SARS CoV-2 coronavirus / Covid-19 (No tin foil hat silliness please)

There are people who seem to think that football will be back in the near future, whilst there's 3 makeshift hospitals being built in London, Birmingham and Manchester. Oh and a 1500 capacity morgue in a Birmingham airport. I mean how does anyone see what's happening and think right... back to football then..
 
There's a lot of people here going to be depressed when the virus eventually disappears. You'll have nothing to moan, whinge and doom monger about. Putting the shits up people seems to be exciting to a lot of people, without even having a clue about anything, just what they've read. Heads full of cartoons fantasizing about a walking dead type scenario ffs.


Watched a programme the other night, well, half watched it, Mrs had it on. All they went on about was negative and worst case scenarios, like ridiculous worst case scenarios. Bad news is news. Good news isn't profitable so they gloss over anything half positive.

While I'm having a moan about this, I'll have a little moan about everyone saying "this is why we needed to fund the NHS more previously" ... No, we needed to stop people taking the piss out the NHS, drug users, obesity, them people who goto the docs for every single cough, parents taking kids for a sneeze. More funding would have been great, but a massive factor is abuse of the system. People getting free boob jobs cos they're depressed and stuff man. That's wrong.

Putting strain on a system/service supposed to be used for good, for ridiculous reasons, obesity man, just stop eating like fecking whales.

is this supposed to be one of those pathetic TRUTH posts because some people are reacting differently to you?

as for the rest of the thread, I am just glad you all didn’t die after brexit. OH MY 2% GDP!!
 
You're assigning 3% CFR to the 10% percent with non-mild symptoms when the CFR for all cases is estimated to be closer to that. Also note that many estimates for the asymptotic proportion don't account for the subset of those who later on tend to develop symptoms. One of the first estimates was the Diamond Princess which found that 50% were asymptotic. However, they later had revise this as then more than half the asymptotic proportion went on to develop symptoms, which aligns with what many models are saying (different studies from 17% to 31%).
I am assigning CFR based on the current documented CRFs (not estimates). For example, Germany has a 0.6 documented mortality rate (which is an upper bound on the real mortality rate).

Diamond Princess is a good example, but it also has an extremely skewed age distribution. There were so many more people over 70 than in any country, while the number of young people 0-40 was much less than outside of it. It also does not show how severe were the syndroms. If you are as sick as when you catch the cold, unless you are an NBA player or a senator, you are not gonna get a test (while in DP, everyone got a test). If many people with no symptoms (or mild symptoms) is a thing, then we can expect the majority of them to be on young people. Finally, there have been next to no studies on kids. They are a large number of population, and it could be that many of them don't have symptoms at all.

I don't know how much is the number of people with no to mild symptoms, but I wouldn't be surprised if it is much larger than 31%. After all, to get a test you need to be very sick. If you are just a bit sick or even moderately sick (cold-like) it is probably just stay home and get paracetamol, with you never being documented as a case.
 
Norwegian health officials, at least, are very confident the real CFR will be below 1%, and probably comfortably so.
I addressed the CFR in a different post further up this page.

The numbers I used in my earlier post were based on widely accepted/reported figures. I could have obviously chosen to editorialise, but I was trying hard to be dispassionate. That's also why I couched every assumption in ifs, buts and maybes.

Hopefully the lower Norwegian estimates you mentioned come true. If they do, I'll happily revise the maths.
 
There's a lot of people here going to be depressed when the virus eventually disappears. You'll have nothing to moan, whinge and doom monger about. Putting the shits up people seems to be exciting to a lot of people, without even having a clue about anything, just what they've read. Heads full of cartoons fantasizing about a walking dead type scenario ffs.


Watched a programme the other night, well, half watched it, Mrs had it on. All they went on about was negative and worst case scenarios, like ridiculous worst case scenarios. Bad news is news. Good news isn't profitable so they gloss over anything half positive.

