Number of Deaths

[WATFORD zero]

I'm sorry if I'm diving in to another conversation, but tonight the government made it very clear that the statistics were 'deaths in hospital' because 'that was the way all other countries were reporting it'.

I have a horrible feeling that the true numbers are known, and for a number of different reasons, they are not being released. I believe the next detailed figures (from NOS) are being released tomorrow, and a week and a half behind the announced stats, may give some more information.

 

[Mellotron]

With total numbers of cases in the UK likely underestimated, but the true values no more than double the numbers reported, and with total COVA deaths greater than those reported, my feeling is that in the UK, Germany, France, Italy and Spain the number of deaths per cased (1 death in 8 cases) is about right for now.

But will it (the rate of death in those infected) get bigger (less 'lethal') in the next few weeks?. I'll have to think about that.

A good case study is the diamond princess ship. 712 confirmed positive, of which about 12 have died. The vast majority were elderly.

Whereas you are suggesting a death rate about 9-10 times higher than that?

UPDATE - I’ve now re-read your post. Still...

 

[Harry Wilson's tackle]

The article I read :


https://www.reuters.com/article/us-health-coronavirus-tbvaccine-explaine-idUSKBN21K372

There are many similar articles.

At least scientists are actively investigating.

I see why you have been alerted to this, but I'm sorry to say that now I have taken a look I find this to be somewhat apocryphal:

“Scientists in several countries are testing a century-old tuberculosis (TB) vaccine to see if it might boost the immune system to reduce respiratory symptoms in people who get new coronavirus infections.”

OK. Here in the UK we all had our BCGs when we were about 12. So where might there be a BCG-naïve population on which to test this idea?

“One study in Guinea-Bissau found 50% lower mortality rates in children vaccinated with BCG than in kids who did not get this vaccine. That is a much bigger drop in deaths than could be explained by a reduction in TB cases.”

OK. Africans. Of course - BCG is not normally given there due to poverty…..this is a population study (case controlled? I doubt it) meaning the parents volunteering to get their kids given BCG is self-selecting and will be different from the control group, invalidating the study immediately. This is not a ‘drop in deaths’ but a difference in deaths between kids of motivated parents versus 'other parents' in a poor country. The inference of a real effect, and certainly one that has relevance to the UK, is wishful thinking.

“WHAT SCIENTISTS DO NOT KNOW
Scientists do not have data yet on the effect of BCG vaccination on coronaviruses in general or SARS-CoV-2 in particular.”

Indeed. Thanks, Reuters.

What does the WHO say?

"There is no evidence that the Bacille Calmette-Guérin vaccine (BCG) protects people against infection with COVID-19 virus. Two clinical trials addressing this question are underway, and WHO will evaluate the evidence when it is available. In the absence of evidence, WHO does not recommend BCG vaccination for the prevention of COVID-19. WHO continues to recommend neonatal BCG vaccination in countries or settings with a high incidence of tuberculosis.

There is experimental evidence from both animal and human studies that the BCG vaccine has non-specific effects on the immune system. These effects have not been well characterized and their clinical relevance is unknown"

I think we should file this in "let's try anything, as long as it's safe, and hope something works". That's how medicines were discovered up to the early 60s and pioneers such as the late great Jim Black. By all means let them test, but I'll bet £50 right now it has no meaningful impact, especially in the UK. And I'm not a betting man.

 

[oldboyroy]

Just off topic sir Patrick Vallaince I think said if we keep the death toll around or below 20000 we will do very well, I wonder what sort of numbers he may think now as we are nearly at 11 and a half thousand

 

[dazzer6666]

I don't quite follow what you're asking in this post, but I'll go with what I think you're saying.
I suspect that we'll have a much more relaxed form of lockdown until the vaccine arrives. This might entail easing the lockdown in certain areas (eg Brighton & Hove has a relatively low total of confirmed cases, currently 213) and/or for certain sectors (eg construction returns to work) and/or demographic profiles (eg 70yo+ no, or strictly limited, human interaction).
All of this lifting will be facilitated by the production (or purchase) of mass tests (both antibody and to see if you have the virus), and it's this that is key to minimisation of economic disruption. Unfortunately, we're looking poor on this front. Better news is the app the government is considering which will constitute a drastic infringement of civil liberties (and will generate a lot of hostility), but will enable economic activity to pick up, and the lockdown to be eased, without mass transmission.

