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  #11 (permalink)  
Old 27th May 2020, 09:51 AM
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The local news channels have started looking at the total deaths compared to the normal levels of deaths for any given time which shows a far different story so underreporting doesn't work. It will be interesting to see the total for the year and if it's much different from normal. We have had many deaths in our carehomes which on the face of it looking terrible, but are the peaks just people that would have died during the year just happened all at once.
In the US if there are no more Covid deaths starting right now and the other causes of death remains as before, Covid will STILL be #7 this year. I suspect that even if no new cases it will hit #3 ( 170,000 deaths in a year) because there are 4 causes of death between 120,000 and 170,000 per year then big increase to cancer and heart conditions. (both 600,000 or more)

And that is not fake news.

https://www.cdc.gov/nchs/fastats/lea...s-of-death.htm


Last edited by Manitoba; 27th May 2020 at 09:56 AM.
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Old 10th June 2020, 12:20 PM
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In the US if there are no more Covid deaths starting right now and the other causes of death remains as before, Covid will STILL be #7 this year. I suspect that even if no new cases it will hit #3 ( 170,000 deaths in a year) because there are 4 causes of death between 120,000 and 170,000 per year then big increase to cancer and heart conditions. (both 600,000 or more)

And that is not fake news.

https://www.cdc.gov/nchs/fastats/lea...s-of-death.htm
And on top of that, in the U.S. Covid deaths are over counted because a covid death pays the hospital more than other deaths, and no matter what the real cause of death, if your autopsy shows covid, you are counted in covid deaths. So if you get hit by a bus and test positive for Covid, you get counted as a Covid death. Crazy, stupid and true. Especially applicable to old folks in nursing homes, who were already in the last days/weeks of their life.

This lady is from Illinois.

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Old 10th June 2020, 11:33 PM
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There will always be issues in counting deaths in a pandemic. How do you classify someone without the virus that dies because no available medical care or who does not get treatment due to the pandemic?

How do you account for the reduced traffic fatalities due to people not traveling?

What about reduced deaths from pother causes because people practicing social distancing?

You are never going to get a 100% accurate count. Lots of deaths will be misreported, rational people will not be able to agree on a definition of what is considered a Covid death. Even with good enough definitions, accepted by all, it is often hard to put any particular death into the correct classification.

When you go international, the problems increase, it becomes much more difficult to get several nations to all agree on a set of definitions. Politics starts to play an important part in reporting the numbers, some want lower numbers for internal political reasons or national pride, some may want higher numbers to get more aid.

To me the best indicator of how many people died as a result of the pandemic, but not necessarily because of the virus directly, is the excess death numbers. These appear to be running at 100 150% above normal in hard hit areas. That means that for every 2 people that died in normal times we are seeing a total of 4 or 5 deaths. Even that can have errors due to delays in reporting and other administrative issues in counting deaths. Determining the expected death rate will not be a single number but a range of numbers.

This is not the number that you would use to do medical decisions upon but it is the number that to me best describes the impact to society of the pandemic, including the responses to it.

However at the end of the day if the number of world wide deaths is 400,000 or 399,000 or 401,000 does the difference really matter from establishing public policy om how to control the virus?

Should we throw up our hands and do nothing when we cannot say to an exact number how many people died from it?

Remember all estimates come from models, all models are somewhat inaccurate but many are useful.

A road map is a model of a highway system. Do you throw out the map because you realize that when you scale up the line you have been following that it would be several kms wide and no way is the road that wide? Or do you accept that the scale of the width of the road is inaccurate but the map is a useful tool to get to where you want to go?
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  #14 (permalink)  
Old 11th June 2020, 12:14 AM
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Originally Posted by Manitoba View Post
There will always be issues in counting deaths in a pandemic. How do you classify someone without the virus that dies because no available medical care or who does not get treatment due to the pandemic?

How do you account for the reduced traffic fatalities due to people not traveling?

What about reduced deaths from pother causes because people practicing social distancing?

You are never going to get a 100% accurate count. Lots of deaths will be misreported, rational people will not be able to agree on a definition of what is considered a Covid death. Even with good enough definitions, accepted by all, it is often hard to put any particular death into the correct classification.

When you go international, the problems increase, it becomes much more difficult to get several nations to all agree on a set of definitions. Politics starts to play an important part in reporting the numbers, some want lower numbers for internal political reasons or national pride, some may want higher numbers to get more aid.

To me the best indicator of how many people died as a result of the pandemic, but not necessarily because of the virus directly, is the excess death numbers. These appear to be running at 100 150% above normal in hard hit areas. That means that for every 2 people that died in normal times we are seeing a total of 4 or 5 deaths. Even that can have errors due to delays in reporting and other administrative issues in counting deaths. Determining the expected death rate will not be a single number but a range of numbers.

