The Official Coronavirus Discussion

[jimilee]

Feeling sick yesterday and today.  Hoping it is just a cold.  Of course, how the hell could I get a cold with my paranoid hand washing and mask wearing?  Ugh!

I've heard not sharing a bathroom if at all possible is a good idea.

Just a good all around general rule for any occasion!


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[Scruffie]

Feeling sick yesterday and today.  Hoping it is just a cold.  Of course, how the hell could I get a cold with my paranoid hand washing and mask wearing?  Ugh!

I've heard not sharing a bathroom if at all possible is a good idea.

Just a good all around general rule for any occasion!


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Well, not according to the NYC DOH https://gizmodo.com/new-york-city-to-sex-havers-1843983738 

To EBK, try and remember that even if it is it, statistically you will likely be okay, extra stress wont do you or your mind any good. Do try and do some light exercise around the house if you feel up to it, it'll help with your immune system and hopefully relax you a bit. Yours - A fellow worrier.

[jimilee]

Definitely not getting your deposit back after that!


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[aion]

Some interesting stats from NYT - the number of excess deaths in the USA this year vs. the statistical average of prior years:

https://www.nytimes.com/interactive/2020/05/05/us/coronavirus-death-toll-us.html

The "official" USA death toll for COVID is 145,000. Lots of people in our country have been pushing an idea that the official COVID count is inflated, pointing to a few examples of people who tested positive and then died in an unrelated way (e.g. a car accident) and were counted as a COVID death.

This NYT page shows that there have been around 190,000 excess deaths in the USA, for all causes, between March and July of this year. It seems reasonable to infer that this excess is mostly COVID-related since I don't know of any other mass-death epidemics during this window.

So the best-case scenario is that the official COVID numbers are accurate - but it's likely that the real number of deaths is a fair amount higher, as much as 30%. I imagine that number could be tightened up with some more in-depth data analysis. But I suspect that the excess deaths are the statistics that future historians will use to get a picture of the real COVID impact - not the official cases & deaths, which are heavily skewed by our deficient testing.

[jimilee]

I'm frustrated that there's no end in sight, and companies, schools, Presidents seem to just be board with it and decided to open back up.

[dan.schumaker]

Some interesting stats from NYT - the number of excess deaths in the USA this year vs. the statistical average of prior years:

https://www.nytimes.com/interactive/2020/05/05/us/coronavirus-death-toll-us.html

The "official" USA death toll for COVID is 145,000. Lots of people in our country have been pushing an idea that the official COVID count is inflated, pointing to a few examples of people who tested positive and then died in an unrelated way (e.g. a car accident) and were counted as a COVID death.

This NYT page shows that there have been around 190,000 excess deaths in the USA, for all causes, between March and July of this year. It seems reasonable to infer that this excess is mostly COVID-related since I don't know of any other mass-death epidemics during this window.

So the best-case scenario is that the official COVID numbers are accurate - but it's likely that the real number of deaths is a fair amount higher, as much as 30%. I imagine that number could be tightened up with some more in-depth data analysis. But I suspect that the excess deaths are the statistics that future historians will use to get a picture of the real COVID impact - not the official cases & deaths, which are heavily skewed by our deficient testing.

Thanks for sharing that!  That is a very interesting and easy-to-grasp way to put the real toll of this...

[TheDude]

Earlier this week, one of the two pro lacrosse leagues arrived to their bubble, and all players were tested well beyond just a simple Covid test.

One of the players had tested positive in June, and was asymptomatic during his time with the virus. This week during his exam, he was shown to not be able to get enough oxygen to his heart, thus putting him at risk for his heart to go out at any moment during physical exertion.

This is a professional athlete in his prime. Regardless of anyone's feelings towards sports, we know these guys to be in peak physical shape. And he could have his heart give out at any moment, and he never showed any previous symptoms for the virus.

I don't like basing opinions on anecdotal evidence. But man, how many others right now are walking around with ticking time bombs in their chest? And how many other kinds of ticking time bombs are out there beyond just lacking oxygen to the heart?