While I'm having a moan about this, I'll have a little moan about everyone saying "this is why we needed to fund the NHS more previously" ... No, we needed to stop people taking the piss out the NHS, drug users, obesity, them people who goto the docs for every single cough, parents taking kids for a sneeze. More funding would have been great, but a massive factor is abuse of the system. People getting free boob jobs cos they're depressed and stuff man. That's wrong.

Putting strain on a system/service supposed to be used for good, for ridiculous reasons, obesity man, just stop eating like fecking whales.
Glad you had time for your little telly show. In the real world however, health service workers are witnessing terrible things and getting worse.

I've deemed your ignorance a mitigating circumstance and shall therefore not be telling you what I really think of you.
 
I addressed the CFR in a different post further up this page.

The numbers I used in my earlier post were based on widely accepted/reported figures.

I could have obviously chosen to editorialise, but I was trying hard to be dispassionate. That's also why I couched every assumption in ifs, buts and maybes.

Hopefully the lower Norwegian estimates come true. If they do, I'll happily revise the maths.
Well, you essentially used worst-case scenario for infections (again, it is likely that can happen within 3 seasons, not 1), highest mentioned mortality rate, assumed no restriction whatsoever, that social distancing and better hygiene will just not work at all, assumed doing nothing to increase the number of beds/ventilators, assumed that no drug that is on trial is gonna help, assumed that there are no silent cases, and then you came with your numbers.

I mean it is possible for this to happen. It is just extremely unlikely (as unlikely as the best scenario that 50% of people are already infected).
 
You're saying the true CFR is 0.3%? Nothing I've read says that. I'd love to read the source.
I am just making some conjecture. In Germany it is 0.6%. It just cannot be higher than that, considering that if that was the case, then it would have been higher than that. It is extremely likely that it is lower than that (last time I checked, they did not test everyone). In Norway, it actually 0.4%. In South Korea and US is somewhere below 1.5%. In Bahrain it is 0.9%.

What do these countries have in common? They have done a lot of testings.

Have they tested everyone in their country? Hell, no.

Even if we assume that for 2 sick people, they test one (truth must be that for every few, they test one), then the real fatality rate would be 0.3% for Germany, 0.2% for Norway and so on. Which is why I think that the true fatality rate is in that region. Anthony Fauci also thinks that it is below 1%.

Obviously, we won't ever know this unless everyone gets tested every week or so. And in the end, it might well be that the documented CFR to converge at 2-3%, but that won't count for many people who did not get a test in the first place.
 
Well, you essentially used worst-case scenario for infections (again, it is likely that can happen within 3 seasons, not 1), highest mentioned mortality rate, assumed no restriction whatsoever, that social distancing and better hygiene will just not work at all, assumed doing nothing to increase the number of beds/ventilators, assumed that no drug that is on trial is gonna help, assumed that there are no silent cases, and then you came with your numbers.

I mean it is possible for this to happen. It is just extremely unlikely (as unlikely as the best scenario that 50% of people are already infected).
I addressed the inaccuracies of the CFR figure in a post further up this page.

1% or less is what Norway and Germany reckon. 4% is what Italy is showing. 2% is middle of the road. There are obviously mitigating factors to all of those numbers. But, as I said, I didn't want to editorialise the maths.

That's not to say I don't appreciate that the widely reported estimates might be wrong (just as you've very reasonably argued). I don't necessarily disagree with you. It's why I went as far pointing out the assumptions in the calculations.
 
I don't have time to respond to all posts. So sorry about that.

Forget CFR.

Where I am we have around say 50 vents. Our models suggest 150 to 250 cases needing vents over 1-2 months. You do the math.

The sheer numbers are going to overwhelm hospital systems all over like how it is happening right now in NYC.

Another reason to ignore CFR. If you get real sick from it, there is not much we can do. Even if the vast majority are ok, if you are unlucky, can't do anything really.
 
I don't have time to respond to all posts. So sorry about that.

Forget CFR.

