Spokane Regional ( COVID-19 Related )

[Markburn1]

If you are actually an MD or work in medicine, you might want to examine the evidence for this view before continuing to suggest it to the public.

I noticed in the lower left hand corner a reference to the Chinese Center for Disease Control and Prevention. I wouldn't give you a plugged nickel for that data.

Also, I'd be curious to know if undiagnosed cases of the virus were factored in. There are indications that a large number of people with the virus don't seek treatment because their symptoms are so mild.

I think what ABE is getting at is when all the data is finally compiled there will be a far lower mortality rate than the media is touting at the moment.

[LTownZag]

I noticed in the lower left hand corner a reference to the Chinese Center for Disease Control and Prevention. I wouldn't give you a plugged nickel for that data.

Also, I'd be curious to know if undiagnosed cases of the virus were factored in. There are indications that a large number of people with the virus don't seek treatment because their symptoms are so mild.

I think what ABE is getting at is when all the data is finally compiled there will be a far lower mortality rate than the media is touting at the moment.

Here's the article where that comparison chart was posted:

https://www.businessinsider.com/coro...y-rates-2020-3

Like you Mark, I don't have a particular faith or reason to trust that the Chinese CDC is operating outside of political pressures, but if they are influenced by communist corruption, wouldn't those pressures or corrupting influences be exerting pressure to underestimate, not overestimate, the death rate?

Is there any non-fringe US media currently reporting death rates very dissimilar from those in this chart? Is "the media" really touting claims far from those shown above? (perhaps so, I haven't read it though).

[MDABE80]

Exactly Mark. When comparing disease outcomes, fundamental to multiple populations is to sure they are at least equal in clinical descriptors. If these populations are not equal, ie age, race, nutrition, genetics, etc, it's impossible to place money on the outcomes and more so to know what the outcomes mean. Laymen often just lump groups into overall groups with out defining important characteristics that may make the groups response to disease and especially the therapies. Basic epidemiology, public health people and those who review the data, always look out for differences. In this message board, there is insufficient space ( or probably interest) to teach skills or fundamental approaches.

A basic example is as follows: 2 groups of heart attack victims are present. One gets reperfuson ( restoration of block flow beyond blockages) while the other gets traditional medical therapy. TO show a therapy works or doesn't work, a long list of variable must show the two groups to statistically similar..in age, gender, prior heart attacks, heart failure status and so on........

The flaw in LTown's logic is obvious. No offense to LTown intended. In bigger populations we use multivariate analysis to be sure populations are adjusted and are equal. Then we test to see whihc variable(s) are most important. These are then weighted and..come conclusions can be made. It's complex work. SO far, with the newness or this outbreak, I know of no work that determines the most important characteristic that may determine outcomes. I used to work for NIH and section did nothing but that.

This said, back to basketball.

[LTownZag]

I wonder which population you're basing your graph on/ Do you know? Does it include everyone? China only? The senior center in Seattle?? You must define your terms if you pretend to be an expert. Wouldn't you agree??? Where are the references from whihc the date is derived.???

I'm not pretending to be an expert. I am not an expert. I am copying and pasting a graph from a business insider article with data sourced to the US CDC and Chinese CDC.

MDABE80 - how many times the normal flu death rate for people under 75yrs old do you think the COVID-19 will be shown to have (when looked at a few years from now). 3x? 5x? 10x? That chart is suggesting just over 20x.

[LTownZag]

The flaw in LTown's logic is obvious. No offense to LTown intended. In bigger populations we use multivariate analysis to be sure populations are adjusted and are equal. Then we test to see whihc variable(s) are most important. These are then weighted and..come conclusions can be made. It's complex work. SO far, with the newness or this outbreak, I know of no work that determines the most important characteristic that may determine outcomes. I used to work for NIH and section did nothing but that.

This said, back to basketball.

Thanks MDABE80, no offense taken. Though it's unclear what logic of mine you are critiquing. I'm simply concluding that if the death rates in that chart are anywhere close to reality, this will be far more deadly (for those infected) than annual flu outbreaks.