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[benny_profane]

Some interesting stats from NYT - the number of excess deaths in the USA this year vs. the statistical average of prior years:

https://www.nytimes.com/interactive/2020/05/05/us/coronavirus-death-toll-us.html

The "official" USA death toll for COVID is 145,000. Lots of people in our country have been pushing an idea that the official COVID count is inflated, pointing to a few examples of people who tested positive and then died in an unrelated way (e.g. a car accident) and were counted as a COVID death.

This NYT page shows that there have been around 190,000 excess deaths in the USA, for all causes, between March and July of this year. It seems reasonable to infer that this excess is mostly COVID-related since I don't know of any other mass-death epidemics during this window.

So the best-case scenario is that the official COVID numbers are accurate - but it's likely that the real number of deaths is a fair amount higher, as much as 30%. I imagine that number could be tightened up with some more in-depth data analysis. But I suspect that the excess deaths are the statistics that future historians will use to get a picture of the real COVID impact - not the official cases & deaths, which are heavily skewed by our deficient testing.

An important thing to note is that linear analysis fails to account for the interconnectedness of the world. In this case, health determinants and outcomes are not experienced in a vacuum.

We have a situation here where CoD is being disputed because the immediate cause of death is not specifically COVID-19, but the underlying factors and contributing factors are. So, let's consider that we're not dealing with that fundamental issue and that mortality is being appropriately measured. When you have large-scale disruptions of health systems, there are correlative effects.

Take for example chronic disease management. If a health system is overrun with response to acute illnesses and a triage is set up, resources are reallocated from stable patients to attend to those in immediate need of attention. This is what has been seen with task shifting medical personnel from chronic disease management to help with respiratory support. This means that non-urgent care is delayed or rationed. Conditions here would include dialysis, etc. Also, elective surgeries are delayed. When most people hear elective surgery, they think of plastic surgery or other minor/optional procedures. That's not strictly true: an elective surgery usually means one that can be planned in advance. Take, for example, a cancer patient. A biopsy or tumor removal would fall under this category if the patient is not in advanced sickness. When this is continually delayed, diseases that may have been able to be cured by early intervention can advance into more serious conditions.

The disruption of health systems also impacts health-seeking behavior. People have been putting off going—or unable—to the doctor for routine care or perceived low-threat conditions. Primary care is a health system's first line of defense at preventing, identifying, and controlling morbidity. If health-seeking behavior is negatively impacted, that benefit is lost. It's much easier to deal with things early rather than late. For example, if someone goes to the doctor with a bacterial respiratory infection early, they can receive an antibiotic regimen and clear the infection; if they wait until they develop acute bronchitis/pneumonia, they may have to have supportive treatment requiring in-patient hospital care.

All of this is to say, the distal effects of SARS-CoV-2 / COVID-19 will lead to poorer health delivery and outcomes, which will result in higher morbidity and mortality that has nothing to do with COVID-19 in many patients.

[aion]

All of this is to say, the distal effects of SARS-CoV-2 / COVID-19 will lead to poorer health delivery and outcomes, which will result in higher morbidity and mortality that has nothing to do with COVID-19 in many patients.

Would you say that the excess deaths statistic is a more useful metric than the official death counts? You're a little more qualified than I am so I appreciate the perspective!

[matmosphere]

Some interesting stats from NYT - the number of excess deaths in the USA this year vs. the statistical average of prior years:

https://www.nytimes.com/interactive/2020/05/05/us/coronavirus-death-toll-us.html

The "official" USA death toll for COVID is 145,000. Lots of people in our country have been pushing an idea that the official COVID count is inflated, pointing to a few examples of people who tested positive and then died in an unrelated way (e.g. a car accident) and were counted as a COVID death.

This NYT page shows that there have been around 190,000 excess deaths in the USA, for all causes, between March and July of this year. It seems reasonable to infer that this excess is mostly COVID-related since I don't know of any other mass-death epidemics during this window.

