COVID-2019 in America, effect on politics and economy

[Ironduke]

Therefore nobody dies of anything else but C19. Yes ?

Then how can death counts be under counted, they are being over counted.

That's like saying if I went around punching hemophiliacs in the face, and they died from internal hemorrhaging, the cause of death wasn't homicide, it was hemophilia. They had an underlying condition that killed them, and would have killed them eventually anyways.

[astralis]

seriously, DE, you're overthinking it.

if the five-year average number of deaths in a certain area is x amount, and there's a one-time spike right now -- three guesses as to why. we're seeing this -worldwide-.

[Double Edge]

seriously, DE, you're overthinking it.

if the five-year average number of deaths in a certain area is x amount, and there's a one-time spike right now -- three guesses as to why. we're seeing this -worldwide-.

Will post more as i get time to chase some leads. For now i have this data

For NYC, Download data, find a list of reports.

Confirmed and Probable COVID-19 Deaths: Daily Report

Why they call it a daily report is odd. It has a summary since counting began at the end.

The definitions on the second page state they list confirmed, probable and neither. Confirmed means they got a test. NYC has been testing patients since day 1. This is good.

Since march 11

Confirmed : 13,319
Probable : 4,038
Neither : 12,080



Now, the question is how do they report the stats.

Confirmed only or do they commingle probable in there as well.

Turns out its the latter, since Apr 14 (look for 'About the data' and click that. Can't link)

Confirmed & Probable Cases

As of April 14, 2020, CDC case counts and death counts include both confirmed and probable cases and deaths. This change was made to reflect an interim COVID-19 position statement pdf iconexternal iconissued by the Council for State and Territorial Epidemiologists on April 5, 2020. The position statement included a case definition and made COVID-19 a nationally notifiable disease.

A confirmed case or death is defined by meeting confirmatory laboratory evidence for COVID-19.

A probable case or death is defined by one of the following:

Meeting clinical criteria AND epidemiologic evidence with no confirmatory laboratory testing performed for COVID-19
Meeting presumptive laboratory evidence AND either clinical criteria OR epidemiologic evidence
Meeting vital records criteria with no confirmatory laboratory testing performed for COVID19

This means until April 14 only the orange bars counted. After Apr 14, blue + orange.

Curious isn't it. Why did CDC decide to add probable in there only after Apr 14 ? Can't find an explanation in their interim doc. But it has been decided clinical criteria & epidemiologic evidence without a test is sufficient ??

Now the result is you are adding probables to the tune of several hundred a day. Across the entire country or at least with states that comply with the CDC since it isn't mandatory.

Numbers on the whole will get larger, faster, yes ?

Will be interesting to see how other states are reporting this data.

[TopHatter]

The Trump Administration projects about 3,000 daily deaths by early June.

Publicly, the Trump administration is pushing for states to let businesses reopen amid the COVID-19 pandemic. Privately, it's forecasting a very disturbing future.

The Trump administration is forecasting the U.S. daily death toll from coronavirus will rise to 3,000 by June 1. That's nearly twice the current toll of 1,750 deaths per day, The New York Times reports via an internal administration document.

The White House's prediction is based on Centers for Disease Control and Prevention modeling, though reported COVID-19 deaths have already far outpaced the CDC's model. The CDC also predicts the U.S. could go from adding about 25,000 new coronavirus cases every day to adding 200,000 or more daily by the end of the month. As some states resume business as usual, those growth rates could further worsen.
____________

I thought we were doing fine with 15 dead and it'll be gone by April?

So, should we still be opening up the country and letting people die with their "rights" intact?

Speaking of which, Trump continues to support his base and calls them "very good people", as usual.

[Double Edge]

Like the way he handled this, takes followup questions. Not just one only

These answers are good for the world not just NY

[Double Edge]

That's like saying if I went around punching hemophiliacs in the face, and they died from internal hemorrhaging, the cause of death wasn't homicide, it was hemophilia. They had an underlying condition that killed them, and would have killed them eventually anyways.

It's a bit more subtle than that

Like i said earlier, the controversy is died of or with C19.

