Covid Discussion

[LTownZag]

According to the Beer's criteria, as provided by the American Geriatric Society, anyone over 65 is included in the "older adult" population. The Merck manual also accepts this definition when discussing geriatrics.

I've include the following chart again so persons don't get distracted by your switching of data sets between NY, the U.S. and Texas.

Covid Deaths By Age Group:

Data from the CDC website, accessed 5/17/2020 [https://www.cdc.gov/nchs/nvss/vsrr/c...kly/index.htm]

Age Group	Covid Deaths	Population	Percent of All Covid Deaths	Percent of Age Group	Deaths Per 100K Persons
<1	4	3,848,208	0.01%	0.00%	0.10
1-4	2	15,962,067	0.00%	0.00%	0.01
5-14	6	41,075,169	0.01%	0.00%	0.01
15-24	59	42,970,800	0.11%	0.00%	0.14
25-34	388	45,697,774	0.71%	0.00%	0.85
35-44	973	41,277,888	1.77%	0.00%	2.36
45-54	2,772	41,631,699	5.05%	0.01	6.658
55-64	6,725	42,272,636	12.26%	0.02%	15.91
65-74	11,524	30,492,316	21.01%	0.04%	37.79
75-84	14,930	15,394,374	27.21%	0.10%	96.98
85<	17478	6,544,503	31.86%	0.27%	267.06
All	54861	327,167,434	100%	0.02%	16.77

Thanks for the totals chart, JP. That is very clear and easy to read. It is the same CDC data (in table form rather than line graph) I had linked to above.

20% of deaths in folks younger than 65 and 41% of deaths in folks younger than 75.

[LTownZag]

Is the rate of death per age group for among those infected with Covid? That is what I have assumed.

It makes limiting the infection paramount. If the overall death rate of 16.7 per 100K is accurate (and I have no reason to assume it is not) trying to get to the 80% for herd immunity implies a very large final loss of life number, unless my feeble brain is missing something or I am overthinking this.

Nonetheless, I am and will be, wearing a mask, for now and the foreseeable future.

You're misunderstanding the deaths per 100K people on the CDC table JP linked. It's a growing cumulative total. It was 0/100k 3 months ago and grows every day.

That's not a generalized death rate or infected fatality rate of the disease, it's just the number (as of 5/17) killed divided by the number of all people in a group. (country as a whole, or a given age range slice).

For example - the CDC says we have 6,544,503 (6.5million) residents older than 85 and in the last 3 months 17,478 have officially died of COVID.

17,478 (dead in that group)/6.5 million (total in that group) = .00267 which can be expressed as .267% of that group, or as 267 out of every 100,000. Just over a quarter of one percent. So that's dividing official dead by every human, not by official cases. If every person in that group were to have gotten inected, rather than 4-10% thus far, you can multiply deaths upward accordingly.

If the overall death rate (infected fatality rate) from cases of COVID were a mere 16.7 per 100k (or .0167% of those infected died, less than one fifth of one percent) then this truly would be similar, mortality wise, to the flu. Unfortunately it's about 4-8x that deadly in western countries with non-overwhelmed health care systems.


A quick estimate of deaths if the disease spreads through the USA population broadly enough to reach herd immunity.

170 million (half the country) x 1/2 of 1 percent (.005) = 850,000.

[sonuvazag]

Population demographics seem to play into the death rate, if it is accurate that places with higher numbers of African American patients have the highest death rates.

I agree that generalizability of the data is a caveat, although everywhere these studies look it suggests a higher prevalence than the PCR tests suggest, which is the major point. This is except for the study of MLB employees, which was much lower (I think 0.7% prevalence). It stands to reason that the prevalence is more than is detected by PCR when many persons are asymptomatic or have very mild symptoms to the tune of 80%. It's a crude calculation that oversimplifies the data but one could divide the total number of PCR-confirmed cases and divide by .2 to get a ballpark of what the actual cases might be in this country. The antibody numbers were obviously worse in New York, and at a homeless shelter in Boston, and I would never use these numbers to extrapolate out to the rest of the country.

In regard to NYC, the 1% death rate is much lower than the case fatality rate of 6.5% that is produced when looking at the PCR numbers. New York is tough, in my opinion, because it has been an outlier. I never assumed that their antibody numbers could be generalized to the rest of the country. California has numbers that are more in line with other antibody testing areas, or areas when closer to universal PCR testing was done.

