The German data have been puzzling me as well. Thinking completely 'out of the box' I've been wondering about secondary factors. Does national physical fitness factor in here? I don't know whether there are measurable statistic about that. I believe Germany has invested much more in its health services as a percentage of GDP than the UK. It has pretty enlightened climate change policies and I think has been successful in making significant reductions in air pollution. How true this still may be I cannot say but it has a culture which by reputation makes Germans obedient to clear central direction.
Perhaps there is an accumulation of marginal advantages at work, leading to surprisingly significant differences? Perhaps also there was greater preparedness?
Whatever, there may be much to be gained from looking at secondary factors.
I have been handling and emptying shipping boxes with gloves then throwing them in the shed - and washing down all my shopping, door handles and surfaces the shopping has been on - with soapy water, careful not to touch my face until after I’ve washed my hands, ever since the start of this. So are my German friends and family.
Of course it's worth bearing in mind that the virus doesn't die off linearly and in the first few hours its more infectious - but even so I have been washing all shopping and/or isolating things with cardboard packing for a few days prior to opening it.
It's also exponential (at first), so for instance a difference of 7* days equates to a factor of 10.
It's not that long since we were a tithe of Italy/Spain which gave our UK government and papers false exceptionalism (and generally not realising that they were operating on a two week delay). Germany I get the impression used that time.
*Either by straight off starting something earlier, or by doing all risky behaviour half as much over a fortnight.
It's also exponential (at first), so for instance a difference of 7* days equates to a factor of 10.
It's not that long since we were a tithe of Italy/Spain which gave our UK government and papers false exceptionalism (and generally not realising that they were operating on a two week delay). Germany I get the impression used that time.
*Either by straight off starting something earlier, or by doing all risky behaviour half as much over a fortnight.
It's also striking that the Italy and Spain figures were greeted apocalyptically in the UK press, a "tsunami", for example, but now that the UK is pushing a 1000 deaths a day, it seems to be downplayed, although not on BBC. Instead we get the Sun saying how marvellous it is that Boris is better.
Part of the issue for the reporting of what was happening in Italy - was the impression given that the hospitals were overwhelmed and people were therefore not getting treated.
As regards the situation in the U.K.: there are beds and people are getting treated but it is a country mile away from being OK (not least because of the problems with PPE supply.)
Well, the Institute for Health Metrics and Evaluation has reduced it's forecast of deaths in the UK. They caused shock on their earlier prediction of 66 000 deaths, but now they are saying 37 000. Reported on the Guardian rolling news.
Well, the Institute for Health Metrics and Evaluation has reduced it's forecast of deaths in the UK. They caused shock on their earlier prediction of 66 000 deaths, but now they are saying 37 000. Reported on the Guardian rolling news.
If our efforts are successful we will probably end up with what I call the Y2K Bug Fallacy - people will say "there weren't anything like as many deaths as they said so it was all a fuss over nothing."
Bit like people pointing to low numbers of road deaths as proof that the police shouldn't prosecute speeding drivers.
Well, the Institute for Health Metrics and Evaluation has reduced it's forecast of deaths in the UK. They caused shock on their earlier prediction of 66 000 deaths, but now they are saying 37 000. Reported on the Guardian rolling news.
If our efforts are successful we will probably end up with what I call the Y2K Bug Fallacy - people will say "there weren't anything like as many deaths as they said so it was all a fuss over nothing."
Bit like people pointing to low numbers of road deaths as proof that the police shouldn't prosecute speeding drivers.
I am sure that various journalists and politicians are waiting to say, it was all exaggerated, and the BBC's fault.
Ok, question: am I the only one on this thread who doesn't have in-depth knowledge of medicine, science, and stats?
Almost certainly not, it depends on what you mean by in-depth.
Compared to say AfZ I don't.
Maths and Science I'm more than good enough to take some facts and (log) graphs and spot some 'lies with stats'. Medicine, with help I can understand.
Compared with the average, I'm sure you count in at least one (and if not there'll be something else you bring). [ETA for a start you realised about resistances to outside diseases. I don't know if they directly are more at threat if we're all unresistant, but they are already squeezed and treating them exposes them to the things we are resistant too, so it is very bad. AfZ probably knows or knows where to look to see if Corona resistance does have a contribution to Cor19 resistance and the actual numbers]
I wish the statistics would indicate what percentage of cases are from nursing homes, as compared with the general community. They are equally important in themselves, but cases in the community have public health implications that nursing homes do not.
