I believe that if we loosen things a little soon, this will be the main one. I think it is likely that we have reduced susceptibility by 15% in New York already. And seasonal factors are swinging to be on our side.
If R0 was 2.5, a virus with Rt of 1.9 (*0.85, and then a little seasonal benefit) is still scary, but it's a completely different ball game.
On the other hand, if we don't experiment with reopening a little soon, we'll lose the chance to effectively use the time where weather is on our side...
Emphasis on "a little". Slightly increase the set of permitted activities, designate an industry or two more as permitted, and continue to encourage mask wearing.
I'm not sure whether I was downvoted for being pessimistic or optimistic. Most places seem headed towards extended controls and demanding a very high standard for any reopening.
I'm in the SF Bay Area which has had a fairly steady daily case count in the face of increased testing, but a declining number of COVID cases in ICU over the past 10 days. The latter is a lagging indicator, so whatever trend is there is going to continue for 10+ more days. IMO, we should slightly loosen controls, but I do not think public health will even consider that before a couple weeks have expired.
This number included "probable" deaths that had not been included before. This is an improvement in seeing the totality of the situation. However, if you want to track change you can see deaths by the old methodology are level:
It's not (or at least, not only) a delay, but a change in methodology of classification. Previously, all patients who tested positive for SARS-CoV-2 were counted, regardless of their cause of death. In the new methodology (in order to ensure that false negatives aren't missed), people with a pattern of symptoms are also counted, regardless of their cause of death.
So, many, many more people are counted than those who died directly from complications arising from Covid-19.
This is not altogether unreasonable; we want to know how many people are dying after contracting the virus. However, it is being reported as though the virus is the cause of death, when nobody doing the reporting is claiming that it is. It's a total mess.
Unfortunately, it's still unclear if these new numbers reflect those cases. If that changes (or has changed without my noticing), I'd love for a reply to this comment with a link, as I am also very much wanting to know.
Unfortunately I’ve seen these methodological updates getting twisted to serve various political ends - such as trying to discount the severity of the pandemic because “clearly they are overcounting”
If the number of deaths is overcounted (it might be, or it might be undercounted, or it might be overcounted in some places and undercounted in others), and the total number of cases is undercounted (it is; it's just a matter of how far we keep adjusting - we can't gain confidence until we have representative serological surveys), then the fatality rate (and thus almost certainly the mortality rate) is also overestimated.
I don't know if that is "discounting the severity", but so far we've watched the CFR go from the announcement at the WHO of 3.4% to paper after paper finding below 1% (sometimes far below). I don't think that these researchers are discounting the severity, I think they're doing the best they can with limited data.
If gp said people are being counted just for showing symptoms regardless of cause of death, then that would definitely be over counting. Same if just showing symptoms without a test. It's a way to count, but it'd artificially high.
New York reclassified a bunch of folks that died over the last few days as COVID deaths under their new methodology, where all deaths are covid deaths if there is even a hint that they might have had COVID.
These are not deaths that occurred in a 24-hour period. These are deaths that were reported in a 24-hour period, and covers basically everyone with any respiratory illness who died at home on Tuesday, Wednesday, or Thursday.
Trying to compare that to a rate of deaths in hospital of likely or confirmed cases (the methodology used from last week until Tuesday), or hospital deaths of confirmed cases (the methodology used before last week) is meaningless.
If you change methodology, you really have to go back and recast historic numbers. But that isn't being done.
...what an asinine headline. This is open letter worthy from reputable epidemiologists. It's been hard enough to identify and asses data (and expert commentary) without unambiguously deceptive (and panic-riddled) reporting like this.
The profitable manufacture of fear and justification of government overreach has been a reliable product and goal of sensationalist journalism for a very long time. The Spanish-American War is a prime example.
If anything, this crisis has drawn visible lines between those with unwavering trust in mass media and those without. Those who have good reasons to distrust authority have been the least likely to comply with orders and recommendations from both government agencies and mass media outlets. On the other hand, those who benefit from the current power structure have taken to their advice with great enthusiasm.
Between these groups are those like yourself who try to sift through the sensationalism for good information. Even then, international authorities like WHO have revealed clear political bias in regards to issues like Taiwanese independence. Who can we trust?
Either here or arriving soon, if recent election corruption scandals are anything to go by. You can add the trade war to that list given the resulting revolution in the Philippines.
> If you change methodology, you really have to go back and recast historic numbers. But that isn't being done.
This makes sense~ without some kind of reporting standard, every jurisdiction is free to apply their own methodology and we're prone to receive inaccurate (or politically biased) information. That might mean inflating numbers, or deflating (as is the case with China, an enormous country with miraculously no infections or deaths since the day they coincidentally kicked all western journalists out).
New York changing their methodology out of the blue this week puts a curious asterisk on both the numbers we're getting from them now and the numbers we got from them previously. Why the sudden change?
NY still has their old number of "confirmed deaths" which they were using previously and continue to report as a separate number from "probable deaths".