Where I am we have around say 50 vents. Our models suggest 150 to 250 cases needing vents over 1-2 months. You do the math.

The sheer numbers are going to overwhelm hospital systems all over like how it is happening right now in NYC.

Another reason to ignore CFR. If you get real sick from it, there is not much we can do. Even if the vast majority are ok, if you are unlucky, can't do anything really.
That is true. All my assumptions on CFR are based on a medical system that is still functional. Otherwise, CFR is as high as the number of people who need a ventilator but cannot get on.

Are there any attempts in your hospital to use a ventilator for multiple people. In Italy apparently they are using 1 ventilator for 2 people, and in NYC they are experimenting with using 1 ventilator for 4 people.

Finally, kudos to you for your job and stay safe!
 
I am just making some conjecture. In Germany it is 0.6%. It just cannot be higher than that, considering that if that was the case, then it would have been higher than that. It is extremely likely that it is lower than that (last time I checked, they did not test everyone). In Norway, it actually 0.4%. In South Korea and US is somewhere below 1.5%. In Bahrain it is 0.9%.
These numbers are changing. South Korea rate was exactly the same as Germany a week ago at 0.6%. It's possible that Germany will take the same trajectory. It makes more sense to go by the CFR estimated in published papers by researchers and experts studying this rather than ball-parking our own to be honest.
 
That is true. All my assumptions on CFR are based on a medical system that is still functional. Otherwise, CFR is as high as the number of people who need a ventilator but cannot get on.

Are there any attempts in your hospital to use a ventilator for multiple people. In Italy apparently they are using 1 ventilator for 2 people, and in NYC they are experimenting with using 1 ventilator for 4 people.

Finally, kudos to you for your job and stay safe!

Everyone is looking into it. There is 0 data on it.

Question is: would it be better to decidie which patient has a better prognosis and using the ventilator for that patient rather than losing 2 patients by using one for both, which might be ineffective to begin with? Having to choose which patient to save is going to be horrible.

No kudos for us. Definitely difficult job but not like we are going to do a good job.

And oh yeah almost forgot, even if you had enough ventilators problem is not solved. You still need resp therapists, nurses, icu physicians to take care of the vents and the patients. Right now there seems to be 10-20‰ rate of infection in Healthcare workers. With the disastrous situation with ppe in USA, expect Healthcare workers to get affected more than elsewhere. That just amplifies the problem then.
 
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These numbers are changing. South Korea rate was exactly the same as Germany a week ago at 0.6%. It's possible that Germany will take the same trajectory. It makes more sense to go by the CFR estimated in published papers by researchers and experts studying this rather than ball-parking our own to be honest.
Sure, I am just speculating. Obviously, the models should be based on real data and published papers. If I was a president who make decisions, I would try to be as cautious as possible and base the decisions on published papers. No harm in being over-cautious, and the models will be always over-cautious.
 
15k new cases in the US today and they're now up to 100k. Feels like they've completely lost control of it.


Losing control would imply that there was any control to begin with. We’re being lead by a malignant narcissist megalomaniac who is absolutely clueless. What’s worse there is still a fairly large Amount of people in the U.S. that think either it’s a hoax to ruin Trumps election campaign, or it’s just the flu because they don’t have it.
 
Losing control would imply that there was any control to begin with. We’re being lead by a malignant narcissist megalomaniac who is absolutely clueless. What’s worse there is still a fairly large Amount of people in the U.S. that think either it’s a hoax to ruin Trumps election campaign, or it’s just the flu because they don’t have it.
“Deep state conspiracy” is what I keep seeing on social media.
 
Glad you had time for your little telly show. In the real world however, health service workers are witnessing terrible things and getting worse.

I've deemed your ignorance a mitigating circumstance and shall therefore not be telling you what I really think of you.

It's cool, you can tell me you fancy me. Don't worry about it
 
Everyone is looking into it. There is 0 data on it.