I have been looking at a map showing cases in Virginia by counties. Some counties have many cases while adjacent counties have relatively few. I have seen newspaper articles about nursing home epidemics in some of the seriously-affected counties. However, I have seen no reports about other seriously-affected counties. I would like to know what's going on.
chris, I think people who die in nursing homes who have, for any reason, a positive COVID-19 test do get counted in the stats. Because it's a notifiable disease, I'm not sure that a GP's opinion that the cause of death was, in whole or in part, COVID-19, would count without the prior test.
It looks as though Belgium and France have decided to include deaths in nursing homes as down to COVID if the doctors say so (with or without a test).
My understanding, is that the UK daily stat is "Deaths in Hospitals where the patient had Covid". Though at best this is 24 hours out and recently almost all of the deaths have been backlogged (in theory though it also includes coincidental deaths). How you interpret that I don't know.
Early on most people would be moved to hospital (and then tested) anyway.
Their weekly stat is at least 2 weeks out of date, but is Deaths anywhere due to Covid.
The ONS are including community deaths where the gp notes suspected covid on the death certificate even if the person wasn’t tested - but those stats are weekly with a lag due to the reporting process (source More or Less).
A total of 9,875 patients have died in hospital after testing positive for coronavirus in the UK
:votive:
A total of 542 people who tested positive for coronavirus in Scotland have died,
NHS England said a further 823 people have died in hospital in England after testing positive for coronavirus, ..., bringing the death toll there to 8,937.
:votive:
The number of people with coronavirus who have died in a hospital setting in Northern Ireland has risen to 107, with 15 further deaths reported on Saturday.
:votive:
Wales wasn't up, and I couldn't get the link to yesterdays.
Note Scotland's stat is phrased differently (I don't know why)
The ... "including an 11-year-old child", each of them has a story.
No, they may get tested in hospital but released to nursing home care if the symptoms are not severe and the nursing home can manage the isolation needs. Hospices may count as nursing homes (?)
I'll check back, Chris, but I remember seeing a breakdown of death figures which included people who had died in nursing homes. I think the counting standards may lack full clarity on this issue.
I'll check back, Chris, but I remember seeing a breakdown of death figures which included people who had died in nursing homes. I think the counting standards may lack full clarity on this issue.
I'm going from articles like this one which would seem to imply that at the very least they aren't included in official death tolls.
A total of 9,875 patients have died in hospital after testing positive for coronavirus in the UK
:votive:
A total of 542 people who tested positive for coronavirus in Scotland have died,
NHS England said a further 823 people have died in hospital in England after testing positive for coronavirus, ..., bringing the death toll there to 8,937.
:votive:
The number of people with coronavirus who have died in a hospital setting in Northern Ireland has risen to 107, with 15 further deaths reported on Saturday.
:votive:
Wales wasn't up, and I couldn't get the link to yesterdays.
Note Scotland's stat is phrased differently (I don't know why)
The ... "including an 11-year-old child", each of them has a story.
Scotland is at least trying to include those who die elsewhere, and has a marginally more extensive testing regime than England (mostly in the area of healthcare staff but possibly covering care homes too, I'm not sure).
I wish the statistics would indicate what percentage of cases are from nursing homes, as compared with the general community. They are equally important in themselves, but cases in the community have public health implications that nursing homes do not.
I'm not sure that's the case. Nursing homes have staff who interact with their residents and then go home to their families. Then those family members go interact with other people in the community. Nursing home aren't hermetically sealed off from the communities in which they're located, especially for something as contagious as COVID-19.
There are a lot of sub-standard nursing homes in the U.S. and one of the most frequently cited deficiencies, even before COVID-19, is inadequate infection control.
The question of whether cases outside hospitals are in nursing homes or not relates to questions of general prevalence in the community. Intuitively, within a nursing home where a small number of staff treat a larger number of elderly people then it seems likely that if the infection gets inside the building it will spread within that community relatively easily. Thus, if a region has a very low incidence but there are within that some communities that are very mush higher the question is are those hot spots the result of low probability high impact infections within small enclosed communities (such as nursing homes) or wider community infection?
Ok, question: am I the only one on this thread who doesn't have in-depth knowledge of medicine, science, and stats?
Don't forget me! I read this thread, I learn, I get confused, I ask inane questions and insert irrelevant anecdotes.
