Tuesday, July 7, 2020

Blowing Smoke

The President's keeps saying that the US has the lowest Corona-virus fatality rate in the world.  And he keeps talking about how we have a high number of cases because we test more. The game he is playing is evident, but I keep waiting for  the talking heads to point it out and being disappointed. He is referring to the US case-fatality rate, not the per-capita fatality rate. More testing lowers the case-fatality rate (deaths/case), simply by increasing the denominator. But it simultaneously raises the infection rate (cases/population) by the same proportion, leaving what we are really concerned about, the per-capita mortality rate (deaths/population =(deaths/cases) * (cases/ population)) unaffected. And on this measure, the US is the 7th highest in the world, at 39.82 deaths per 100,000. (I  ignore San Marino and Andorra, because the measured rate is meaningless with such tiny numbers). We are below Italy, Spain, Sweden, the UK, Belgium, France. But we are far above Germany (10.88), Canada (23.61), Mexico (24.66), Iran (13) and a host of others.


22 comments:

kevin quinn said...

The numbers are from the Johns Hopkins coronavirus site --

Kaleberg said...

The problem is that our case count is still rising, and this bodes poorly for the death rate.

Anonymous said...

https://www.worldometers.info/coronavirus/

July 7, 2020

Coronavirus

US

Cases   ( 3,086,630)
Deaths   ( 133,816)

India

Cases   ( 743,481)
Deaths   ( 20,653)

UK

Cases   ( 286,349)
Deaths   ( 44,391)

Mexico

Cases   ( 261,750)
Deaths   ( 31,119)

Germany

Cases   ( 198,355)
Deaths   ( 9,103)

Canada

Cases   ( 106,106)
Deaths   ( 8,708)

Sweden

Cases   ( 73,344)
Deaths   ( 5,447)

China

Cases   ( 83,565)
Deaths   ( 4,634)

Fred C. Dobbs said...

‘None of us really anticipated the amount of community spread,’ Birx said.

(It was in the news a month ago that coronavirus would be raging
across the south & west soon enough. Meanwhile, rates have fallen
in the northeast.)


Dr. Deborah L. Birx, the Trump administration’s coronavirus response coordinator, made an unusually candid admission in comments to a group of foreign diplomats on Tuesday: She said that local and federal officials were not prepared for the kind of outbreaks spreading across the United States, which she said resulted from younger Americans feeling less inhibited.

“None of us really anticipated the amount of community spread that began in really our 18-to-35-year-old age group,” she said in a brief appearance on an Atlantic Council panel. “This is an age group that was so good and so disciplined through March and April. But when they saw people out and about on social media, they all went out and about.”

Separately, Dr. Anthony S. Fauci, the nation’s top infectious disease expert, cautioned on Tuesday that it was a “false narrative to take comfort in a lower rate of death,” something that Mr. Trump, top White House officials and several governors have stressed in recent days.

“By allowing yourself to get infected because of risky behavior, you are part of the propagation of the outbreak,” Dr. Fauci said at an event with Senator Doug Jones, Democrat of Alabama. “There are so many other things that are very dangerous and bad about this virus. Don’t get yourself into false complacency.”

People under 40 have made up a significant portion of new cases recorded in states with recent outbreaks, a sign of how the virus has spread in bars, restaurants and offices that have reopened. ...

Anonymous said...

‘None of us really anticipated the amount of community spread,’ Birx said.

[ What a horrid, horrid comment. ]

Fred C. Dobbs said...

US launches ‘surge’ testing targeting virus hotspots

via @financialtimes - July 7

The US has announced it will set up “surge” testing sites in several states suffering large increases in coronavirus cases and hospitalisations, as authorities struggle to contain the outbreak in the south and west of the country.

The Department of Health and Human Services announced on Tuesday it would temporarily increase federal support to Jacksonville, Florida; Baton Rouge, Louisiana; and Edinburg, Texas, where there had been a “recent and intense level” of new infections and coronavirus-related hospitalisations.

The sites will have the capacity to test 5,000 people a day for the next five to 12 days. The health department said the regions were chosen because testing was “fairly evolved” in those places. Surge sites could reveal coronavirus cases that would have otherwise gone undetected, particularly among asymptomatic or younger residents.