So the best-case scenario is that the official COVID numbers are accurate - but it's likely that the real number of deaths is a fair amount higher, as much as 30%. I imagine that number could be tightened up with some more in-depth data analysis. But I suspect that the excess deaths are the statistics that future historians will use to get a picture of the real COVID impact - not the official cases & deaths, which are heavily skewed by our deficient testing.

An important thing to note is that linear analysis fails to account for the interconnectedness of the world. In this case, health determinants and outcomes are not experienced in a vacuum.

We have a situation here where CoD is being disputed because the immediate cause of death is not specifically COVID-19, but the underlying factors and contributing factors are. So, let's consider that we're not dealing with that fundamental issue and that mortality is being appropriately measured. When you have large-scale disruptions of health systems, there are correlative effects.

Take for example chronic disease management. If a health system is overrun with response to acute illnesses and a triage is set up, resources are reallocated from stable patients to attend to those in immediate need of attention. This is what has been seen with task shifting medical personnel from chronic disease management to help with respiratory support. This means that non-urgent care is delayed or rationed. Conditions here would include dialysis, etc. Also, elective surgeries are delayed. When most people hear elective surgery, they think of plastic surgery or other minor/optional procedures. That's not strictly true: an elective surgery usually means one that can be planned in advance. Take, for example, a cancer patient. A biopsy or tumor removal would fall under this category if the patient is not in advanced sickness. When this is continually delayed, diseases that may have been able to be cured by early intervention can advance into more serious conditions.

The disruption of health systems also impacts health-seeking behavior. People have been putting off going—or unable—to the doctor for routine care or perceived low-threat conditions. Primary care is a health system's first line of defense at preventing, identifying, and controlling morbidity. If health-seeking behavior is negatively impacted, that benefit is lost. It's much easier to deal with things early rather than late. For example, if someone goes to the doctor with a bacterial respiratory infection early, they can receive an antibiotic regimen and clear the infection; if they wait until they develop acute bronchitis/pneumonia, they may have to have supportive treatment requiring in-patient hospital care.

All of this is to say, the distal effects of SARS-CoV-2 / COVID-19 will lead to poorer health delivery and outcomes, which will result in higher morbidity and mortality that has nothing to do with COVID-19 in many patients.

I get what you're saying, but from the perspective of looking at the overall impact I'm not sure a death has to be caused by an actual case of Covid to be counted as part of the impact overall. I haven't had time to read the article posted yet, so I am not sure where they are coming from, but I think it's not unreasonable to think that while those additional 40k deaths may not be from COVID-19 it isn't unreasonable to say they are due to the impact of Covid-19. Its also concerning to think of how many more deaths may come due to things like not catching cancer or things like that earlier because of the impact on nonessential care this has caused.

[benny_profane]

All of this is to say, the distal effects of SARS-CoV-2 / COVID-19 will lead to poorer health delivery and outcomes, which will result in higher morbidity and mortality that has nothing to do with COVID-19 in many patients.

Would you say that the excess deaths statistic is a more useful metric than the official death counts? You're a little more qualified than I am so I appreciate the perspective!

That depends on what you're trying to determine. The official counts should be used to discuss mortality attributable to COVID-19. Excess mortality here simply states that there is an excess of what would be expected during 'normal' conditions. Normal conditions are estimates that come from statistical modeling using historical data and variables. These data are usually used in crises when cause of death is not known. Epidemiologist use the metric in famines or natural disasters, for example. In these situations, the crisis is an acute cause of death beyond what would have occurred had the crisis not happened. With COVID-19, however, a blanket statement saying that anything above the average is attributable to COVID-19 is wrong. Again, we're dealing with an interconnected system. To illustrate, in the US, there is/was a prolonged period of shutdown in many parts of the country. This resulted in less road traffic, which would affect the mortality due to traffic accidents. So, that would subtract from the projected mortality because that is an aberration from 'normal' conditions. Unless that and other aberrations from 'normal' conditions are controlled for, the excessive mortality becomes less meaningful.