C19 was present but is it a key player in the CoD.

What is the contribution of C19 to Cod in the different deaths ?

Unless you can answer those questions it is presumptive to include probables with confirmed.

Will take time to get more mature data in the US that explains what is killing these people and how.

This is bringing into question the number of confirmed as well.

Just because some one tests positive it too is automatically presumed died of ?

That is true only in cases with no underlying causes.



The number of years lost for this category is significant in comparision to some one older with pre-existing conditions. If we consider those in the range 18 -64 had many more years left.

In Italy, 99% of deaths had underlying causes and at times multiple ones that could also have contributed to their demise.

So it is difficult to say these people specfically died of C19. Which the death count of several countries is implying presently.

Likely many of them would have died anyhow if not immediately then within a short period of time because of their pre-existing causes.

If 80% are mild infections and over 50% of total infected are asymptomatic then why is it that people with pre-exiting conditions cannot have a mild infection ?

For now the numbers will be added up but there could be a correction downwards in the future when we know more.

This creates an environment where the reflex is to list C19 on the death cert where it could be a less signficant contributor if not innocent bystander.

We continue to have an incomplete perception of this disease.

[Double Edge]

The Trump administration is forecasting the U.S. daily death toll from coronavirus will rise to 3,000 by June 1. That's nearly twice the current toll of 1,750 deaths per day, The New York Times reports via an internal administration document.

Where and how are those extra deaths coming from ?

What is becoming more clear is why the number of deaths is as high in NYC, Italy & Spain.

They allowed people with mild symptoms to show up at hospitals, this then infected the staff who went to infect patients.

A hospital is the worst place possible to fight this virus.

Nosocomial infection

In other places if a patient has mild symptoms they are advised to stay home and get treated there.

Only if things get serious do they get admited.

NYC could be an outlier this way and not representative of the rest of the country.

Yes its densely populated but so is HK.

[Albany Rifles]

Where and how are those extra deaths coming from ?

What is becoming more clear is why the number of deaths is as high in NYC, Italy & Spain.

They allowed people with mild symptoms to show up at hospitals, this then infected the staff who went to infect patients.

A hospital is the worst place possible to fight this virus.

Nosocomial infection

In other places if a patient has mild symptoms they are advised to stay home and get treated there.

Only if things get serious do they get admited.

NYC could be an outlier this way and not representative of the rest of the country.

Yes its densely populated but so is HK.

DE,

That explains some of the infections. But public gatherings account for the majority...the BIO-Genesis Conference in Boston, the gathering in New Rochelle and the funeral in Albany Georgia....these were all locations where large number of infections occurred.

Several to the outbreaks in the Midwest are starting to be traced to Spring Break crowds on the Florida beaches.

I acknowledge the issue of infections in hospitals....but that is not where the majority of cases have occurred across the US.

What are the vector locations and reasons in India?

[Ironduke]

It's a bit more subtle than that

Just because some one tests positive it too is automatically presumed died of ?

That is true only in cases with no underlying causes.

You've become a complete bullshit artist.

• At least 34.2 million Americans have diabetes
• 30.3 million Americans have diagnosed heart disease
• The American Heart Association estimates that 121.5 million Americans adults (48%) have heart disease
• The CDC estimates 37 million American adults (15%) have chronic kidney disease
• 16 million Americans have been diagnosed with COPD. More have it.
• 105 million American adults have hypertension
• According to the CDC, 6 in 10 Americans adults have at least one chronic disease, 4 in 10 with two or more

The fact is, most American adults have an underlying condition.

Despite the prevalence of underlying conditions remaining more or less constant in the previous 5 years, we are seeing:

• a massive spike in death rates
• it is happening now
• the number of excess deaths is greater than the number of deaths attributed to COVID-19

Now if I punch a hemophiliac in the face and he dies of a brain bleed, it's not homicide, he had an underlying condition.

What you're saying isn't a bit more subtle than that, it's the exact same type of logical contortions you're employing.

[Double Edge]

You've become a complete bullshit artist.

Because you disagree i'm a bullshit aritist ?

Nah, you disagreeing does not make me wrong.