Edit: this is a much better summary of the options ahead:

https://www.theguardian.com/comment...-the-coronavirus-crisis-end-lockdown-pandemic

Kind of. You said we we’d head for hundreds of thousands of deaths by progressing to herd immunity, but now you explain how we might avoid that by a gradual relaxation of lockdown and a slow progression to herd immunity (which is the only logical way put of this IMO - we can’t wait for a vaccine).

 

[Machiavelli]

Yes. These studies are not reliable.

I am slowly developing a postition on this that, like yours, is based on skepticism, and using the only global data set that is comprehensive (even if unreliable), the BBC daily set.

It is very hard for people not used to reading original research publications (as opposed to editorials, or even lay summaries, or newspaper articles) to be able to smell the coffee from the bullshit.

Here's the thing. In hospitals 99% of what goes on between doctor and patient is the delivery of healthcare. Collecting data for scientific purposes is not high on the agenda. It isn't done all that well in most cases even when it is top of the agenda (testing a new drug, for example).

So what we have here is a hospital agenda focused on making a clinical judgement about whether to hospitalize based on symptoms, not lab testing, and in which diagnostic lab testing is ordinarily done for selecting treatment not for collecting data for governments. This is the same in the UK, Germany, India, America, you name it. Furthermore, there is little point a doctor lab testing to prove COVA infection right now because it would not affect treatment (we have no 'treatment' for this virus, only a pathway to alleviate symptoms - so-called 'palliative intervention') and diagnosis would be of value to the patient only if it could prove the infection were something else, i.e., bacterial, that could be treated (with a specific antibiotic). So the data we get for modelling is always going to be 'poor'. But would it be too poor to assist in planning? No, I wouldn't say that.

My first hypothesis is that the poverty of the data has a systematic bias element so, when it comes to estimating how many people have had the virus so that the rate of death (that number divided by the number of bone fide COVA deaths) can be calculated is concerned, although it will always be a bit 'back of the envelope', we can expect a systematic (and therefore correctable) bias based on an assumption that the total number of proven cases is an underestimate, and the number of recorded COVA deaths is an underestimate. But by how much?

Some are modelling based on an assumption that the number of reported cases is only 10% of the total, due to a large number of asymptomatic folk who never become 'patients'. Based on data I have seen, and equivalent (but MUCH better) data for ordinary flu, I would expect this to be way out - and the real value closer to 80-90%. In other words the number of reported cases (in countries other than the big fat liars like Russia) are almost certainly no more than a 50% underestimation, and probably much less than that (i.e., pretty reasonable, on a log scale).

Meanwhile what about the number of reported COVA deaths? Might this be an overestimate or an underestimate? With death certification out of hospital based on clinical diagnosis (not 'testing'), and out of hospital data in the UK accurate only once every few days, I nevertheless doubt the true values are wrong by no more than 20% (plus or minus). Radio 5 just stated that out of hospital values are not part of the total mortality data. So there we are then, officiel death numbers in the UK will be systematically underestimated. By how much I don't know.

With total numbers of cases in the UK likely underestimated, but the true values no more than double the numbers reported, and with total COVA deaths greater than those reported, my feeling is that in the UK, Germany, France, Italy and Spain the number of deaths per cased (1 death in 8 cases) is about right for now.

But will it (the rate of death in those infected) get bigger (less 'lethal') in the next few weeks?. I'll have to think about that.