But, the official data is imperfect: there's the human influence (see above re: disputes over CoD), people die outside of a hospital setting and their disease status was not known, the pathogen is novel and we're still learning about the role it has in mortality, and testing is overall not sufficient. So excess mortality statistics should be seen as a starting point for further study. It can be used to understand the toll of the pathogen in the society, but it is not an absolute marker of what can/should be attributable to the virus.

[benny_profane]

I get what you're saying, but from the perspective of looking at the overall impact I'm not sure a death has to be caused by an actual case of Covid to be counted as part of the impact overall. I haven't had time to read the article posted yet, so I am not sure where they are coming from, but I think it's not unreasonable to think that while those additional 40k deaths may not be from COVID-19 it isn't unreasonable to say they are due to the impact of Covid-19. Its also concerning to think of how many more deaths may come due to things like not catching cancer or things like that earlier because of the impact on nonessential care this has caused.

I don't think we disagree. Both the immediate mortality from COVID-19 and the net mortality including other systems elements are important. When studying the pathogen, the mortality caused by the virus is what is important; when developing a public health response and public policy, both are important. If the deaths caused by the other elements (e.g., breakdowns in health-seeking behavior, misdiagnosis of ailments, etc.) are folded into the COVID-19 mortality figure, the virulence of the pathogen is affected by human interaction and we don't have a true understanding of the virus. Human intervention is captured in things like the R (replication) metric, but what studying the pathogen/disease, they shouldn't be included.

[madbean]

The latest in bean-verse:

So, after months of deliberation on the part of TENN school district they finally released guidelines for re-opening last week. Then gave us all of 7 days to decide what to do. We initially decided we would have our daughter do virtual classes for the semester. The deciding factor for me is that the state has not yet mandated that all students wear masks in school (stupid stupid stupid). However, we ended up changing our minds. The two primary reasons are that 1) our daughter goes to a magnet school which is essentially all AP courses and if she did virtual school, it would be the state curriculum not the AP one (IOW, she would miss out on the thing that makes her school special) and 2) she advocated for returning. This really surprised me. Up until now she was adamant about not going back but she changed her mind when she realized just how isolated she'd be for the next five months.

Couple important caveats: they only actually go in for two days a week but now she gets to follow the magnet school curriculum instead of the state one. And, she is on-board with wearing a mask at all times. I have a feeling that common sense will prevail and the state will mandate masks for all students by the time school starts.

It's hard to know if this is the right decision but I am concerned about her over-all well being. Children need socialization. I think 2 days a week is a manageable risk. I also think it won't last long. I would not be surprised if they close everything down within a month or so and go virtual for everyone.

[aion]

It's hard to know if this is the right decision but I am concerned about her over-all well being. Children need socialization. I think 2 days a week is a manageable risk. I also think it won't last long. I would not be surprised if they close everything down within a month or so and go virtual for everyone.

My oldest is just starting kindergarten this fall and we'll be homeschooling - but we were already leaning that direction before COVID hit and this was just the nudge to get us there. But honestly, if I was in your position I'd probably do the same thing as you. It seems reasonable and low-risk, all things considered, at least relative to 5-day reopening at a school with a large population.

And you're right, the school year almost certainly won't go as planned. But she'd still be on the AP track if they do end up shutting down and going virtual.

[Bio77]

It's hard to know if this is the right decision but I am concerned about her over-all well being. Children need socialization. I think 2 days a week is a manageable risk. I also think it won't last long. I would not be surprised if they close everything down within a month or so and go virtual for everyone.

My daughter starts her senior year this fall.  Our district was planning the hybrid model you are describing.  We were planning to let her attend. Unfortunately, California cases blew up and all the schools are now going to be virtual only.  At the time, I told her to view it as a privilege, one that would likely be taken away as soon as someone got reckless and some kids ended up infected.