California has had one of the most strict lockdowns, so there's some conversation that will be had about that, I'm sure.

My point was seroprevalance studies for some areas like NYC have of 20% while others like Boise have 1.7%. So you can't take LA County's number and use it to make calculations for Arizona or Washington which is what it seems you did.

You can multiply the population of Washington State (or the U.S., or wherever) by 4.65% to get the denominator.

Everything I have read suggests false positives in these studies are a very real problem that can potentially inflate the numbers quite dramatically, but more dramatically in areas that have lower seroprevalence, so the NYC numbers are probably more solid, it being a harder hit area where false positives would impact the numbers less.

[JPtheBeasta]

The deaths would be much lower in the scenario I suggested because you would be developing herd immunity in the low risk population and doing other things to protect the elderly. Your number includes the hardest hit demographic.

Per the New York Times, 1/3 of Covid deaths were of nursing home residents or workers. If we do a better job at the nursing homes (including not putting Covid-19 patients from the hospital into nursing homes), this would be a start. If mom, dad, and kids get Covid and recover, they are not as likely to give it to grandma. If they can do this sooner than later, grandma will be happier, to boot.

[sonuvazag]

The deaths would be much lower in the scenario I suggested because you would be developing herd immunity in the low risk population and doing other things to protect the elderly. Your number includes the hardest hit demographic.

Per the New York Times, 1/3 of Covid deaths were of nursing home residents or workers. If we do a better job at the nursing homes (including not putting Covid-19 patients from the hospital into nursing homes), this would be a start. If mom, dad, and kids get Covid and recover, they are not as likely to give it to grandma. If they can do this sooner than later, grandma will be happier, to boot.

One problem I have with this theory is that we don't know a lot about the more widespread nonfatal consequences of COVID-19, even to otherwise healthy people. What we do know is enough to give me pause.

https://www.vox.com/2020/5/8/21251899/coronavirus-long-term-effects-symptoms

Also, I have seen a lot of people say you can't trust a serology test as proof that you can no longer be infected/infectious.

[JPtheBeasta]

One problem I have with this theory is that we don't know a lot about the more widespread nonfatal consequences of COVID-19, even to otherwise healthy people. What we do know is enough to give me pause.

https://www.vox.com/2020/5/8/21251899/coronavirus-long-term-effects-symptoms

Also, I have seen a lot of people say you can't trust a serology test as proof that you can no longer be infected/infectious.

The specificity of the test they used, as well the confidence interval of values are given, so you can get a good idea of the low and high end of the range of results. I don’t know enough about the “bootstrap method” and other things they do to weight the results and normalize the results. The take home message for me continues to be that PCR testing of sick individuals underestimates the prevalence of this disease.

I would expect a place with lower death rates to either have a healthier population or a lower prevalence within the population. I would expect Boise to be lower than Los Angelas. I expect Phoenix metro area to be closer to LA than Boise. Spokane might be closer to Boise than LA. Seattle... LA, etc.

[MDABE80]

Reported yesterday...….deaths up from older infections ( still a problem with correct diagnoses) but surprisingly the more testing done is yielding less positive results. Usually the more testing finds more positives. Not last week. I haven't seen an explanation yet.

[sonuvazag]

The take home message for me continues to be that PCR testing of sick individuals underestimates the prevalence of this disease.

I don't see anyone who is arguing otherwise. The question of how much more prevalent, however, is still very much a matter of debate. The conclusions you can draw from 5x are very different from 50x. I believe it's typically 10x, but it depends on the testing criteria for a region.

[Hoopaholic]

This should not be political. No one is trying to do the wrong thing. Most leaders have a reason for wanting what they're asking for and few are doing it for a personal agenda. Just what they believe is right.

Economists should not be ignored in the least, nor should the epidemiologists.

Whatever the data is on any given today is a snapshot of that day, and the future is contingent upon behaviors and the virus, neither are that predictable.

I applaud everyone for keeping any agenda out of this, no one wants anything but to go back to normal, from there is all a sense of what one sees as dangerous, etc. We're helping care for an elderly, sharp but ailing woman. My priorities will be very different, but keep in mind that what others decide (to go to church) impacts me.