You're too kind, but I know diddly squat about reading data. It's been illuminating you sharing your expertise. The only thing I still don't follow is why you're giving credence to the issue of confirmed cases, which I just discard because of the various ways of collection. It's deaths that I regard to be more reliable at present, even these are riddled with problems (hospitalised vs non, categorising CV19 or comorbidies, etc).

 

[Machiavelli]

Kind of. You said we we’d head for hundreds of thousands of deaths by progressing to herd immunity, but now you explain how we might avoid that by a gradual relaxation of lockdown and a slow progression to herd immunity (which is the only logical way put of this IMO - we can’t wait for a vaccine).

Ha! Ditto:
Not quite. What I'm suggesting is avoiding herd immunity (until we get a vaccine), so we can keep the death count down. Herd immunity without a vaccine means:
c60% of the UK population of 66m contracting it = 45m
From which, working off an imperfect figure of 1% deaths = 450,000 deaths.
My view is that's unacceptable. Dominic Cummings disagrees. Fortunately, he's been sidelined at present (or is out of action), and the government concurs.

 

[hans kraay fan club]

You're too kind, but I know diddly squat about reading data. It's been illuminating you sharing your expertise. The only thing I still don't follow is why you're giving credence to the issue of confirmed cases, which I just discard because of the various ways of collection. It's deaths that I regard to be more reliable at present, even these are riddled with problems (hospitalised vs non, categorising CV19 or comorbidies, etc).

I’m not convinced the deaths figure is all that reliable either.

As things stand you can be admitted to hospital suffering from CV-like symptoms, die in hospital, from what your doctors conclude was CV19, and still not be ‘counted’.

And nobody knows the extent of the toll in care homes. Our elderly next-door neighbour died last night in a care home, of ‘pneumonia’. She will be one of many thousands.

 

[darkwolf666]

And all the while, with the talk of relaxing the lockdown, herd immunity, etc., the 1.5 million currently shielding get forgotten!

 

[Machiavelli]

I’m not convinced the deaths figure is all that reliable either.

As things stand you can be admitted to hospital suffering from CV-like symptoms, die in hospital, from what your doctors conclude was CV19, and still not be ‘counted’.

And nobody knows the extent of the toll in care homes. Our elderly next-door neighbour died last night in a care home, of ‘pneumonia’. She will be one of many thousands.

Care homes are a f&%^ing disgrace. No-one is talking about them. Last I heard, they're still employing agency staff who are often visiting multiple care homes in a single day. The lead item on C4 News (which I'm poorly watching while typing this post) and a report in The Guardian today suggests that half of deaths in Italy and Spain are in care homes.
The ONS figures I think are imminent, and they're taking death certificates (which inevitably lag) as their guide. Oh, C4 News are now saying that a whistleblower is indicating that CV19 is not being recorded in care home deaths with eg Alzheimers, pneumonia, etc recorded instead.
We need parliament reopened as a matter of urgency IMO.

 

[Solid at the back]

Ha! Ditto:
Not quite. What I'm suggesting is avoiding herd immunity (until we get a vaccine), so we can keep the death count down. Herd immunity without a vaccine means:
c60% of the UK population of 66m contracting it = 45m
From which, working off an imperfect figure of 1% deaths = 450,000 deaths.
My view is that's unacceptable. Dominic Cummings disagrees. Fortunately, he's been sidelined at present (or is out of action), and the government concurs.

This. Herd immunity in the form of atleast 60% of the population being infected and the amount of deaths that brings is totally unacceptable. Should not even be a suggestion. If people thought that 900 deaths per day currently is bad, the herd immunity idea would be much more disastrous.
This cannot be an option.

 

[LamieRobertson]

...