There is no clincher here man, if you're right so am I. Hence controversy.

Why didn't you ask me for a source ?

I'll give you one, pour your self something and listen

I like that guy because he has the basis to challenge conventional narratives.

• At least 34.2 million Americans have diabetes
• 30.3 million Americans have diagnosed heart disease
• The American Heart Association estimates that 121.5 million Americans adults (48%) have heart disease
• The CDC estimates 37 million American adults (15%) have chronic kidney disease
• 16 million Americans have been diagnosed with COPD. More have it.
• 105 million American adults have hypertension
• According to the CDC, 6 in 10 Americans adults have at least one chronic disease, 4 in 10 with two or more

The fact is, most American adults have an underlying condition.

Despite the prevalence of underlying conditions remaining more or less constant in the previous 5 years, we are seeing:

• a massive spike in death rates
• it is happening now
• the number of excess deaths is greater than the number of deaths attributed to COVID-19

So the disease is killing them isn't it. This is the conclusion we draw.

I thought that too until i heard Ionnadis. So there is more going on here.

Now if I punch a hemophiliac in the face and he dies of a brain bleed, it's not homicide, he had an underlying condition.

What you're saying isn't a bit more subtle than that, it's the exact same type of logical contortions you're employing.

Depends how hard you hit. And that is the point being made. Why is it that some one with pre-existing conditions cannot have a mild infection ? you assume it was a serious one and ergo they died because of the virus.

Will post more when i had a look at the data.

This is a war with assumptions & goalposts changing with time. What we know today gets dated fast. The most frustrating bit is the experts are still groping in the dark. They're learning slowly.

Incomplete understanding means more arguments

[Ironduke]

I'll provide an anecdote. My own grandfather.

• heart attack in his late 50s
• diagnosed with cardiovascular disease (CVD)
• likely had CVD by 10-15 years prior to heart attack
• took statins for next 30 years
• died age 88 from Alzheimers complications

There are millions upon millions of Americans with chronic diseases who live a normal life expectancy or beyond, only to die of an entirely different cause.

And COVID-19 is killing these types of people.

[Ironduke]

Because you disagree i'm a bullshit aritist ?

Nah, you disagreeing does not make me wrong.

There is no clincher here man, if you're right so am I. Hence controversy.

Why didn't you ask me for a source ?

I'll give you one, pour your self something and listen

I like that guy because he has the basis to challenge conventional narratives.



I will reply to this when i had a look at the data.

You said anyone with an underlying condition doesn't count. Most Americans adults have underlying conditions. They live perfectly ordinary lifespans and many don't even die from them. They get dementia, cancer, Parkinson's, die from accidental falls, causes completely unrelated to the chronic disease they have.

You're flat-f*cking wrong on this and you're peddling bullshit.

[Double Edge]

DE,

That explains some of the infections. But public gatherings account for the majority...the BIO-Genesis Conference in Boston, the gathering in New Rochelle and the funeral in Albany Georgia....these were all locations where large number of infections occurred.

Several to the outbreaks in the Midwest are starting to be traced to Spring Break crowds on the Florida beaches.

I acknowledge the issue of infections in hospitals....but that is not where the majority of cases have occurred across the US.

ok, the prof said that is what happened in Italy and this lead to the higher death rates. I look at NYC and i see a pattern.

Thing i'm trying to figure out is the causes for the death rate in the US. What's driving it.

Understand that and you stem the deaths happening else where in the country.

If the death rate continues to climb despite measures taken then you are missing something.

Put it this way if you see the same number of deaths as occurred during the lock downs after you relax then what purpose did the lock down serve ?

Virginia's lock down stretches into June. That's quite stringent.

That NYC graph looks promising, the deaths are over the hill and on the decline. Lock down helped there.

What are the vector locations and reasons in India?

Inadequate enforcement of the lock down. Not adhering to body distancing. Inadequate contact tracing in some states.

We see this with infection spikes in some over others in spite of the over 42 days lock down. That is all on the head of state govts in charge. Politics interferes when state chief ministers have a personal difference with the centre. I mean the chief minister does not like the PM. This matters more than the party difference. Some states are a coalition that means more than one cook in the kitchen. These are all own goals against a virus that demands 90% performance or better.