Florida and Texas have been two of the hardest-hit states during the new outbreak, with the number of cases surpassing 200,000 in both states; Louisiana has reported more than 66,000 cases. Late last month, Florida and Texas rolled back some reopening plans, while Louisiana has paused further lockdown easing.

Officials had hoped their efforts to expand testing would enable local governments to contain new outbreaks by tracking new infections and tracing them to others who have been exposed.

It’s a false narrative to take comfort in a lower rate of death

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases
But while the US has increased its testing capacity to about 640,000 a day, Admiral Brett Giroir, assistant secretary for health, acknowledged that turnround times for results at some of the large commercial laboratories were increasing, as tests for hospitalised patients are prioritised.

While lab capacity had not yet reached a maximum, “we are certainly pushing the frontiers”, Adm Giroir said.

“We cannot test our way out of this,” he added. “If there is very high transmission with very high positive rates, testing alone is not the answer.” ...

Anonymous said...

https://www.worldometers.info/coronavirus/

July 7, 2020

Coronavirus

US

Cases   ( 3,093,772)
Deaths   ( 133,858)

Anonymous said...

https://www.worldometers.info/coronavirus/

July 7, 2020

Coronavirus   (Deaths per million)

Belgium   ( 843)
UK   ( 654)
Spain   ( 607)
Italy   ( 577)

Sweden   ( 539)
France   ( 458)
US   ( 404)
Netherlands   ( 358)

Ireland   ( 353)
Canada   ( 231)
Switzerland   ( 227)
Luxembourg   ( 176)

Portugal   ( 160)
Germany   ( 109)
Denmark   ( 105)
Austria   ( 78)

Finland   ( 59)
Norway   ( 46)
Greece   ( 19)
India   ( 15)

Japan   ( 8)
China   ( 3)

Anonymous said...

https://www.nytimes.com/2020/07/06/opinion/covid-19-trump.html

July 6, 2020

How America Lost the War on Covid-19
It wasn’t because of our culture, it was because of our leadership.
By Paul Krugman

When did America start losing its war against the coronavirus? How did we find ourselves international pariahs, not even allowed to travel to Europe?

I’d suggest that the turning point was way back on April 17, the day that Donald Trump tweeted “LIBERATE MINNESOTA,” followed by “LIBERATE MICHIGAN” and “LIBERATE VIRGINIA.” In so doing, he effectively declared White House support for protesters demanding an end to the lockdowns governors had instituted to bring Covid-19 under control.

As it happens, the Democratic governors Trump was targeting in those tweets stood firm. But Republican governors in Arizona, Florida, Texas and elsewhere soon lifted stay-at-home orders and ended many restrictions on business operations. They also, following Trump’s lead, refused to require that people wear masks, and Texas and Arizona denied local governments the right to impose such requirements. They waved away warnings from health experts that premature and careless reopening could lead to a new wave of infections.

And the virus came.

The initial outbreak of Covid-19, centered on New York, should have taught us to be wary. Rising rates of infection can seem like a minor concern at first, especially if you don’t have adequate testing, until they explode with terrifying speed.

But neither Republican politicians nor the Trump administration was willing to heed that lesson. By the second week of June new Covid-19 cases were surging in Arizona and clearly on the rise in Texas. Yet the governors of both states dismissed calls for a pause in reopening, insisting that things were under control.

And on June 16, of course, The Wall Street Journal published an opinion article by Vice President Mike Pence declaring that there wasn’t and wouldn’t be a coronavirus second wave. Given the Trump administration’s track record, this virtually guaranteed that the wave was about to hit. And so it was.

Over the past three weeks things have quickly gotten very grim. Hospitals in Arizona and Texas are in crisis. And, yes, it was premature reopening that did it, both directly and by sending a signal to individuals that the risk was past.

But why did America bungle Covid-19 so badly? ...

Anonymous said...

https://www.worldometers.info/coronavirus/

July 7, 2020

Coronavirus

US

Cases   ( 3,096,894)
Deaths   ( 133,971)

ilsm said...