For example: Doublethink brought up air pollution and, once again, I wonder why my home state of West Virginia is doing so well? I remember a time when the Kanawha valley (Charleston) had the second highest smog level in the U. S. just after Las Angeles. West Virginia is also second in obesity and still has lots of smokers.
Barnabas was wondering about the general fitness level of Germans vs Italians and I've been thinking about how, for the past thirty years, American doctors have been telling us that the very best diet is the "Mediterranean Diet." All that fish and olive oil should have kept the Italians safer.
All that fish and olive oil should have kept the Italians safer.
It did. That's why there were so many old people around to fall victim to the virus.
Here's a question: given that men seem to be far more vulnerable to the virus, should the age/vulnerability criteria for advice about self-isolation be sex-differentiated?
I agree that the Y2K problem is likely with anything under say 100,000 deaths (!). I think we said that about 40 pages back... this is a mammoth thread of course.
As to whether exposure to other coronaviruses affects your immunity to Covid-19... it will depend on the similarities between the virus particles and thus if there's any antibody cross-reactivity and the exact mechanisms the virus uses to enter the cell. This could be esoteric to Covid-19 or very similar to other viruses. I'll have a look.
There is now strong data that the biggest risk factor for Covid mortality is pre-existing cardiac disease. (Even more than respiratory disease). I also strongly suspect there is a significant genetic component. The fact that some people get profound and often fatal effects whilst others get few or no symptoms implies an underlying difference between those patient groups.
The following is speculation but the virus probably binds to a specific cell protein in order to invade the cell. If said protein is one that varies between individuals then that would be a good explanation for why some are clearly much more vulnerable than others despite equivalent health statuses.
I don't know how the general health of the German population compares with other countries but I doubt that's the key factor. The reason is this: as already stated, data shows cardiac disease to be a key predictor of outcome. Historically, France has had the lowest cardiovascular mortality of large European countries...
Most of this is speculation but I'll go and see what's out there about the virus's life cycle and infectivity.
Which is precisely the way I understand things. Protein molecules on surfaces of human cells will vary, just like our noses are all the same yet different. My favourite examples come from HLA (human leukocyte antigens) which are well established for some rheumatological (arthritic) conditions to vary. If you have one of the variants your immune system will function differently. Thus virus's stereochemistry (physical structure) fits differently in differently into the physical structure of the human cell it connects with.
The problem with Dr Don is that he's got the idea the virus itself is treatable with antibiotics. No doubt there will be a toilet paperesque run on antibiotics now.
isn't that idea conflating two things - the virus in the air and the virus on a surface?
Sorry, I didn't mean to conflate them, I was listing two examples of contamination vectors that I personally find hard to integrate in the general scheme of things.
Just wanted to come back to this. On an individual level, transmission of a virus from one person to another is always a probability distribution. We know the virus remains viable on certain surfaces for upto 72 hours.
The probability of you, as an individual contracting the disease from touching one contaminated surface and then touching your face such that viable virus enters your body is going to be very small. However each of us touch lots and lots of surfaces in a day... and there are a lot of people out there so you then multiply that up again and surfaces might be important on the population level. There appears to be big variations in the infection rates. In some series it's reported than someone with Covid infects 6 other people on average. It's really easy to see how that leads to very rapid, exponential growth in the number of cases in just a few days. Conversely, with various measures this infectivity rate can be brought down to just over 1 meaning only a linear growth in cases. Hence, on a population level, everything is likely to help and have a meaningful difference on the overall disease burden in the population.
Do hospices count? For example, is it possible for a sufferer from COVID-19 to be a prior DNS person and be transferred to a hospice to die, rather than remain in an NHS hospital and be ventilated?
I can imagine hospices with PPE being asked to help in this way.
The other stats dimension is that the Office of National Statistics (ONS) which produces weekly stats works to different recording standards to the NHS and may well record COVID-19 deaths if that's what the death certificate says. There's a note on the NHS website to that effect.
Throw in the Scottish and Welsh dimension and you get a certain amount of complexity!
The NHS daily report on deaths link here has the following caveat:
Figures on deaths relate to patients who have died in hospital in England and who have tested positive for COVID-19.
We do not include deaths outside hospital, such as those in care homes. Our approach allows us to compile deaths data on a daily basis using up to date figures. Our data includes confirmed cases reported as at 5pm the previous day. Confirmation of COVID-19 diagnosis, death notification and reporting in central figures can take up to several days, so totals reported at 5pm on each day may not include all deaths that occurred on that day or on recent prior days.