The article linked to doesn't mention that but what NY is doing makes sense. It lets us see the general trends using the old methodology while still being smart about counting going forward.
It is very open and every state + country should do something similar.
China never kicked Western journalists out. It revoked journalist liscence from a number of journalists from Washington Post, nyt, and wall street journal as a retailation when the US designated five Chinese media as Beijing operatives. Media from other countries, UK, Germany etc are all in China. You can see reporting and interviews in China by bbc, Reuters and many others right now.
As from the virus in China, as person who have many relatives and friends near wuhan and in Beijing, from all information sources I can gather, there is no massive spread in China right now. They staying highly alert but there isn't a large number of infections right now. And my anecdotal observation on the severity of the issue during February matches with the official count. So I don't believe there is massive under-reporting. All my friends and family don't buy there is massive deliberate under reporting as well.
> as is the case with China, an enormous country with miraculously no infections or deaths since the day they coincidentally kicked all western journalists out
Where are you getting your information? There has not been a single day since the outbreak where China has reported no new cases or deaths. They just added ~1000 deaths today in a move similar to TFA.
Somehow, the number of deaths has become a partisan political issue -- with one party wanting to suppress the numbers and another party wanting to "run up the score" -- because the lockdowns are a partisan issue now.
Democrats want to keep the lockdowns through at least June 1st, with major restrictions on movement at least through 2022, and some restrictions forever (see the "new normal" propaganda push)
Republicans see an opportunity to compare these lockdowns with authoritarian policies from history, and are pushing to end restrictions quickly, and make it harder for states and counties to impose lockdowns in the future.
As a result, virtually nobody has an interest in just reporting how the virus is going. Everyone has a narrative in mind, and chooses facts based more or less solely on how they promote that narrative.
New York wants high numbers. Many Midwest states want low numbers. So they produce them.
"If you change methodology, you really have to go back and recast historic numbers. But that isn't being done."
That is completely inaccurate. The deaths were added to historic numbers, and the "garbage number" is what was added to the total cumulatively to-date, and did not represent a 24 hour number on official stats. See the graphs on these pages. As you can see there is no discontinuous jump.
That's a wrong number for daily deaths.
It factors in previous deaths counts that weren't counted (mainly in NY). Those numbers should have been backdated. Currently it seems like the daily death toll is rising, although it doesn't (at least not so sharply).
These numbers need to be seriously scrutinized for everyone's sake. Hospitals are now financially incentivized to claim as many Coronavirus hospitalizations/deaths as possible so they get their piece of the stimulus package.
That sounds like a conspiratoral worry. Hospitals are all lying? We should just publish overall death rates long with traditional death rates and known cv cases. it's guaranteed there are missed cv tests. In Seattle they have not had enough cv tests to 'bother' testing the sad cases of large numbers of people dying, even in the famous kirkland senior citizen homes.
This was brought up during the daily Cuomo yesterday. The media have not fully explained the new reporting (am I cynical if I say so they get better clicks?)
CDC mandated that all localities, not just NYC/NYS, count probable deaths in addition to those where a covid positive test was available. These figures are not part of the 'official' covid death totals but instead are a separate category.
The reason this has been done is likely due to the reports coming from NYFD/PD concerning the much higher incidence of finding dead people when called. Those bodies are not being brought to hospitals for autopsie or anything else if there are no suspicious circumstances. By one report I read a few days back, a year ago it was typical to have encounter 25 dead on 911 calls over a 24 hour period. They are now seeing upwards of 200.
It is worthwhile to notice that there are as of April 13 there are 11k weekly coronavirus related deaths according to the CDC out of 600k tested [1].
In a normal flu season there are 8k daily flu deaths [2].
The ones that are the worst affected should be in the hospital. The cumulative rate of hospitalization is 12.3 per 100k, which adds up to 39k. So that puts an upper bound on known risk. [3]
41 comments
[ 4.2 ms ] story [ 92.3 ms ] threadIf R0 was 2.5, a virus with Rt of 1.9 (*0.85, and then a little seasonal benefit) is still scary, but it's a completely different ball game.
On the other hand, if we don't experiment with reopening a little soon, we'll lose the chance to effectively use the time where weather is on our side...
Emphasis on "a little". Slightly increase the set of permitted activities, designate an industry or two more as permitted, and continue to encourage mask wearing.
I'm in the SF Bay Area which has had a fairly steady daily case count in the face of increased testing, but a declining number of COVID cases in ICU over the past 10 days. The latter is a lagging indicator, so whatever trend is there is going to continue for 10+ more days. IMO, we should slightly loosen controls, but I do not think public health will even consider that before a couple weeks have expired.
https://twitter.com/NateSilver538/status/1250917711586168835
"New York City raised its likely death toll from coronavirus by 3,778 people on Tuesday afternoon"
https://www.wsj.com/articles/nursing-homes-remain-a-concern-...
So, many, many more people are counted than those who died directly from complications arising from Covid-19.
This is not altogether unreasonable; we want to know how many people are dying after contracting the virus. However, it is being reported as though the virus is the cause of death, when nobody doing the reporting is claiming that it is. It's a total mess.
