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Axiom of Choice

Coronavirus - discussion of what ifs and hypotheticals

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On 5/5/2020 at 10:49 AM, bschoolprof said:

I agree the lockdown has given us time to learn about the threat. One thing we have learned is it can be instructive to break out the threat by region.  Despite being part of the same land mass, Texas (and most of the rest of the country) has not had the same experience as the New York metro area, just as Germany has not had the same experience as Spain or Italy. When I look at the Texas data, it's hard for me to get too worked up about COVID.  From the CDC data linked above, here are the COVID deaths by age in Texas along with the TOTAL deaths by age. 

texas

One thing I didn't appreciate - and I bet most of you didn't appreciate - is how many people in this state die every day of various causes.  Even if we double or triple the number of deaths attributed to COVID, it's still a tiny fraction of the total people dying in each age group.  Here's the excess "all causes" deaths in Texas from the CDC dataset.  Yes, there's been a spike due to COVID, but it's smaller than in Jan 18 (due to flu) and not a single person on this board probably ever even worried about it at the time. 

Weekly-Excess-Deaths

 

 

     

Can you share the link for that last chart?

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On 5/4/2020 at 11:19 PM, Dahobbs said:

I thought I'd come back to this comment from the OP. The CDC currently has more detailed data for 38,576 of the 69,921 US deaths. 

https://www.cdc.gov/nchs/nvss/vsrr/COVID19/ (detailed data set)

https://www.worldometers.info/coronavirus/ (CDC listing with 67,456)

https://www.worldometers.info/coronavirus/ (Current worldometer listing at 69,921).

 

In particular, the detailed data includes an age breakdown (available to download here). I've pulled the data below and created a current estimate based on the relative percentage and total death count from worldometer:

Age group COVID-19 Deaths Percent of Total Estimated Current Age Breakdown
Under 1 year 4 0.011% 7
1-4 years 2 0.005% 4
5-14 years 3 0.008% 6
15-24 years 42 0.113% 79
25-34 years 278 0.745% 521
35-44 years 707 1.895% 1,325
45-54 years 1,929 5.170% 3,615
55-64 years 4,688 12.566% 8,786
65-74 years 8,001 21.446% 14,995
75-84 years 10,196 27.329% 19,109
85 years and over 11,458 30.712% 21,474
All Ages 37,308 100.000% 69,921

51 people under the age of 25 have died based on the CDC data. And that number grows to 96 in the estimate. That's 10x the OP's estimate. And  that is with an exposure level much lower than 25% (New York, the hardest hit state, is only at 12.3% according to recent testing, with NYC the largest concentration at 19.9%). The estimate for ages of 25-54 results in 5,461 current deaths, generally matching the total suggested by the OP.  If we were to actually reach 25% exposure, we should expect those numbers to easily double several times over. For instance, if the whole country were hit like New York, we'd be talking about 40 million infected (328 million times 12.3%), an IFR of 1.04% (24,999 deaths divided by [19.45 million times 12.3%]),  400,000 total dead (40 million times 1.04%), 500 dead under 25, and 31k dead between 25 and 54. If we were to actually get to 25% exposure, those numbers would double (800k total dead, 1k under 25, and 62k between 25 and 54). 

This was the first real good batch of data I've seen on the age breakdown, and I wanted to bring it up not to criticize the OP for an incorrect prediction, but to demonstrate the folly of using optimistic estimates when dealing with a largely unknown risk. We knew from early on that this thing had the potential to be really bad, but our data was unreliable. I advocated for an short-term early shutdown precisely because we need more information to know what kind of risk we were facing. 

 

 

I think there is some discrepancy in the way deaths are being categorized by various organizations in various regions.  This site shows no CV deaths in anyone below the age of 17 in New York.  The CDC link above shows 10 in the country.   Maybe all 10 are outside the hardest hit region in the country, but that would be unlikely.  I think it comes down how a death is attributed.  Maybe we are an international outlier and have 10 deaths in children below 14; maybe we had 10 die who had other issues and tested positive for CV.  I would be interested in some medical professional's thoughts on this.   

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Reading that the virus can enter through the eyes makes me a bit nervous about my retina surgery tomorrow.

Should I wear the eye patch afterwards for an extended length of time beyond what they recommend?

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Reading that the virus can enter through the eyes makes me a bit nervous about my retina surgery tomorrow.
Should I wear the eye patch afterwards for an extended length of time beyond what they recommend?

Your extra large bifocals should be alright

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1 hour ago, Armybrat said:

Reading that the virus can enter through the eyes makes me a bit nervous about my retina surgery tomorrow.

Should I wear the eye patch afterwards for an extended length of time beyond what they recommend?

Any time that the question "should I wear an eye patch" is asked, the answer is yes.  It is always "yes."

plissken.jpg

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Posted (edited)
4 hours ago, Axiom of Choice said:

I think there is some discrepancy in the way deaths are being categorized by various organizations in various regions.  This site shows no CV deaths in anyone below the age of 17 in New York.  The CDC link above shows 10 in the country.   Maybe all 10 are outside the hardest hit region in the country, but that would be unlikely.  I think it comes down how a death is attributed.  Maybe we are an international outlier and have 10 deaths in children below 14; maybe we had 10 die who had other issues and tested positive for CV.  I would be interested in some medical professional's thoughts on this.   