And notes the ONS figures are released weekly on a Tuesday and do include other deaths where COVID 19 is mentioned on the death certificate. That started on 31 March.
The main site is here and today's figures are to be found there as a downloadable Excel sheet broken down into lots of different categories (including age).
That too says that the figures are only those from hospitals and has caveats as to the accuracy.
The ONS figures are to be found here and the most recent analysis on death figures I can see are to 27 March.
The other research that is happening is from Kings College - where you can sign up to a COVID symptom tracker and have your information added into the work being done - that research is trying to track the movement of symptoms in the community, both in the UK and USA, by daily updates on an app. From the e-mail I've just received:
Through Health Data Research UK (the national institute for health data science) we are making the data available to local government and the NHS so they can support your community. The Welsh and Scottish governments have just announced an urgent appeal for the public to download the app and share how they feel.
COVID near you
Furthermore, teams of data scientists at ZOE and King's College London have built a model to predict which areas of the country have the most symptomatic COVID.
Or to put it another way, the UK govt were late, and flirted with herd immunity, before the lockdown. Possibly also, British exceptionalism was hovering, as Boris said, it's an Englishman's inalienable right to go to the pub. Plus, NHS had been shredded by 10 years austerity.
And the US were even later, some states following tRump’s terrible lead - full of denial and false hope.
We weren't all even later. Some of us are led by people with a lot more sense than Boris Johnson. Here are the dates of when stay-at-home orders started to come out:
March 17 - Bay Area in northern California
March 19 - California state-wide order
March 21 - Illinois, New Jersey
March 22 - New York, Ohio
March 23 - Connecticut, Louisiana, Oregon, Washington -- and the UK
More than 92,000,000 Americans -- more than live in the UK -- got stay-at-home orders before you did.
List of countries with at least 5,000 known COVID-19 cases.
United States - 502,876 (456,815 / 27,314 / 18,747)
Spain - 158,273 (86,524 / 55,668 / 16,081)
Italy - 147,577 (98,273 / 30,455 / 18,849)
France - 124,869 (86,740 / 24,932 / 13,197)
Germany - 122,171 (65,522 / 53,913 / 2,736)
China - 81,953 (1,089 / 77,525 / 3,339) 4.1%
United Kingdom - 73,758 (64,456 / 344 / 8,958)
Iran - 68,192 (28,495 / 35,465 / 4,232)
Turkey - 47,029 (43,600 / 2,423 / 1,006)
Belgium - 26,667 (18,080 / 5,568 / 3,019)
Switzerland - 24,551 (12,449 / 11,100 / 1,002)
Netherlands - 23,097 (20,336 / 250 / 2,511)
Canada - 22,148 (15,566 / 6,013 / 569)
Brazil - 19,943 (18,696 / 173 / 1,074)
Portugal - 15,472 (14,804 / 233 / 435)
Austria - 13,560 (7,177 / 6,064 / 319)
Russia - 11,917 (11,028 / 795 / 94)
South Korea - 10,450 (3,125 / 7,117 / 208) 2.8%
Israel - 10,408 (9,130 / 1,183 / 95)
Sweden - 9,685 (8,434 / 381 / 870)
Ireland - 8,089 (7,777 / 25 / 287)
India - 7,600 (6,577 / 774 / 249)
Ecuador - 7,161 (6,496 / 368 / 297)
Chile - 6,501 (4,865 / 1,571 / 65)
Norway - 6,314 (6,169 / 32 / 113)
Australia - 6,238 (3,043 / 3,141 / 54)
Japan - 6,005 (5,221 / 685 / 99)
Poland - 5,955 (5,456 / 318 / 181)
Peru - 5,897 (4,159 / 1,569 / 169)
Denmark - 5,819 (3,799 / 1,773 / 247)
Czechia - 5,732 (5,267 / 346 / 119)
Romania - 5,467 (4,468 / 729 / 270)
The listings are in the format:
X. Country - [# of known cases] ([active] / [recovered] / [dead]) [%fatality rate]
Fatality rates are only listed for countries where the number of resolved cases (recovered + dead) exceeds the number of known active cases by a ratio of at least 2:1. Italics indicate authoritarian countries whose official statistics are suspect. Other country's statistics are suspect if their testing regimes are substandard.
If American states were treated as individual countries seventeen of them would be on that list. New York would be ranked at #2, between "everywhere in the U.S. except New York" (#1) and Spain (#3).