Do you still think "Mortality has been about what you might expect of a flu or flu variants."? Or is it too early to tell?

When you write "mortality" are you using it as a synonym for death rate, or some other calculation that also includes the R-naught?

[tummydoc]

Mortality rate and death rate are synonymous. Mortality rate would be reported in a science journal, death rate in a business journal.

[MDABE80]

No tummy. He’s asking a different question. Mortality may be static. Like in hospital mortality. ThAts fixed Not so with attrition over the next year. In the ensuing year there is an event rate that may include a death rate. Example: As an aortic valve becomes critically stenotic the death rate is 4% in yr one 7 % in yr two and 12 % at 3-5 years. Sounds like splitting hairs I know but there are important differences

[Zagger]

At 270-ish miles away Spokane has a pretty close relationship with Seattle. When it comes to travel the two cities are about as close as two can get being that far apart. I-90 runs between the two. Want to catch a flight from Spokane to a city in Montana? Your plane goes to Seattle first. Our flight out of Spokane to Vegas on Sunday very likely goes through Seattle (haven’t checked yet). Even though we Spokanites do have close ties to Seattle we’re also more/less the capitol of North Idaho (just 20-ish mi away). Spokane is a very important economic hub for the Inland NW. Since BC is 100-ish miles north you also see lots of maple leaf flags fluttering in Spokane. If a significant outbreak of the Coronavirus occurs in Spokane it’ll impact a significant area. Many of us have relatives and/or close pals in Seattle (we have 2 nieces and a brother over there). We visited Seattle just a couple weeks ago (drove).

When it comes to what may happen with fan attendance at NCAA games it’s likely a prudent measure in helping slow the spread of a disease with our nation’s worst occurrence of it in our own state to not have spectators. The Coronavirus is going to spread in the USA. The more quickly it spreads the greater the health/economic impact. Americans travel a heck of a lot - short and long distances. We were even in Wuhan on a river cruise last May. Forgoing travel and attending large events is not something many of us want to curtail. At some point though we’ll have to put ‘the bigger picture’ at a higher priority. It’s not easy to change lifestyles - at least voluntarily. We are creatures of habit. The Mrs & I have only just these past couple of days begun to question our wisdom about going to the Zags games in Vegas. We’re rationalizing at the moment that it’s best to go now rather than later when more people have COVID-19. Vegas could really suffer if the virus spreads there as travelers are the key to its existence. Decisions, decisions .....

[Alum08]

Due to the antibody dependent nature of coronavirus infections, it's not surprising that the mortality figures are skewed since the most heavily affected populations are those with existing subneutralizing antibodies that live near the outbreak.

[RenoZag]

From this morning's WaPo:

In the end, the NCAA will have to weigh risks. While del Rio said he and his fellow panel members would provide recommendations based solely on public health, the NCAA will have to make final decisions.

“For me, it’s a public-health decision,” del Rio said. “What I will tell the NCAA is based on public health. For them, it’s going to be also a business decision. It has to be.”

The unpredictability of the coronavirus makes forecasting the NCAA’s decisions impossible. In Italy, all soccer league games for the next 60 days will be played in empty stadiums. Del Rio would not expect the NCAA tournament to be played under those conditions. But he would not have expected Italy to look that way, either.

“If the tournament was today — except for places like Spokane or Washington, where you may have some questions — I would say: ‘Go on. There’s no concern,’ ” del Rio said. “But will that change? It may. I would have never predicted we’d be where we are with Italy. And yet we are. Nobody a month ago would have in their wildest dreams said, ‘Italy is going to be a disaster.’

LINK: https://www.washingtonpost.com/sport...s-complicated/

[Zags11]

Im just confused in this virus. We didnt cancel march madness when Sars was horrible with a 10% death rate. I feel like social media is scaring people. I am not saying dont take precaution but if you are healthy, you will 99% be fine just like other flu like illnesses. I know they reported 100,000 cases but trust me their has been way more that healthy people got sick and got over.

