I myself haven't yet seen any data that would make this virus any worse than the flu (which means it's still dangerous, just maybe not "everybody-hide-under-the-rock" dangerous). Even data from Italy doesn't show mortality any higher than previous years.
Do you have links to data that supports what you wrote?
I agree it is a communication disaster though. If I see another chart with red line, logarithmic scale, not starting from zero or with some approximated (red) curve that doesn't specify the formula... :-/
Doesn't that require a study after the fact? So your proposal is to just wait and see?
BTW, how do you explain the unprecedented hospitalization and ICU rates in Northern Italy?
As an example, this report from European Society of Anaesthesiology[1] mentions:
> The number of intensive care beds in Italy continues to change. Initially, there were 500 public intensive care (ICU) beds in Lombardy, and 140 private ICU beds. However, now there are more than 900.
[1]: https://www.esahq.org/esa-news/analysis-of-covid-19-data-on-...
A lot of people aren't tested unless they are severely sick, they're just told to stay at home.
When they arrive in the hospital they're already in a pretty bad condition, and only then tested. Which means that no therapeutic actions are made until patients are admitted, with the exception of self-administration of paracetamol.
> The number of intensive care beds in Italy continues to change. Initially, there were 500 public intensive care (ICU) beds in Lombardy, and 140 private ICU beds. However, now there are more than 900.
But a lot of ICU beds were slashed in the past 10 years due to budget cuts, and we were at 80% capacity when the virus hit. If the testing keeps on like this, and we can't even palliatively treat patients until they start suffering respiratory problems, these problems will continue.
What do you think the mechanism is here? Why are people being hospitalised with covid-19, if it's not covid-19 causing the hospitalisation?
People under 50 don't spend much time in ITUs on ventilators, until covid-19 happens and now the ITUs are full of people with covid-19 having air pumped into their lungs to push the fluid out.
What's causing that if not covid-19?
People are counted in the stats produced by hospitals if they have the virus, not if they've been hospitalised because of the virus. Literally if someone breaks their arm and they're tested positive, that goes into the stats for "COVID-19 cases". This is also true if someone dies of anything whilst having the virus; they're recorded as a "COVID-19 death".
The statistics here don't tell us what they sound like they're telling us. We'd see exactly the same pattern if the rules were suddenly changed to require every hospital admission to be tested for the common cold in a regular year - the number of "cases" and "deaths" would increase dramatically every day.
People under 50 don't spend much time in ITUs on ventilators
That statement is far too vague. People of all ages spend time on ventilators every years, especially during a flu outbreak. This is especially true of young children (under 5) whom COVID-19 doesn't affect at all! And COVID-19 is known to affect very few under 50s; the numbers here are so tiny the media can literally write entire stories about individual cases.
So what does "people" and "much time" mean in this sentence?
You can see some data on deaths from pneumonia by age group here:
https://ourworldindata.org/pneumonia#pneumonia-mortality-rat...
Of course deaths isn't the same thing as hospitalisation as the young are more likely to recover than the old. So this data isn't exactly what you're talking about, but it's at least quantifiable.
It's not safe to make a claim about this virus without comparing it to known values from prior years or outbreaks, when comparing the same thing. Every single number we're being presented with is presented without context and it leads to catastrophic mistakes of understanding. Number of positive test increases is shown without the number of negative test increases as well (i.e. an exponential increase in testing looks like an exponential increase in cases), deaths are counted without any investigation to decide what caused that death and so on.
It's very easy to get a totally misleading impression of what's going on. This is likely why in so many parts of the world hospitals are now reporting themselves as empty for weeks, despite the supposed "exponential growth" that should have overwhelmed them by now. In fact in Switzerland hospitals are needing to apply for emergency funding because the huge drop in patient numbers has caused their revenue to dry up.
There's clearly a virus spreading. It sends some people to hospital. Quite a few viruses do that.
Unlike those, this virus is different in one key way - governments have decreed that any death where the virus is present is counted as a "virus death", and have decreed mass testing to find infections. Consider a virus that is not really dangerous but highly infectious, like any common cold or flu. Then many people will turn up at hospital with it, but in reality their problem is something else. With our current data that would look like hospitals being flooded in a way never seen before, but it'd be a data artifact, not something real.
As for countries having to build makeshift hospitals, two things:
1. Local overloads happen during bad flu seasons too. You can find many reports in the past about wards being converted, tents being constructed to hold patients on the streets from earlier flu pandemics. Arguably making quick hospitals to handle that sort of bad flu season should be a more common practice.
2. No country anywhere is experiencing general overload. Even in Italy, a few days ago a politician was publicly asking why they're sending patients to Germany when in nearby Veneto there are hospitals that are 2/3rds empty.
Projections of mass death requiring everyone to shelter-in-place are based on the belief that everywhere will "go Bergamo" simultaneously at once. That isn't happening, it's not even close to happening.