Question is: would it be better to decidie which patient has a better prognosis and using the ventilator for that patient rather than losing 2 patients by using one for both, which might be ineffective to begin with? Having to choose which patient to save is going to be horrible.

No kudos for us. Definitely difficult job but not like we are going to do a good job.

And oh yeah almost forgot, even if you had enough ventilators problem is not solved. You still need resp therapists, nurses, icu physicians to take care of the vents and the patients. Right now there seems to be 10-20‰ rate of infection in Healthcare workers. With the disastrous situation with ppe in USA, expect Healthcare workers to get affected more than elsewhere. That just amplifies the problem then.


In Spain there are over 9000 health care workers infected already and is putting even more strain to the problem. They are risking literally their lives for not decent salaries. And putting at risk their families.

Actually I read and article of one health care woker that she said goodbye to her family. Not because she believed that she was about to die, but because she would not be able to even touch them for months. Even living with them, her routine of entering the house. Absolutely everything made her not being able to touch her partner and her kids
 
The analytics are developed to create projection on constant flux in change to assess decision making; however their accuracy is atrocious because there are far too many variables to address.

The only things that can be measured are rates of change by running massive simulations and examining how different assumptions affect the results.

mav_9me hit it on the head, relying on CFR accuracy is a fools errand because the statistical error is far too large.
Hence the reason you need to look at ventilators, ICU beds and the biggest issue the health and welfare of medical staff.

You can have all this medical equipment made but if the medical staff are not available to use it the efficacy of the medical equipment is rendered next to totally ineffective.

Equipment can be made but it is more difficult and time consuming to train people.
 
There's a lot of people here going to be depressed when the virus eventually disappears. You'll have nothing to moan, whinge and doom monger about. Putting the shits up people seems to be exciting to a lot of people, without even having a clue about anything, just what they've read. Heads full of cartoons fantasizing about a walking dead type scenario ffs.


Watched a programme the other night, well, half watched it, Mrs had it on. All they went on about was negative and worst case scenarios, like ridiculous worst case scenarios. Bad news is news. Good news isn't profitable so they gloss over anything half positive.

While I'm having a moan about this, I'll have a little moan about everyone saying "this is why we needed to fund the NHS more previously" ... No, we needed to stop people taking the piss out the NHS, drug users, obesity, them people who goto the docs for every single cough, parents taking kids for a sneeze. More funding would have been great, but a massive factor is abuse of the system. People getting free boob jobs cos they're depressed and stuff man. That's wrong.

Putting strain on a system/service supposed to be used for good, for ridiculous reasons, obesity man, just stop eating like fecking whales.

Glad you had time for your little telly show. In the real world however, health service workers are witnessing terrible things and getting worse.

I've deemed your ignorance a mitigating circumstance and shall therefore not be telling you what I really think of you.

Whilst I think he could have said a few things differently. He’s not ignorant at all, if you talk to a lot of London Ambulance staff (I happen to do this) one of their massive complaints about the state of the NHS is the abuse and misuse of it by people. We’re British and we’re polite and we don’t like to offend in general so people don’t really mention it.
It’s obvious it’s under funded and the government have handled it atrociously for years (labour included) but if it’s to be fixed all basis have to be covered, there has to be some home truths and a portion of the British public held accountable for their decision making. These people (who are in the minority tbf) are massively affecting those who actually need it and they are wasting resources and more importantly, the time of in particular, the London Ambulance Service.
 
There's a lot of people here going to be depressed when the virus eventually disappears. You'll have nothing to moan, whinge and doom monger about. Putting the shits up people seems to be exciting to a lot of people, without even having a clue about anything, just what they've read. Heads full of cartoons fantasizing about a walking dead type scenario ffs.


Watched a programme the other night, well, half watched it, Mrs had it on. All they went on about was negative and worst case scenarios, like ridiculous worst case scenarios. Bad news is news. Good news isn't profitable so they gloss over anything half positive.