[LTownZag]

Im just confused in this virus. We didnt cancel march madness when Sars was horrible with a 10% death rate. I feel like social media is scaring people. I am not saying dont take precaution but if you are healthy, you will 99% be fine just like other flu like illnesses. I know they reported 100,000 cases but trust me their has been way more that healthy people got sick and got over.

Death rate is calculated outside of any consideration for how contagious a disease is. The rate is(People who died from "x" / people who ever acquired "x") A disease with a 10 or 20% (or higher) death rate but which is extremely extremely hard to catch (HIV) should be responded to differently than a ver contagious disease which might have a death rate far lower.

So any reasonably wise response is based largely on how it spreads, not just the rate it kills. Make any sense?

[GonzagasaurusFlex]

From this morning's WaPo:

LINK: https://www.washingtonpost.com/sport...s-complicated/

Sadly, at this point I expect the Dance to be negatively impacted by Coronavirus and likelihood of games being played in empty stadiums but still televised seems greater and greater.

Seems common sense to assume that this Coronavirus, which is not being tested for extensively, is already out of the box and spreading...we just don’t have confirmation of real #s due to lack of testing.

I’ll be so bummed if it causes NCAA to cancel the tourney but not nearly as bummed as the teams and players would be.

[LTownZag]

No tummy. He’s asking a different question. Mortality may be static. Like in hospital mortality. ThAts fixed Not so with attrition over the next year. In the ensuing year there is an event rate that may include a death rate. Example: As an aortic valve becomes critically stenotic the death rate is 4% in yr one 7 % in yr two and 12 % at 3-5 years. Sounds like splitting hairs I know but there are important differences

I was actually just trying to learn if you still believe in this claim:

"Mortality has been about what you might expect of a flu or flu variants."

[Markburn1]

Death rate is calculated outside of any consideration for how contagious a disease is. The rate is(People who died from "x" / people who ever acquired "x") A disease with a 10 or 20% (or higher) death rate but that is extremely extremely hard to catch (HIV) should be responded to differently than an extremely contagious disease which might have a death rate far lower.

So any reasonably wise response is based largely on how it spreads, not just the rate it kills. Make any sense?

I still think you are overlooking a large percentage of "people who ever acquired x". There will be huge numbers that have been infected that never make it into your denominator because they will never go to hospital or be tested for the virus. Your assumed death rate from your sources is almost assuredly inflated because of that.

[LongIslandZagFan]

Much ado about...... something but not quite deserving the hysteria that some are exhibiting. i.e. Mask hoarders, runs on water and such at Costco, this is not helping.

This virus is serious and should be monitored but the level of concern should not be panic mode.

According to the CDC, 16,000 people died from the flu in the US during the 2019-20 flu season.
39,000 people died in auto accidents in 2019.

It would seem obvious that you’re much more likely to die driving to the event than you are from COVID-19.
Again, not saying it isn’t important, it is. Just don’t go crazy. (Said to no one on this board, just in general)

Be careful with numbers. If the 1-2% mortality rate is correct, if the same number of people got it that got the flu so far this flu season, we'd be talking about 300K+ dead. Bad flu years kills about 80K... if it was similar to those... we'd be talking 1.6 million dead.

Not saying there is need to panic. Just saying using end numbers without thinking about the starting number and actual mortality rates.

[gonzagafan62]

Be careful with numbers. If the 1-2% mortality rate is correct, if the same number of people got it that got the flu so far this flu season, we'd be talking about 300K+ dead. Bad flu years kills about 80K... if it was similar to those... we'd be talking 1.6 million dead.

Not saying there is need to panic. Just saying using end numbers without thinking about the starting number and actual mortality rates.

This is correct but we currently don’t have a vaccine for this yet correct? I wonder if we did have a vaccine or cornonavirus shot for it if it would take those numbers down drastically - potentially down to the normal flu level.

Just an idea without any real evidence to support or detract from the argument

[LTownZag]

I still think you are overlooking a large percentage of "people who ever acquired x". There will be huge numbers that have been infected that never make it into your denominator because they will never go to hospital or be tested for the virus. Your assumed death rate from your sources is almost assuredly inflated because of that.