Ecuador has been added to the list since the last compilation with a huge increase of 2,196 diagnosed cases on April 10. For comparison the previous record daily increase in known cases for that country was 515 on April 9. This suggests an increase in testing capabilities rather than a sudden surge of infections.
I am having problems with these statistics in that they do not show the flattening of the curve. While the US is indeed continuing to increase, as shown above, the percentage of the increase is flattening, moreover, new cases are starting to show a reduction, however slight. Take a look at the graph showing daily new cases (US). There are similar charts for other countries.
So, for me, the more informative data at this point is that graph showing Daily New Cases.
Of course, we will not be out of the woods until there is a vaccine (or several) and approved therapeutics available. Even then, the virus will become ubiquitous in the population.
The following is speculation but the virus probably binds to a specific cell protein in order to invade the cell. If said protein is one that varies between individuals then that would be a good explanation for why some are clearly much more vulnerable than others despite equivalent health statuses.
Here's an article that I linked toa century ten days ago. It details some of the questions you're interested in about how SARS-CoV-2 infiltrates human cells but in language geared towards a general audience rather than specialists.
Bear in mind that the article itself is from March 29 and this is a fast-moving field of study.
The following is speculation but the virus probably binds to a specific cell protein in order to invade the cell. If said protein is one that varies between individuals then that would be a good explanation for why some are clearly much more vulnerable than others despite equivalent health statuses.
Here's an article that I linked toa century ten days ago. It details some of the questions you're interested in about how SARS-CoV-2 infiltrates human cells but in language geared towards a general audience rather than specialists.
March 17 - Bay Area in northern California: Mayor of San Fran is a Democrat.
March 19 - California state-wide order: Governor of California is a Democrat
March 21 - Illinois, New Jersey: Governors are Democrats
March 22 - New York, Ohio: Governors are Democrat, Republican respectively
March 23 - Connecticut, Louisiana, Oregon, Washington: Governors are all Democrats
March 17 - Bay Area in northern California: Mayor of San Fran is a Democrat.
March 19 - California state-wide order: Governor of California is a Democrat
March 21 - Illinois, New Jersey: Governors are Democrats
March 22 - New York, Ohio: Governors are Democrat, Republican respectively
March 23 - Connecticut, Louisiana, Oregon, Washington: Governors are all Democrats
Hmmmm.... there seems to just maybe be a pattern emerging here. If only I could spot it...
Just imagine if the USA had an even vaguely competent leader...
As I was saying - the people who follow tRump’s lead are full of denial and false hope. He doesn’t even know that bacteria and viruses are completely different things. He’s more dangerous than any politician I can think of.
The fact that Boris Johnson has no sense goes without saying @Ruth. I’m most certainly not defending him. He put himself, and others, in harms way and is lucky to be alive. But at least our govt seems to now be following the science.
About time too. We have a lot to learn from Germany at every level of society imo.
I don't know how the general health of the German population compares with other countries but I doubt that's the key factor. The reason is this: as already stated, data shows cardiac disease to be a key predictor of outcome. Historically, France has had the lowest cardiovascular mortality of large European countries...
Err, a lot more of us seem to be dying than Germans, though...
The probability of you, as an individual contracting the disease from touching one contaminated surface and then touching your face such that viable virus enters your body is going to be very small. However each of us touch lots and lots of surfaces in a day... and there are a lot of people out there so you then multiply that up again and surfaces might be important on the population level. There appears to be big variations in the infection rates.
On the other hand, this leaves me confused again. Given that multiplication factor, you'd think that infection rates would be worse than they are. Or at least that's my uninformed perception. I find it very frustating that little is (can?) be done to trace where people have caught the disease now.
I don't know how the general health of the German population compares with other countries but I doubt that's the key factor. The reason is this: as already stated, data shows cardiac disease to be a key predictor of outcome. Historically, France has had the lowest cardiovascular mortality of large European countries...
Err, a lot more of us seem to be dying than Germans, though...
I think that's the point. If it were just general health. France ought to be lower. France is not lower, therefore the assumption is that there is something more to it in Germany.
On the other hand, this leaves me confused again. Given that multiplication factor, you'd think that infection rates would be worse than they are. Or at least that's my uninformed perception. I find it very frustating that little is (can?) be done to trace where people have caught the disease now.