Things have relaxed a bit since May 3. However all major cities are red zones. So we're not allowing people out of them other than goods & essential services. Within cities, we have colour codes, red, orange & green. With decreasing levels of restrictions as you go from red to green. We have containment zones in certain areas where people cannot leave their locality. To get out of the red zone you need to show no new infections for 21 days. Curfew 7pm - 7am. No night activity allowed whatsoever. If you have business to do its sunrise to sunset. Offices at 50% or 33% max capacity. All employees have to install a tracking app. This helps automate contact tracing, they've made changes when privacy advocates voiced objections earlier.

The thing i notice with you guys here is you are more concerned about deaths than infections.

It's the opposite for me, more concerned with the infection rise and spread as deaths are still very low as that determines whether i get locked in or not. So far so good.

The cause for deaths in India from what i can see is not getting treated in time.

A failure to recognise symptoms in time and then the disease gets more advanced and harder to treat.

This could be due to inability to access health care or not acting in time.

I don't think these reasons apply in the US. Is lack of insurance cover an issue ?

From what i understood you only test people with symptoms as is the case worldwide.

Therefore some one with symptoms gets the test, what about treatment.

The question whether lack of insurance cover is a contributor to C19 deaths as you record them ?

I asked a doctor how death certs are done in India and this is what she told me

Only confirmed cases, and that too if the primary cause is COVID-19 induced Pneumonia, ARDS, Respiratory failure, MODS etc.

In india our death certificate has a primary cause of death and a secondary cause of death, and any additional causes of death, so it makes it easier for us to distinguish between COVID-19 and non-COVID-19 related deaths.

Its issued by the treating physician, but honestly speaking, the proforma ideally, should be the same in every country because it is drafted by the WHO and followed worldwide.. so

To qualify for C19 CoD in India person has to be tested and die of very specific symptoms.

Keep in mind even though India's population is relatively younger, there is still a high prevalence of diabetes, hyper tension, heart disease and other co-morbidities with them. If such a person dies without those specific symptoms they won't be recorded as a C19 death, it would be listed as a secondary cause.

It's not the same in every country as she thinks evidently : )

When it comes to testing, you had to conduct 5 million tests to find 1 million infected (20% national average)

If the present positivity rate holds in India, we'd need more than 25 million tests (4% national average) to find 1 million. We've crossed the 1 million mark in number of tests already and plan to get to 100k tests a day. We're at 75k presently. On Mar 13, we'd conducted a total of just 500 tests for entire country.

Clearly that rate is higher in hotspots and that's where we concentrate efforts. Still low though at 8% (state avg), expect it would be higher as you get more granular.

[kato]

There have been autopsy series of Covid-19 positive dead in Germany and Switzerland in which it was found that:

a) virtually all had one or more commonly multiple underlaying conditions, including 80% suffering cardiovascular problems. Among those dead unter 60 significant numbers were obese.
b) for 95%, cause of death was not the underlaying condition or any other cause* but either a respiratory tract infection, a lung infection, a pulmonary embolism or a combination of any of these (all three directly caused by Covid-19)

* the autopsy series in Germany apparently included some crime victims and suicides tested positive for Covid-19.

[Double Edge]

There have been autopsy series of Covid-19 positive dead in Germany and Switzerland in which it was found that:

a) virtually all had one or more commonly multiple underlaying conditions, including 80% suffering cardiovascular problems. Among those dead unter 60 significant numbers were obese.
b) for 95%, cause of death was not the underlaying condition or any other cause* but either a respiratory tract infection, a lung infection, a pulmonary embolism or a combination of any of these (all three directly caused by Covid-19)

* the autopsy series in Germany apparently included some crime victims and suicides tested positive for Covid-19.

So the CoD in Germany to qualify for C19 is strict ?

Could this explain why we see the low death rates in Germany. Then you are following the WHO guidelines as that doctor told me.

I need to dig around more in the US data, i think there will be some states that adhere to this way of thinking.