While I'm having a moan about this, I'll have a little moan about everyone saying "this is why we needed to fund the NHS more previously" ... No, we needed to stop people taking the piss out the NHS, drug users, obesity, them people who goto the docs for every single cough, parents taking kids for a sneeze. More funding would have been great, but a massive factor is abuse of the system. People getting free boob jobs cos they're depressed and stuff man. That's wrong.

Putting strain on a system/service supposed to be used for good, for ridiculous reasons, obesity man, just stop eating like fecking whales.

Don't be so silly.
 
There's a lot of people here going to be depressed when the virus eventually disappears. You'll have nothing to moan, whinge and doom monger about. Putting the shits up people seems to be exciting to a lot of people, without even having a clue about anything, just what they've read. Heads full of cartoons fantasizing about a walking dead type scenario ffs.


Watched a programme the other night, well, half watched it, Mrs had it on. All they went on about was negative and worst case scenarios, like ridiculous worst case scenarios. Bad news is news. Good news isn't profitable so they gloss over anything half positive.

While I'm having a moan about this, I'll have a little moan about everyone saying "this is why we needed to fund the NHS more previously" ... No, we needed to stop people taking the piss out the NHS, drug users, obesity, them people who goto the docs for every single cough, parents taking kids for a sneeze. More funding would have been great, but a massive factor is abuse of the system. People getting free boob jobs cos they're depressed and stuff man. That's wrong.

Putting strain on a system/service supposed to be used for good, for ridiculous reasons, obesity man, just stop eating like fecking whales.

the UK's spending per capita is among the lowest between comparable countries

can you qualify your opinion that it's actually the people's fault and not the governments?
 
There's a lot of people here going to be depressed when the virus eventually disappears. You'll have nothing to moan, whinge and doom monger about. Putting the shits up people seems to be exciting to a lot of people, without even having a clue about anything, just what they've read. Heads full of cartoons fantasizing about a walking dead type scenario ffs.


Watched a programme the other night, well, half watched it, Mrs had it on. All they went on about was negative and worst case scenarios, like ridiculous worst case scenarios. Bad news is news. Good news isn't profitable so they gloss over anything half positive.

While I'm having a moan about this, I'll have a little moan about everyone saying "this is why we needed to fund the NHS more previously" ... No, we needed to stop people taking the piss out the NHS, drug users, obesity, them people who goto the docs for every single cough, parents taking kids for a sneeze. More funding would have been great, but a massive factor is abuse of the system. People getting free boob jobs cos they're depressed and stuff man. That's wrong.

Putting strain on a system/service supposed to be used for good, for ridiculous reasons, obesity man, just stop eating like fecking whales.
So uninformed.
 
I was just asking, I don't know what the British guidelines are.

We came back to Denmark from Ethiopia a week ago and have been in quarantine since. We weren't specifically told to do that, I don't think. It just seemed like the thing to do (plus everyone else we traveled with were doing the same). So another week I'm this summer house and then we'll see what happens.
 
I’ve just worked 14 days in a row in a busy London hospital. More than 3/4 of the patients I’m admitting under acute medicine are possible COVID-19s.

It’s an easy, boring diagnosis - ARDS on the CXR, normal white cell count with lymphopenia and a raised CRP. Management options are incredibly frustrating - all we can do if oxygenate and hope they get better.

It’s mental, and will only get worse - patients who would’ve gone straight to ITU a month ago are being admitted to medical wards. And the ones admitted to ITU haven’t done well so far, although the majority of them are still tubed and might still improve.

Admitted a couple of younger, fit patients from resus today - fit, muscular men in their late 40s with no past medical history (pO2 of 4 on room air!!!). Requiring 15L to barely maintain 85+% O2 sats.

We’re going to see incredibly sad things over the coming months.

How effective is ventilator treatment? Or is it mostly just keeping people alive while they fight the infection themselves? Is there an average time that people need to be on the vent?
 