I 100% agree that if the denominator is wrong with false positives or false negatives, the rate is wrong. I don't know how the denominator was determined for the rates in the chart I linked. If it is simply the totality of positive clinically-run tests, then it is obviously missing some cases. I wasn't able to learn if the denominator included some estimate of likely cases that didn't result in official diagnosis.

So I'm not overlooking that possibility, I just have no idea where to start in terms of estimating the total of % of cases which exist but go undiagnosed. It's a great point though, Mark.

[LTownZag]

Be careful with numbers. If the 1-2% mortality rate is correct, if the same number of people got it that got the flu so far this flu season, we'd be talking about 300K+ dead. Bad flu years kills about 80K... if it was similar to those... we'd be talking 1.6 million dead.

Not saying there is need to panic. Just saying using end numbers without thinking about the starting number and actual mortality rates.

Even if the mortality for people under 75 is just .1% (1in1000) that's still 10x the death rate of the typical flu, so even if you think current death rate estimates are wildly high, the actual covid-19 death rate could still be much higher than flu. If just 1/3 of Americans caught covd-19 with a .1% death rate, it would result in greater than 100,000 deaths directly and likely a huge surge in sick people in a small period of time which would stretch community medical resources, potentially bringing lots of other harms.

[MickMick]

Workers that face occupational exposure to any hazardous substance can wear the appropriate protective clothing if the hazard has been analyzed. In the lab it is analyzed for health effects. In the field it is sampled and quantified with actual numbers to predict exposure rate (time, proximity, concentration, exposure path).

When the analysis in the lab or in the field proves to be inconclusive, the standard approach is to categorize the unknown as IDLH (immediate danger to life and health).

In other words, it doesn't matter if you do or don't believe the Chinese science. It doesn't matter if there isn't enough evidence to prove or disprove mortality rate. What matters is that you are dealing with a relatively new strain and there has not been enough data collected to provide proper predictability. In such cases you revert to IDLH levels because you are dealing with an unknown. In other words, to err on the side of conservativism, you treat unknowns as an immediate danger to life and health until enough data is collected to prove otherwise.

It is premature and dangerous to make any claims that marginalize precautionary actions without further study.

If Washington State or the CDC recommends self quarantine for 60 year olds with a history of lung illness, then that is what you should definitely do.

[TexasZagFan]

Social media will be the death of us all!

If anyplace is ripe for a coronavirus meltdown, it's Las Vegas. However, I've yet to see or hear much about shutting down the WCC Tournament.

https://www.sltrib.com/sports/2020/0...not-affecting/

[zagfan24]

A national conference (American Psychosocial Oncology Society) some of my colleagues were attending in Portland was just cancelled. Given the risk of the immune-compromised patients we work with it just wasn't worth the benefits of the conference, and many medical institutions are now limiting travel for providers and staff. This conference was deemed a particular risk given not only the patient population but the number of flights going through WA and CA.

[scrooner]

Coronavirus is not the flu, it is not SARS, it is not MERS, it is not Spanish influenza. Claiming that we know anything about the danger of Coronavirus by comparing to other outbreaks is misguided at best.

We DO know that people can carry it and spread it for up to 14 days before showing symptoms, and that it has a high death rate for the elderly and others who have lowered immunity, like diabetics for example. Saying that you aren't personally worried about your risk may make you personally feel better, but it's a pretty selfish point to make, IMO.

[Markburn1]

Coronavirus is not the flu, it is not SARS, it is not MERS, it is not Spanish influenza. Claiming that we know anything about the danger of Coronavirus by comparing to other outbreaks is misguided at best.

We DO know that people can carry it and spread it for up to 14 days before showing symptoms, and that it has a high death rate for the elderly and others who have lowered immunity, like diabetics for example. Saying that you aren't personally worried about your risk may make you personally feel better, but it's a pretty selfish point to make, IMO.

Who is making that point? I think most everybody here have empathy for those at higher risk.

[Zagdawg]

Scrooner and Mick make good points --- better to be safe than sorry. I was supposed to be in Altlanta next week for a conference -- but it was cancelled also.

Be safe-- wash you hands and stay healthy folks -- and have a great weekend.

Go Zags!!