On the school/sports side? I think it's far smarter to plan to be there (with adjustments such as starting early) and planning as responsibly as possible. But I say that for the simple reason that it's far easier to cancel plans than build them. So plan, hope for the best, and see what happens.

For the kids I desperately hope that this season is as normal as possible. None of them are really in danger. The older guy cleaning the halls is the one we worry about.

Take care everyone.

Really
Like governor Inslee saying he is keeping Washington state closed so he can revamp the economy to align with his green deal

[GonzaGAW]

- or like govenor newson (california) and cuomo (new york), who say because of the virus they must fundamentally change our way of life and adapt to a new normal.........that fits their political agenda.
- i do not want to take sides, or make a sports arena more than just a sport areana.........but left or right, decisions affecting sports are being made by politicians and they will make them to benefit their own ends..........all the while saying its all for the best of everyone.

[LTownZag]

I'm starting to see folks waving signs and gathering on street corners to protest the state shutdown rules. I am not interested in a discussion about WA's required lockdown rules but it did prompt the question in my mind:

Does anyone know if other countries (many in western Europe have more deaths per capita) are seeing widespread political divisions regarding gov imposed shutdowns? I looked around online and couldn't find any reference to any similar divisions or protests.

Also here's a interesting map.

[kitzbuel]

I'm starting to see folks waving signs and gathering on street corners to protest the state shutdown rules. I am not interested in a discussion about WA's required lockdown rules but it did prompt the question in my mind:

Does anyone know if other countries (many in western Europe have more deaths per capita) are seeing widespread political divisions regarding gov imposed shutdowns? I looked around online and couldn't find any reference to any similar divisions or protests.

This is from Germany

https://www.dw.com/en/germany-politicians-worry-about-radicalization-at-anti-lockdown-protests/a-53388404

[Markburn1]

Me going to church doesn’t affect anyone or their grandma in the least if they don’t want it to. If you keep your distance, six feet, ten feet or whatever from me or anyone else, you won’t be in any danger of getting infected or taking it home to your grandma.

I am NOT putting anyone at risk, especially if proper precautions are taken during services and your risk is zero if you take proper precautions when at the grocery store or any other public place. If you still think I and others are a risk to you, don’t venture out. Simple.

[willandi]

Me going to church doesn’t affect anyone or their grandma in the least if they don’t want it to. If you keep your distance, six feet, ten feet or whatever from me or anyone else, you won’t be in any danger of getting infected or taking it home to your grandma.

I am NOT putting anyone at risk, especially if proper precautions are taken during services and your risk is zero if you take proper precautions when at the grocery store or any other public place. If you still think I and others are a risk to you, don’t venture out. Simple.

If you think you and others are not a risk, why take any precautions?

Religious contacts have proven fertile ground in more than one situation.

Just stay home is as naive as Just Say No to using drugs, or don't drink to an alcoholic.

[Markburn1]

If you think you and others are not a risk, why take any precautions?

Religious contacts have proven fertile ground in more than one situation.

Just stay home is as naive as Just Say No to using drugs, or don't drink to an alcoholic.

I am no risk to you if YOU take precautions.

Why is just stay home naive? Unless you have an emergency and need assistance there is no need to interact with any human without keeping your distance. It’s your decisions that will affect you. If I become infected at church and you keep your distance you aren’t in any danger. I would prefer not to get sick so I take care of myself. I don’t rely on others for my personal wellbeing. I’m not fearful when I go out because I don’t put myself in dangerous situations. Because of that, nobody should be afraid of me or anyone else that chooses to attend church.

Not to put too fine a point on it but early Christians were in more danger of getting killed by the authorities just for worshipping together than being a victim of this virus.

By the way, I haven’t been inside a retail establishment, including grocery stores for at least eight weeks. There is no need. We order online, pull up in the parking lot, pop the back door, kid loads the groceries and we drive home. Home Depot, Amazon Prime , UPS, FedEx, etc. drop stuff off at our home on a regular basis. Staying isolated hasn’t been an issue.

I ride a bike 25-50 miles a day with my son. I walk 5-7 miles a day with my wife. I always distance myself from any other humans doing the same. I am no threat to anyone.