I suppose you could rely on completely un-sourced (seriously, you have to subscribe to even see where the data came from) data from a random website over the CDC. That seems like an odd choice though. 

Also: "maybe we had 10 die who had other issues and tested positive for CV" isn't the criteria used by the NCHS:

Quote

The National Center for Health Statistics (NCHS) uses incoming data from death certificates to produce provisional COVID-19 death counts. These include deaths occurring within the 50 states and the District of Columbia. COVID-19 deaths are identified using a new ICD–10 code. When COVID-19 is reported as a cause of death – or when it is listed as a “probable” or “presumed” cause — the death is coded as U07.1. This can include cases with or without laboratory confirmation.

 

Edited by Dahobbs

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Posted (edited)
1 hour ago, Dahobbs said:

I suppose you could rely on completely un-sourced (seriously, you have to subscribe to even see where the data came from) data from a random website over the CDC. That seems like an odd choice though. 

Also: "maybe we had 10 die who had other issues and tested positive for CV" isn't the criteria used by the NCHS:

 

That is my point on the codes.  The CDC site you linked says in footnote 1 "Deaths with confirmed or presumed COVID-19, coded to ICD–10 code U07.1."  It would be good to know the process/rigor to determine a presumed CV case, which is why I said I was interested in some medical professionals view on this.  My point is that how this is determined can make a difference when dealing with such small numbers.

Edited by Axiom of Choice
I originally misunderstand footnote 5

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7 minutes ago, Axiom of Choice said:

That is my point on the codes.  The CDC site you linked says in footnote 1 "Deaths with confirmed or presumed COVID-19, coded to ICD–10 code U07.1," and also in footnote 5 "Deaths with confirmed or presumed COVID-19, pneumonia, or influenza, coded to ICD–10 codes U07.1 or J09-18.9."  The way footnote 5 is worded, it seems like someone could get coded U07.1 if they die from presumed pneumonia or influenza.  Also, deaths can get coded U07.1 multiple ways based on presumptions.  Maybe there is more rigor to it than that (that's my assumption), which is why I said I was interested in some medical professionals view on this.  My point is that when dealing with such small numbers these details can make a difference.  

https://www.cdc.gov/nchs/data/icd/COVID-19-guidelines-final.pdf

 

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Posted (edited)
14 hours ago, Axiom of Choice said:

That is my point on the codes.  The CDC site you linked says in footnote 1 "Deaths with confirmed or presumed COVID-19, coded to ICD–10 code U07.1."  It would be good to know the process/rigor to determine a presumed CV case, which is why I said I was interested in some medical professionals view on this.  My point is that how this is determined can make a difference when dealing with such small numbers.

dcar00's link is a good source for how CDC recommends using ICD coding for diagnosis. Presumed positive cases are generally cases that have positive tests, but that have yet to be confirmed by the CDC. That's going to cover the vast majority of tested cases at this this point. What you probably mean by "presumed" is probable cases (where there is no testing confirmation, but other factors that indicate Covid-19). According to the CDC coding guidelines, you wouldn't use the same code for diagnosing a probable case.

However, attribution of cause of death on a death certificate requires another level of analysis by multiple professionals. Ultimately,  whether Covid-19 is a contributing cause of death is determined the same way any other cause of death is: by professional judgment. And, somewhat interestingly, according to the CDC it can be coded using U0.71 whether or not there is laboratory confirmation (which differs from the general case confirmation criteria above), but this is practice will vary at the state and local level. Keep in mind, all the NCHS is doing here is confirming and categorizing what is on the death certificate. It is up to coroners/medical examiners/treating physicians to do the actual work. If it is reported in the NCHS numbers, someone put it on a death certificate. 

Here is a handbook from the CDC on certification of death: https://www.cdc.gov/nchs/data/misc/hb_cod.pdf

And, since you asked, below is what ChiTownDoc posted in the other thread. Maybe he'll be willing to provide further insight to address your question. 

9 hours ago, ChiTownDoc said:

Deaths are underreported.  By a lot.  

Edit:  Look where the most deaths are, nursing homes.  For the longest time there was very little testing.  We saw dozens pass and without any C19 testing they were marked as a viral PNA death, not C19.  I myself saw dozens.  Our group is hundreds of providers...everyone has the same stories.  That's the sad truth.  I see no way in hell deaths are being overreported?  I'd love any physician actually working with these pts to explain what they're seeing to me. 

 

Edited by Dahobbs

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On 4/27/2020 at 6:14 PM, Bartles said:

Maybe the main point of anti-shutdowners was to keep low wage workers from getting stimulus checks and/or $600 unemployment bonus?

On 4/28/2020 at 12:58 PM, Enchubben said:

Seriously? Thats as dumb as someone making the argument that the reason why people want to be shutdown is to receive the unemployment bonus and stimulus check. GTFO with that shit. 

