own reserves.
Sure, peddle a conspiracy rather than incompetence in the face of a new outbreak that when it started nobody knew how serious it was going to be.
It was both malice on the part of Chinese and incompetence of Europeans. But the punchline is the contrast between the hyper-competent, serious image of US healthcare in the movie Contagion and how it turned out in practice.
Most cases here in India are from Europe, the Middle East, and the US. These self-conceited nations really screwed us over in India (and now the idiots here are spreading it via Mosques).

Gee! Thanks guys! Great work!

Amusingly reddit is full of whining pricks from these very countries who were salivating at the possibility of millions dying here. Now, whatsmore, dim-witted Indians, being the loyal slaves of the Anglo-Saxons that they are, are now jumping on the "ChinaVirus" bandwagon of the American wingnuts...

The world really is an Orwellian cesspit.

The root cause failure was not complacency about medical supplies.

The root cause failure was complacency about the contagiousness and mortality rate and the failure to contain Covid-19 to China by stopping all international travel.

Containment at the source should have started at least in early December 2019 to be effective. And even then, that would likely not have been effective (because the severity of the epidemic was not asserted widely & seriously enough by then).

So the issue is realistically not there.

Surprisingly former Eastern Bloc countries are doing quite well thanks to early lockdowns. I think it's largely due to people not trusting public health systems.