I think (and we had a warning about engineers thinking earlier),
We touch 100 [made up figures throughout] surfaces that in turn are touched by 100 people giving 10,000 possible transmissions.
In 99.95% of these cases something went wrong from the viruses point of view (someone washed their hands, someone touched the wrong part of the face, it forgot to get on/off the hand, they swallowed it). Making 5 successful transmissions.
Whereas for the sneezing route it gets to skip half the dangerous (to it) steps. It's much rarer for someone to cough directly up someones nose, perhaps it only happens 10 times, but when that happens 50% of the time it gets lucky.
Comments
Perhaps there is an accumulation of marginal advantages at work, leading to surprisingly significant differences? Perhaps also there was greater preparedness?
Whatever, there may be much to be gained from looking at secondary factors.
Of course it's worth bearing in mind that the virus doesn't die off linearly and in the first few hours its more infectious - but even so I have been washing all shopping and/or isolating things with cardboard packing for a few days prior to opening it.
It's not that long since we were a tithe of Italy/Spain which gave our UK government and papers false exceptionalism (and generally not realising that they were operating on a two week delay). Germany I get the impression used that time.
*Either by straight off starting something earlier, or by doing all risky behaviour half as much over a fortnight.
Link.
It's also striking that the Italy and Spain figures were greeted apocalyptically in the UK press, a "tsunami", for example, but now that the UK is pushing a 1000 deaths a day, it seems to be downplayed, although not on BBC. Instead we get the Sun saying how marvellous it is that Boris is better.
As regards the situation in the U.K.: there are beds and people are getting treated but it is a country mile away from being OK (not least because of the problems with PPE supply.)
The Sun is a rag and I never read it.
There ought to be a middle way between not encouraging the country at large to panic and despair; and not disappearing up Boris’ backside.
If our efforts are successful we will probably end up with what I call the Y2K Bug Fallacy - people will say "there weren't anything like as many deaths as they said so it was all a fuss over nothing."
Bit like people pointing to low numbers of road deaths as proof that the police shouldn't prosecute speeding drivers.
"Boy from isolated Amazon tribe dies after being infected with coronavirus" (AFP, via Yahoo).
And they have little resistance to outside diseases to begin with.
I am sure that various journalists and politicians are waiting to say, it was all exaggerated, and the BBC's fault.
Compared to say AfZ I don't.
Maths and Science I'm more than good enough to take some facts and (log) graphs and spot some 'lies with stats'. Medicine, with help I can understand.
Compared with the average, I'm sure you count in at least one (and if not there'll be something else you bring). [ETA for a start you realised about resistances to outside diseases. I don't know if they directly are more at threat if we're all unresistant, but they are already squeezed and treating them exposes them to the things we are resistant too, so it is very bad. AfZ probably knows or knows where to look to see if Corona resistance does have a contribution to Cor19 resistance and the actual numbers]
I'm pretty dumb about medicine, but higher education helps me with the other two.
Very helpful, DT, many thanks.
I have been looking at a map showing cases in Virginia by counties. Some counties have many cases while adjacent counties have relatively few. I have seen newspaper articles about nursing home epidemics in some of the seriously-affected counties. However, I have seen no reports about other seriously-affected counties. I would like to know what's going on.
At least in the UK, cases where people actually die from the virus in nursing homes are currently not included in the reported daily death toll.
It looks as though Belgium and France have decided to include deaths in nursing homes as down to COVID if the doctors say so (with or without a test).
Early on most people would be moved to hospital (and then tested) anyway.
Their weekly stat is at least 2 weeks out of date, but is Deaths anywhere due to Covid.
I am not aware that they are testing people in nursing homes.
A total of 9,875 patients have died in hospital after testing positive for coronavirus in the UK
:votive:
A total of 542 people who tested positive for coronavirus in Scotland have died,
NHS England said a further 823 people have died in hospital in England after testing positive for coronavirus, ..., bringing the death toll there to 8,937.
:votive:
The number of people with coronavirus who have died in a hospital setting in Northern Ireland has risen to 107, with 15 further deaths reported on Saturday.
:votive:
Wales wasn't up, and I couldn't get the link to yesterdays.
Note Scotland's stat is phrased differently (I don't know why)
The ... "including an 11-year-old child", each of them has a story.
I'll check back, Chris, but I remember seeing a breakdown of death figures which included people who had died in nursing homes. I think the counting standards may lack full clarity on this issue.
I'm going from articles like this one which would seem to imply that at the very least they aren't included in official death tolls.