 

It's been a couple weeks, but I'm not the only one making this suggestion. (Prospect.org)

"The real value to states from reopening is they can kick people off unemployment if they fail to show up to a reopened business that takes them off furlough. Some states are even setting up “snitching” websites so workers can report their employees and get them removed from the rolls. Reopening isn’t about the economy at this stage, it’s about keeping people poor to preserve state budgets for what God intended: tax cuts for millionaires."

 

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Does anyone know a source for Austin/TravCo hospitalization and death numbers by day?  

 

I checked the Travis County dashboard and saw a lot of data there, but that didn't seem to be something they're tracking.  It's possible I just missed it, though.

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This subject has been broached here before, but ...

Quote

... Birx and others believe that the CDC is over counting cases. The Washington Post reports they are concerned that the CDC’s “antiquated” accounting system is double counting cases and inflating mortality and case counts “by as much as 25 percent.”

There are additional reasons for concern. Some doctors feel pressure from hospitals to list deaths as due to the Coronavirus, even when they don’t believe that is the case, “to make it look a little bit worse than it is.” There are financial incentives that might make a difference for hospitals and doctors. The CARES Act adds a 20 percent premium for COVID-19 Medicare patients.
...

https://townhall.com/columnists/johnrlottjr/2020/05/16/the-us-is-dramatically-overcounting-coronavirus-deaths-n2568925

Policy driven by models.  Models built upon data.  Quality matters...

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On 5/12/2020 at 1:05 PM, Bartles said:

It's been a couple weeks, but I'm not the only one making this suggestion. (Prospect.org)

"The real value to states from reopening is they can kick people off unemployment if they fail to show up to a reopened business that takes them off furlough. Some states are even setting up “snitching” websites so workers can report their employees and get them removed from the rolls. Reopening isn’t about the economy at this stage, it’s about keeping people poor to preserve state budgets for what God intended: tax cuts for millionaires."

 

For fucks sake.  That's about as political a post as we've seen.  Maybe someone will counter with something equally stupid from Brietbart and the two of you can go jerk each other off in the CR.

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5 hours ago, bernorange said:

This subject has been broached here before, but ...

https://townhall.com/columnists/johnrlottjr/2020/05/16/the-us-is-dramatically-overcounting-coronavirus-deaths-n2568925

Policy driven by models.  Models built upon data.  Quality matters...

Yes, quality matters. But, claims of substantially over counting from within the administration are almost certainly politically motivated. Also, that article greatly misstates what health officials have said. Not any death is being listed as covid-19 related, but those that could be covid-19 related. So, some countries are not counting stroke deaths while also testing positive as Covid-19 related. However, there is a growing body of evidence that Covid-19 does cause clotting problems and may be associated with increased stroke risk. What isn't generally being included is things like automobile accidents where the cause of death can be readily attributed to something else. To extent something like that gets included in initial reporting, it is removed after being identified (see Illinois).  

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Posted (edited)
4 hours ago, PenelopeWitherspoon said:

Cool.

Now, let's list every consumer product that contains more than 3 components that DOESN'T contain a component that was made in china.....Once you exclude handmade wooden furniture made from more than 3 pieces of wood, the list will probably be about 20 items.  The global supply chain is going to be next to impossible to break for a shitload of products.

"Stealth Chinese components" is like stealth sugar and sodium in so many of our foods.  We may try to steer clear of those things, even thinking that we've done so, but accidentally pick up a product that's loaded with extra sugar.

Edited by Brisketexan

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4 hours ago, Smax said:
4 hours ago, PenelopeWitherspoon said:

I would love to see the populance actually do what they say on this but the packed walmarts tell a different story..

Me too.  I have actually been very particular on this front, and have been for years.  Yes, I am not totally free of goods made in China, but I make every attempt to take into consideration where goods are made, and have for the last 4-5 years.  I am ok paying more for better quality.  

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1 minute ago, Brisketexan said:

Cool.

Now, let's list every consumer product that contains more than 3 components that DOESN'T contain a component that was made in china.....Once you exclude handmade wooden furniture made from more than 3 pieces of wood, the list will probably be about 20 items.  The global supply chain is going to be next to impossible to break for a shitload of products.

Certain designer clothing and certain designer handbags.  :D  I say certain because there are some that have allowed China to source certain things, and it has bitten them in the ass.  The Chinese company will duplicate the machinery, sell to counterfeiters, and profit. 

It may be next to impossible, but it is, IMO, something worthy to work to.

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1 minute ago, PenelopeWitherspoon said:

Certain designer clothing and certain designer handbags.  :D  I say certain because there are some that have allowed China to source certain things, and it has bitten them in the ass.  The Chinese company will duplicate the machinery, sell to counterfeiters, and profit. 

It may be next to impossible, but it is, IMO, something worthy to work to.

I agree -- it's worth making some better conscious consumer choices.  For example, we try to buy local as much as we can (from small retailers as opposed to Wally world), we try to support mostly local restaurants, etc.  It's worth an effort.  Doesn't reach nearly a 100% success rate, but it can make a difference if enough of us do it.

China, for all of its faults, is also revenue/profit-driven.  Hit them in the pocketbook as a consequence of their numerous bad behaviors, and that incentivizes the shit out of some change.

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