Go investigate and you can find stories of deserted hospitals all over the world right now. They've been cleared out in anticipation of an imminent surge that isn't appearing. That's why Germany and Switzerland can take in patients from neighbouring countries - not only are there no makeshift hospitals but hospitals need financial bailouts because they've having to pay so many staff who are basically idled, like many other businesses.
Clearly there's a huge mismatch between the global view and a small number of local hotspots, and our understanding of what's happening is heavily coloured by the press.
If we succeed at slowing the growth, even stopping it, then thank god those hospitals will remain empty.
e.g. here's German data:
https://swprs.files.wordpress.com/2020/03/infizierte-pro-tes...
and US data:
https://twitter.com/FScholkmann/status/1246122535793680386
It looks like it doubles every few days because of the rapid increase in testing.
Moreover these hospitals are now entering their second week of being idled. They should be very busy by now if the sick were really growing exponentially - they're still mostly empty.
Even in New York you see this:
https://www.dailymail.co.uk/news/article-8173563/Elmhurst-ta...
"New York City's Elmhurst hospital - the 'epicenter of the epicenter' - is now receiving fewer patients but they are arriving sicker, doctor warns, as he says some come in with no symptoms other than diarrhea then test positive"
"He said testing was surprising and that some people show up with a fever and cough but test negative. Others who are there for different ailments - like car accident victims - end up testing positive."
New York is supposed to be the epicentre of the outbreak yet the most overloaded hospital is now seeing fewer patients arrive than before. That's not consistent with being at the start of a very long exponential growth phase (it obviously can't grow exponentially forever so this discussion is only about how long it lasts in that phase and where the peak is).
Edit: got throttled, will reply to Joe here
Many sources show only the number of positive cases and deaths. Here's one that shows total tests performed in the USA:
https://covidtracking.com/data/us-daily
On the 5th April 2020 there were 332,308 positive cases in the USA. So the halving point was between 29th and 30th March (139,061 and 160,530 cases respectively). It took about 5 days to double.
On the 5th April 2020 there were 1.42 million negative cases. On 29th March 2020 there were 692,290 negatives or 48% of the figure today. It took exactly the same amount of time to double.
So we can see that number of tests doubled in that time. Total tests went from 831,351 (47%) to 1,762,032.
The proportion of positive to negative cases is 18% today. On the 29th March it was 16%. A 2% rise, nothing even close to doubling. The graph in the tweet I linked to shows this visually - a fairly smooth and slow increase over time. We think it's spreading exponentially because of misuse of data, but all that's actually growing exponentially is testing. And yes - that's probably why there are now global shortages of reagents and other ingredients for tests. You can't keep globally doubling demand for tests without eventually hitting production limits!
Look at the worldwide data, then at the data for pretty much every country: https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h...
Its geometric growth pretty much any place you look. Now, unless testing were proceeding completely uniformly across the board, its hard to imagine that explains any of this.
This is an example of how you are making straw man arguments. No-one is arguing that the growth rate will continue to be exponential in the face of effective mitigation.
We're not testing the general population. Its testing of folks coming to a hospital? Folks who aren't having hospitalizing symptoms are not tested at all, and sent home to quarantine.
So if tests doubled that means that folks are feeling bad at an increased rate. Showing up at a hospital with alarming symptoms.
You can finagle the statistics both ways - by ignoring what the 'test sample' is and assuming its uniform for instance.
You're right that it's not a uniform sample, but the consistency across the world is very suggestive. Not everywhere has test shortages.
It links to a document from the Intensive Care National Audit and Research Centre.
The evidence from actual covid treatment doesn't support the "they die with, not of, covid" argument.
I think one of the biggest public health communication disasters of covid19 is the reliance on mortality as the communication endpoint.
It's acceptable for other threats-- like automotive accidents-- to speak in terms of mortality because there isn't a huge population which is much less exposed to dying but still exposed to serious illness. Automotive accidents also seriously injure many more people than they kill, but not in a way that lends itself to a false impression of immunity.
"Death" makes a nice clear warning for the risks of driving, and other very bad but not death outcomes are just some factor of the death outcomes... it isn't like the audience is comparing death rates to population numbers then deciding that the death from driving isn't worth worrying about just because we didn't also include maimed-for-life.
For covid19 we've ended up making many 20 and 30 year olds believe that it doesn't threaten them. It does. They may not be dying in especially large numbers-- especially where either hospitals are not overloaded or where they're engaging in the ethically dubious practice of triaging younger people ahead of others based purely on their age rather than, e.g. response to treatment--, but they are still becoming seriously and painfully ill and ending up with severe immune system damage -- which takes a long time will recover and will result in latent mortality --, and for many likely lifelong injury in the form of extensive lung scaring.
Infections like influenza are much less contagious-- with an R0 of 1.3 vs 2 to 3 (an enormous difference)--, less deadly, face a population which is at least somewhat resistant (in part due to heroic vaccination efforts) and which knows how to rapidly create new and effective vaccines against it. It's not really that comparable.