Krugman,

See the effects from decades of red state 'leadership' in excess mortality from Covid 19. Read the NYC spike in excess! We can look for Tx, Ca, Az etc. soon enough.

https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm?fbclid=IwAR3ZvlEsuF6TC4QZn0JIJpHswJxCtn9tNVZW45QwXNW-HHvXxifmD6rPy90

No one did an RCT on shuttering the US economy. No one could or should have tried what PRC and Germany did.

NYC ran its mass transit. No one took active infections and the risky demographics out of the mixing bowl. Some leaders sent positive Covid 19 patients in to nursing homes. As to leadership failures see the NE I95 corridor.

As to NY Times quoting Dr Fauci about use of death rates (accumulated deaths per million) he should send everyone to the above CDC's under utilized site on 'excess mortality due to Covid 19' against trend!

Narrative from CDC?

kevin quinn said...

Apparently, the numbers I used above are out-of-date. As of July 8, the US mortality rate is second highest in the world at 40 per 100,000, with only the UK higher at 66.

kevin quinn said...

I am wrong in my last comment. The Hopkins numbers are the same as the ones I originally posted - US at #7. The #2 ranking is among "the 20 countries most affected" by the virus -- i.e, most deaths.

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ilsm said...

I will answer myself about motrality attributed to COVID 19 in TX, Ca and Fl:

https://twitter.com/boriquagato/status/1280871098028920833

"peak NY: 51 deaths/day/mm
7 day MA
TX: 1.43
FL: 2.25
CA: 1.69"

We may see this go up, however, (more tests less "prioritized, edging toward a bit random) the much lower median age of positive tests, demographic differences and better treatments should dampen the rates compared to NYC, which endured 200% of trend "excess deaths" in MAr, Apr and May 2020.

Dan Crawford said...

May I repost this post, or an updated version, at Angry Bear. The notion of death rate, infection rate, and positivity rate is not part of common understanding.

ilsm said...

Does anyone know how many deaths per hundred thousand (I like that JBR uses the US standard denominator for this measure rather than the high integer denominator used at worldometer!) cardio pulmonary disease cause in the US? Does anyone need to care about deaths per million from cardio pulmonary disease?

If my PCP told me I had need for a “turn” in the cardiac catheter lab (I never had that discussion, but a friend has) would I wonder how many deaths per million for my diagnosis? No, I would want to talk risk (in addition to quality of life (QoL), ask my cardiologist what the case fatality rate for my diagnosis is.

Going on to Covid 19, the virus. There are estimates of case/infection fatality rate (IFR), which must include asymptomatic cases in the denominator. What makes IFR better than total cumulated deaths per million since counting began is IFR helps with risk reward decisions.

Also IFR is estimated from observations for different age and health condition, demographics as well as ethnicity and economic condition. IFR is affected by political geography and the ‘mixing’ in the general area people reside. IFR is impacted by successful therapies!

An example: the IFR for a healthy male under 55 is in the range of .0006 (6/10000 cases). Dr. Birx cannot be so naive to [tell the Atlantic Council she is] be surprised that people below 30 go out their IFR is likely .000005 (5/100000). Using IFR I ask: “why would anyone under 65, with generally good health want to shelter in place because there was community transmission”?

A 75 year old with diabetes has an IFR closer to .13 (13/100). That person needs to shelter, use grocery deliver service and stay away from 30 somethings.

That is the conversation I have with my PhD son and his wife in Nassau County NY! Son is disappointed that Texas has closed anything down, given the median age in the 30’s of the new testing regimen there.

Today the US has almost 41/100000 Covid 19 deaths, nothing we can do to lower it, it is a trailing observation. IFR however can be fixed by new therapies, and improved science of treatments. Or a spike/dip in IFR might suggest mutating virus……

Some may fall in to a ‘sunk cost fallacy’ by over using cumulative deaths that would make risk reward analysis problematic.

I track excess deaths in my own morbid way…. Don’t go to worldometer much lately. Enough good stuff on twitter, Nature and science direct.

https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm?fbclid=IwAR3ZvlEsuF6TC4QZn0JIJpHswJxCtn9tNVZW45QwXNW-HHvXxifmD6rPy90

pgl said...