This is not the number that you would use to do medical decisions upon but it is the number that to me best describes the impact to society of the pandemic, including the responses to it.

However at the end of the day if the number of world wide deaths is 400,000 or 399,000 or 401,000 does the difference really matter from establishing public policy om how to control the virus?

Should we throw up our hands and do nothing when we cannot say to an exact number how many people died from it?

Remember all estimates come from models, all models are somewhat inaccurate but many are useful.

A road map is a model of a highway system. Do you throw out the map because you realize that when you scale up the line you have been following that it would be several kms wide and no way is the road that wide? Or do you accept that the scale of the width of the road is inaccurate but the map is a useful tool to get to where you want to go?
Comparing the death rate with the averages is a useful tool but for reasons you presented must under report besause you need to subtract the prevented deaths such as the large drop in road death etc. from the average, it's all a how long is a peice of string at the end of the day.


Last edited by Gary D; 11th June 2020 at 12:16 AM.
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Old 11th June 2020, 01:05 AM
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The metric I think should be used to guide the lockdown management is the excess deaths. The lockdown will in addition to saving lives from less traffic deaths will cause deaths by not letting people easily get to medical treatment or for other issues not related to covid, domestic violence could increase in the lockdowns etc.

You really cannot use the excess death number to come up with medical responses to the virus, it is too crude a measure for that.

All too often in making decisions on matters of public policy, the decision does not come down to saving everyone's lives or saving the lives of identifiable individuals but comes down to making the decision that will save the most lives overall (for a reasonable cost of course).

Often these decisions have to be made in the absence of accurate information let alone full information. There will always be issues of having accurate measures and counts, but to go back to my road map analogy, you have to plan your trip based on the best map you have, You may know or believe that it is inaccurate or outdated but it is better than just driving off in a random direction, hoping that you arrive at your destination.

After it is all over you cannot blame anyone who acted in good faith for a death that some other measure would have prevented. You cannot put blame on any official for a death that occurs due to domestic violence brought on by the close quarters in the lock down if the overall measures were responsible for fewer overall deaths. You can never identify someone who would have died by the virus but who never got sick because of the lockdown.

You can look at the results from a lessons learned perspective. To stay with the domestic violence example, you could next time plan into the lock down some safeguards to prevent or reduce domestic violence, say making safe houses or providing some sort of pressure relief for the tensions that will build up. ( And I do believe that there will be additional lockdowns when the second wave or even the third wave starts up.)

But as is often the case in making public policy, you have to decide that a few deaths from domestic violence is preferable to many more due to the virus.
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Old 20th June 2020, 01:19 AM
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Perhaps we should not look at the deaths overall but the confirmed cases,,,,,,,,,,, where there are no back handers claiming a C-19 death, as said I watch this site for the world events and not one or two countries that maybe taking advantage of a nasty situation. Money and opportunity aside the world is heading now into bigger problems than we had 2 or 3 months ago, the infection rate is escalating and obviously the death rate will follow.

Today (not that it is a race) the world hit a new record for infections, over 180,000 new cases, previously under 150,000. A higher death toll will follow. While some countries have secured some measure of control it appears others either through arrogance, naivety or simple (indestructible) stupidity are facing an ever escalating problem that is going to further the economic hurt of all countries.

Opening borders to reinfection? Too soon, only my lowly opinion but the numbers don't look good, for my own country I know they will suffer the economic pains and keep the borders closed. The economic fallout will be worse than C-19.

Cheers, Steve.

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Old 20th June 2020, 04:13 AM
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Confirmed cases relies on testing and since every country is testing at a different rate and requires different criteria to be tested the confirmed case count will not be easy to compare across countries.
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Old 20th June 2020, 09:53 AM
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Confirmed cases relies on testing and since every country is testing at a different rate and requires different criteria to be tested the confirmed case count will not be easy to compare across countries.
And the easiest way to keep the cases to a few tens of tbousands is to do very little testing.
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Old 20th June 2020, 10:18 AM
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If you haven't seen it, CDC now has a fairly nice excess deaths chart where you can also see the numbers at the state level.

https://www.cdc.gov/nchs/nvss/vsrr/c...ess_deaths.htm

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Old 20th June 2020, 10:36 AM
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The point is that regardless of how, when and why different countries test for C-19 for perhaps their own agendas (like some that report some few cases and no deaths for months), whatever, the numbers are rising, not declining, yes of course there is more testing now but that is giving a clearer picture of this event.

Cheers, Steve.

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