I am just making some conjecture. In Germany it is 0.6%. It just cannot be higher than that, considering that if that was the case, then it would have been higher than that. It is extremely likely that it is lower than that (last time I checked, they did not test everyone). In Norway, it actually 0.4%. In South Korea and US is somewhere below 1.5%. In Bahrain it is 0.9%.

The thing about this is that it's a fluid situation and there is constant upward pressure on the death rates in these countries (the number of new deaths is a greater proportion of existing deaths than new cases is of existing cases). Germany was at 0.3% last week, at one stage South Korea was at 0.4, now it's at 1.5.

As of right now the best data for an entire country is without question Iceland and this really should give the clearest picture going forward. They've already tested 3.7% of the entire country. Above and beyond the government tests, they've also got a company (deCode Genetics) that's doing voluntary community testing. The government has a detailed and dedicated page for both: https://www.covid.is/data

To put that in perspective, NY, which has by far the biggest testing program in the states had by yesterday tested 5,319 per million. Iceland has tested 37,371 per million. The current data out of Iceland is encouraging: 890 cases, 97 recovered, 18 hospitalised, 6 in ICU, 2 dead. That's obviously very hopeful but it's clearly not the end of the story either. For instance yesterday there were only 3 people in Iceland's ICUs. I think one of the things widespread testing does besides capturing more people with genuintely asymptotic and milder conditions is that it captures them at earlier stages the disease. There is therefore a greater lag between discovery and death in these countries. That needs to be factored in when attempting to ascertain the true death rate.
 
There have been impassioned pleas in Italy from the Minister for the South, where poverty, large family size and poor infrastructure is making the situation much worse than it is in more affluent parts of the country.

Italy's really two countries in one. The wealthy, industrialised northern regions have very little in common with the rural, impoverished south. Unfortunately, when the plans to extend the northern locked-down areas were leaked the night before it happened, many people immediately got on a train or bus to the south where presumably they had their family homes. Now that the measures are the same across the whole of the country, they've gained nothing in terms of avoiding restrictions, and the south is seeing an alarming rise in cases with no means to handle it.

edit - the fact that there is so much "underground economy" which has disappeared overnight there is resulting in people using social media to organise raids on supermarkets to simply take food. Organised crime is playing a part of course, as ever.
 
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I am assigning CFR based on the current documented CRFs (not estimates). For example, Germany has a 0.6 documented mortality rate (which is an upper bound on the real mortality rate).

Diamond Princess is a good example, but it also has an extremely skewed age distribution. There were so many more people over 70 than in any country, while the number of young people 0-40 was much less than outside of it. It also does not show how severe were the syndroms. If you are as sick as when you catch the cold, unless you are an NBA player or a senator, you are not gonna get a test (while in DP, everyone got a test). If many people with no symptoms (or mild symptoms) is a thing, then we can expect the majority of them to be on young people. Finally, there have been next to no studies on kids. They are a large number of population, and it could be that many of them don't have symptoms at all.

I don't know how much is the number of people with no to mild symptoms, but I wouldn't be surprised if it is much larger than 31%. After all, to get a test you need to be very sick. If you are just a bit sick or even moderately sick (cold-like) it is probably just stay home and get paracetamol, with you never being documented as a case.
It is not an upper bound. Deaths lag behind, so it could easily rise. People were saying the same thing about S Korea when it was 0.4%, now it is well over 1%. For the record i think true CFR will be around 0.5%-1%. But Germany doesn't provide an upper limit at the moment like you claim
 
You're assigning 3% CFR to the 10% percent with non-mild symptoms when the CFR for all cases is estimated to be closer to that. Also note that many estimates for the asymptomatic proportion don't account for the subset of those who later on tend to develop symptoms. One of the first estimates was the Diamond Princess study which found that 50% were asymptomatic. However, they later had revise this as then more than half the asymptomatic proportion went on to develop symptoms, which aligns with what many models are saying (different studies from 17% to 31%).
Do you have links to studies about the asymptotic %. I know of the DP and Vo Euganeo, any others? I do agree with your assessments. But would like to share more studies