"The President's keeps saying that the US has the lowest Corona-virus fatality rate in the world. And he keeps talking about how we have a high number of cases because we test more. The game he is playing is evident, but I keep waiting for the talking heads to point it out and being disappointed. He is referring to the US case-fatality rate, not the per-capita fatality rate. More testing lowers the case-fatality rate (deaths/case), simply by increasing the denominator. But it simultaneously raises the infection rate (cases/population) by the same proportion, leaving what we are really concerned about, the per-capita mortality rate (deaths/population =(deaths/cases) * (cases/ population)) unaffected."

Thanks for saying what I have attempted to get across with such clarity. I just heard some clip of Trump with his spin followed by some statement that basically says Fauci is an idiot. Yes Donald Trump knows more than the experts I guess.

Fred C. Dobbs said...

Trump delaying Saturday rally in NH

via @BostonGlobe - July 10

WASHINGTON — President Trump’s reelection campaign on Friday postponed a Saturday night rally in Portsmouth, N.H., citing the threat of an approaching tropical storm even though it was not expected to impact the area during his scheduled speaking time.

The event was “postponed for safety reasons because of Tropical Storm Fay,” said Tim Murtaugh, the campaign’s communications director, in a statement. White House Press Secretary Kayleigh McEnany told reporters traveling with Trump to Miami Friday that the rally would be delayed “by a week or two” because of a “big storm.”

Tropical Storm Fay was tracking well to the west of Portsmouth, according to the National Weather Service. Forecasts show it could bring rain and thunderstorms to the region on Saturday morning, but there is only a small chance of precipitation by the evening. Trump was scheduled to speak at 8 pm.

The Portsmouth event was supposed to be Trump’s latest attempt to reboot his ailing reelection campaign, which has lagged in key battleground states as polls show strong disapproval of his handling of the coronavirus pandemic. His first attempt to return to the campaign trail and reenergize his supporters sputtered late last month when he held a rally in Tulsa, Okla., at an indoor arena that was only one-third full.

Trump’s plan to try again with an outdoor rally at Portsmouth International Airport at Pease was met with immediate concern from locals who worried it could spread the coronavirus in a state where the pandemic is largely under control. The campaign tried to address worries about the virus that might have caused the low Tulsa turnout by touting that there would be “ample access to hand sanitizer” at the Portsmouth rally and that all attendees would be given face masks “that they are strongly encouraged to wear.”

Still, Chris Sununu, the Republican governor of New Hampshire, said he would greet the president but was not planning to attend the rally.

The decision to cancel the rally is likely to prompt questions about how many people were actually planning to attend, since the president and his advisors are keenly attuned to the optics of crowd size. ...

Fred C. Dobbs said...

Most people ... population ........cases ...... deaths
1. China ...... 1,394,015,977 .... 83,585 ..... 4,634
2. India ,,,,,, 1,326,093,247 .... 822,570 .... 22,144
3. United States 329,877,505 ... 3,287,329 .. 136,576
4. Indonesia 267,026,366 ...... 72,347 ..... 3,469
5. Pakistan 233,500,636 ...... 243,599 .... 5,058

https://www.census.gov/popclock/print.php?component=counter

https://www.worldometers.info/coronavirus/?utm_campaign=homeAdvegas1?%22%20%5Cl%22countries

ilsm said...

Who controls the questions ruins the debate.

https://twitter.com/gummibear737/status/1276928929287286784/photo/1

Emphasizing positive tests is not the tool, it is meant to tumble Trump.

Fred,

What kind of power does Biden want to give the "Karens"? Conclusion I get from praising China: Democrats admire their total control of the population. The vast number of "Karens" in China can get anyone "disappeared".


Fred C. Dobbs said...

The people...cases...deaths numbers
above are consistent (for #1, #3, #4)
with the high fatality rates observed
for elderly populations. (Not so for #2 & #5.)

Otherwise, the low numbers for large populations
for #1, #2 & #4 may seem implausible.