I agree

 

[Harry Wilson's tackle]

You're too kind, but I know diddly squat about reading data. It's been illuminating you sharing your expertise. The only thing I still don't follow is why you're giving credence to the issue of confirmed cases, which I just discard because of the various ways of collection. It's deaths that I regard to be more reliable at present, even these are riddled with problems (hospitalised vs non, categorising CV19 or comorbidies, etc).

Ha! Cheers. You have good instincts, then (that's an example of my 'confirmation bias' as it is known, by the way - assuming people who agree with me or flatter me are correct, and the other b'stards talking out their bum holes ).

Well I'm not giving credence to anything, just looking at the numbers from one source (a good source, the BBC, data via Johns Hopkins, an independent and impeccably academic - in this case - American university) and considering their implications. They could be wrong, and someone else right. David Icke, maybe?

You are right, deaths are the best measure (of what matters - deaths). On reflection, the wide disparity in the ratio between cases and deaths from country to country does suggest one or other (cases being more likely) is unreliable. I did the calculation again today and the numbers (ratio of cases to deaths) is rock solid from country to country, while massively different between countries, showing that the overwhelming source of variation is country (i.e., how each reports).

I'll keep an eye on this. Patterns of change should reveal who is making up the most of their data (too little variation is usually the best evidence of fraud).

 

[darkwolf666]

This. Herd immunity in the form of atleast 60% of the population being infected and the amount of deaths that brings is totally unacceptable. Should not even be a suggestion. If people thought that 900 deaths per day currently is bad, the herd immunity idea would be much more disastrous.
This cannot be an option.

But from a financial point of view, think of all the money that can be saved not treating all those unfortunate vulnerable people once they are no longer with us, all the PIP payments that won’t need to be made, all those spare beds in care homes, all those pensions that won’t need to be paid.

Lots of problems solved for hard hearted politicians and their advisors. “save the economy, sod the vulnerable” maybe that should be the new lectern tag line...

I spit on your herd immunity!

 

[Machiavelli]

This. Herd immunity in the form of atleast 60% of the population being infected and the amount of deaths that brings is totally unacceptable. Should not even be a suggestion. If people thought that 900 deaths per day currently is bad, the herd immunity idea would be much more disastrous.
This cannot be an option.

Thanks. I spent c30 minutes looking through the first c300 posts on this thread, this morning (I didn't feature!). You, the OP, [MENTION=25402]Blue Valkyrie[/MENTION] and [MENTION=805]Kalimantan Gull[/MENTION] came out the best from this.
A question: are you jittery/insightful/ with most issues, or have you struck lucky with this?

 

[dazzer6666]

This. Herd immunity in the form of atleast 60% of the population being infected and the amount of deaths that brings is totally unacceptable. Should not even be a suggestion. If people thought that 900 deaths per day currently is bad, the herd immunity idea would be much more disastrous.
This cannot be an option.

So what other options exist ?

Only ongoing partial lockdown for an indeterminate time period - and if herd immunity isn’t an option, potentially forever. There is no cure, there is no vaccine.

 

[dazzer6666]

I’m not convinced the deaths figure is all that reliable either.

As things stand you can be admitted to hospital suffering from CV-like symptoms, die in hospital, from what your doctors conclude was CV19, and still not be ‘counted’.

And nobody knows the extent of the toll in care homes. Our elderly next-door neighbour died last night in a care home, of ‘pneumonia’. She will be one of many thousands.

It’s not reliable either way - people dying are also Covid19 stats even if they were already in end of life palliative care. The care home situation is horrific.

The unreliability of stats is quite distressing.

 

[Guinness Boy]

Ha! Cheers. You have good instincts, then (that's an example of my 'confirmation bias' as it is known, by the way - assuming people who agree with me or flatter me are correct, and the other b'stards talking out their bum holes ).

Well I'm not giving credence to anything, just looking at the numbers from one source (a good source, the BBC, data via Johns Hopkins, an independent and impeccably academic - in this case - American university) and considering their implications. They could be wrong, and someone else right. David Icke, maybe?