Here's the actual data sheet: https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-d...
They weren't including these results previously as they were overwhelmed with testing the living, so weren't testing suspected deaths at home
I don't know if that is "discounting the severity", but so far we've watched the CFR go from the announcement at the WHO of 3.4% to paper after paper finding below 1% (sometimes far below). I don't think that these researchers are discounting the severity, I think they're doing the best they can with limited data.
New York reclassified a bunch of folks that died over the last few days as COVID deaths under their new methodology, where all deaths are covid deaths if there is even a hint that they might have had COVID.
These are not deaths that occurred in a 24-hour period. These are deaths that were reported in a 24-hour period, and covers basically everyone with any respiratory illness who died at home on Tuesday, Wednesday, or Thursday.
Trying to compare that to a rate of deaths in hospital of likely or confirmed cases (the methodology used from last week until Tuesday), or hospital deaths of confirmed cases (the methodology used before last week) is meaningless.
If you change methodology, you really have to go back and recast historic numbers. But that isn't being done.
If anything, this crisis has drawn visible lines between those with unwavering trust in mass media and those without. Those who have good reasons to distrust authority have been the least likely to comply with orders and recommendations from both government agencies and mass media outlets. On the other hand, those who benefit from the current power structure have taken to their advice with great enthusiasm.
Between these groups are those like yourself who try to sift through the sensationalism for good information. Even then, international authorities like WHO have revealed clear political bias in regards to issues like Taiwanese independence. Who can we trust?
Where is our John Quincy Adams?
This makes sense~ without some kind of reporting standard, every jurisdiction is free to apply their own methodology and we're prone to receive inaccurate (or politically biased) information. That might mean inflating numbers, or deflating (as is the case with China, an enormous country with miraculously no infections or deaths since the day they coincidentally kicked all western journalists out).
New York changing their methodology out of the blue this week puts a curious asterisk on both the numbers we're getting from them now and the numbers we got from them previously. Why the sudden change?
The article linked to doesn't mention that but what NY is doing makes sense. It lets us see the general trends using the old methodology while still being smart about counting going forward.
It is very open and every state + country should do something similar.
https://www.nytimes.com/2020/04/14/nyregion/new-york-coronav...
As from the virus in China, as person who have many relatives and friends near wuhan and in Beijing, from all information sources I can gather, there is no massive spread in China right now. They staying highly alert but there isn't a large number of infections right now. And my anecdotal observation on the severity of the issue during February matches with the official count. So I don't believe there is massive under-reporting. All my friends and family don't buy there is massive deliberate under reporting as well.
Where are you getting your information? There has not been a single day since the outbreak where China has reported no new cases or deaths. They just added ~1000 deaths today in a move similar to TFA.
https://www.worldometers.info/coronavirus/country/china/
They also did not "kick all western journalists out". Here's a report from the BBC with interviews of people in Wuhan that was published a week ago:
https://www.bbc.com/news/world-asia-china-52197054
Democrats want to keep the lockdowns through at least June 1st, with major restrictions on movement at least through 2022, and some restrictions forever (see the "new normal" propaganda push)
Republicans see an opportunity to compare these lockdowns with authoritarian policies from history, and are pushing to end restrictions quickly, and make it harder for states and counties to impose lockdowns in the future.
As a result, virtually nobody has an interest in just reporting how the virus is going. Everyone has a narrative in mind, and chooses facts based more or less solely on how they promote that narrative.
New York wants high numbers. Many Midwest states want low numbers. So they produce them.
That is completely inaccurate. The deaths were added to historic numbers, and the "garbage number" is what was added to the total cumulatively to-date, and did not represent a 24 hour number on official stats. See the graphs on these pages. As you can see there is no discontinuous jump.
[0] https://www.nytimes.com/2020/04/14/nyregion/new-york-coronav...
[1] https://www1.nyc.gov/site/doh/covid/covid-19-data.page
Do you have a link?
CDC mandated that all localities, not just NYC/NYS, count probable deaths in addition to those where a covid positive test was available. These figures are not part of the 'official' covid death totals but instead are a separate category.
The reason this has been done is likely due to the reports coming from NYFD/PD concerning the much higher incidence of finding dead people when called. Those bodies are not being brought to hospitals for autopsie or anything else if there are no suspicious circumstances. By one report I read a few days back, a year ago it was typical to have encounter 25 dead on 911 calls over a 24 hour period. They are now seeing upwards of 200.
In a normal flu season there are 8k daily flu deaths [2].
The ones that are the worst affected should be in the hospital. The cumulative rate of hospitalization is 12.3 per 100k, which adds up to 39k. So that puts an upper bound on known risk. [3]
[1] https://www.cdc.gov/nchs/nvss/vsrr/COVID19/index.htm
[2] https://www.cdc.gov/mmwr/volumes/68/wr/mm6826a5.htm
[3] https://gis.cdc.gov/grasp/COVIDNet/COVID19_3.html?fbclid=IwA...