You are right, deaths are the best measure (of what matters - deaths). On reflection, the wide disparity in the ratio between cases and deaths from country to country does suggest one or other (cases being more likely) is unreliable. I did the calculation again today and the numbers (ratio of cases to deaths) is rock solid from country to country, while massively different between countries, showing that the overwhelming source of variation is country (i.e., how each reports).

I'll keep an eye on this. Patterns of change should reveal who is making up the most of their data (too little variation is usually the best evidence of fraud).

Trying to get my head round this a little so bear with me.

With more testing being rolled out we still seem to have a 1 in 8 death rate against actual confirmed cases (circa 11k compared to circa 88k yesterday). Right? And the expectation you have is that this will continue (that seems to be what the data is saying). And just because we are testing more doesn't mean more people actually have it, it just means we're testing more. But, the more you test, the more cases you should eventually pick up, right?

So are you saying you expect that ratio to continue? Or would widening testing further, beyond hospital and NHS staff stretch it more? The bottom end of the scale which was mentioned when we went into lockdown was 20k deaths which, sadly, I do not think is achievable now. To get to around 30k in July would mean an average of around 220 deaths a day between now and then, and we are nowhere near that low

On the other hand, that would also mean that only 240,000 out of a population of circa 70M had actually had "it", it being an incredibly infectious disease, albeit with an R less than one at the moment (probably) thanks to social distancing.

I guess I'm trying to work out if the best strategy is a longer lockdown, keeping R way below 1 or if the best strategy is much more testing to get to a true ratio? Or something else?

 

[dazzer6666]

Trying to get my head round this a little so bear with me.

With more testing being rolled out we still seem to have a 1 in 8 death rate against actual confirmed cases (circa 11k compared to circa 88k yesterday). Right? And the expectation you have is that this will continue (that seems to be what the data is saying). And just because we are testing more doesn't mean more people actually have it, it just means we're testing more. But, the more you test, the more cases you should eventually pick up, right?

So are you saying you expect that ratio to continue? Or would widening testing further, beyond hospital and NHS staff stretch it more? The bottom end of the scale which was mentioned when we went into lockdown was 20k deaths which, sadly, I do not think is achievable now. To get to around 30k in July would mean an average of around 220 deaths a day between now and then, and we are nowhere near that low

On the other hand, that would also mean that only 240,000 out of a population of circa 70M had actually had "it", it being an incredibly infectious disease, albeit with an R less than one at the moment (probably) thanks to social distancing.

I guess I'm trying to work out if the best strategy is a longer lockdown, keeping R way below 1 or if the best strategy is much more testing to get to a true ratio? Or something else?

Death rate looks very high because it's mainly only people in hospital with severe symptoms that are being tested (as testing expands, the gap between nos tested and deaths should grow v quickly ?)
No-one really has any clue as to how many have been infected - I've seen studies elsewhere indicating it might be as high as 38% (so if you extrapolated that our current death rate would be 1k/70m or 0.015% of the population)
Getting a true ratio doesn't hugely help with the strategy much really other than clarifying the risk - options seems to me to be either continued lockdown, progression to herd immunity through gradual relaxation of lockdown and protection of the vulnerable or a vaccine............

 

[Mellotron]

Death rate looks very high because it's mainly only people in hospital with severe symptoms that are being tested (as testing expands, the gap between nos tested and deaths should grow v quickly ?)
No-one really has any clue as to how many have been infected - I've seen studies elsewhere indicating it might be as high as 38% (so if you extrapolated that our current death rate would be 1k/70m or 0.015% of the population)
Getting a true ratio doesn't hugely help with the strategy much really other than clarifying the risk - options seems to me to be either continued lockdown, progression to herd immunity through gradual relaxation of lockdown and protection of the vulnerable or a vaccine............

Some level of lockdown remaining for the next 3-4 months (at a guess) whilst mass testing gives us far, far more information than we have currently.