Scotland is at least trying to include those who die elsewhere, and has a marginally more extensive testing regime than England (mostly in the area of healthcare staff but possibly covering care homes too, I'm not sure).
I'm not sure that's the case. Nursing homes have staff who interact with their residents and then go home to their families. Then those family members go interact with other people in the community. Nursing home aren't hermetically sealed off from the communities in which they're located, especially for something as contagious as COVID-19.
There are a lot of sub-standard nursing homes in the U.S. and one of the most frequently cited deficiencies, even before COVID-19, is inadequate infection control.
Don't forget me! I read this thread, I learn, I get confused, I ask inane questions and insert irrelevant anecdotes.
For example: Doublethink brought up air pollution and, once again, I wonder why my home state of West Virginia is doing so well? I remember a time when the Kanawha valley (Charleston) had the second highest smog level in the U. S. just after Las Angeles. West Virginia is also second in obesity and still has lots of smokers.
Barnabas was wondering about the general fitness level of Germans vs Italians and I've been thinking about how, for the past thirty years, American doctors have been telling us that the very best diet is the "Mediterranean Diet." All that fish and olive oil should have kept the Italians safer.
It did. That's why there were so many old people around to fall victim to the virus.
Here's a question: given that men seem to be far more vulnerable to the virus, should the age/vulnerability criteria for advice about self-isolation be sex-differentiated?
I agree that the Y2K problem is likely with anything under say 100,000 deaths (!). I think we said that about 40 pages back... this is a mammoth thread of course.
As to whether exposure to other coronaviruses affects your immunity to Covid-19... it will depend on the similarities between the virus particles and thus if there's any antibody cross-reactivity and the exact mechanisms the virus uses to enter the cell. This could be esoteric to Covid-19 or very similar to other viruses. I'll have a look.
There is now strong data that the biggest risk factor for Covid mortality is pre-existing cardiac disease. (Even more than respiratory disease). I also strongly suspect there is a significant genetic component. The fact that some people get profound and often fatal effects whilst others get few or no symptoms implies an underlying difference between those patient groups.
The following is speculation but the virus probably binds to a specific cell protein in order to invade the cell. If said protein is one that varies between individuals then that would be a good explanation for why some are clearly much more vulnerable than others despite equivalent health statuses.
I don't know how the general health of the German population compares with other countries but I doubt that's the key factor. The reason is this: as already stated, data shows cardiac disease to be a key predictor of outcome. Historically, France has had the lowest cardiovascular mortality of large European countries...
Most of this is speculation but I'll go and see what's out there about the virus's life cycle and infectivity.
AFZ
The problem with Dr Don is that he's got the idea the virus itself is treatable with antibiotics. No doubt there will be a toilet paperesque run on antibiotics now.
Just wanted to come back to this. On an individual level, transmission of a virus from one person to another is always a probability distribution. We know the virus remains viable on certain surfaces for upto 72 hours.
The probability of you, as an individual contracting the disease from touching one contaminated surface and then touching your face such that viable virus enters your body is going to be very small. However each of us touch lots and lots of surfaces in a day... and there are a lot of people out there so you then multiply that up again and surfaces might be important on the population level. There appears to be big variations in the infection rates. In some series it's reported than someone with Covid infects 6 other people on average. It's really easy to see how that leads to very rapid, exponential growth in the number of cases in just a few days. Conversely, with various measures this infectivity rate can be brought down to just over 1 meaning only a linear growth in cases. Hence, on a population level, everything is likely to help and have a meaningful difference on the overall disease burden in the population.
AFZ
I can imagine hospices with PPE being asked to help in this way.
The other stats dimension is that the Office of National Statistics (ONS) which produces weekly stats works to different recording standards to the NHS and may well record COVID-19 deaths if that's what the death certificate says. There's a note on the NHS website to that effect.
Throw in the Scottish and Welsh dimension and you get a certain amount of complexity!
The main site is here and today's figures are to be found there as a downloadable Excel sheet broken down into lots of different categories (including age).
That too says that the figures are only those from hospitals and has caveats as to the accuracy.
The ONS figures are to be found here and the most recent analysis on death figures I can see are to 27 March.
The other research that is happening is from Kings College - where you can sign up to a COVID symptom tracker and have your information added into the work being done - that research is trying to track the movement of symptoms in the community, both in the UK and USA, by daily updates on an app. From the e-mail I've just received:
We weren't all even later. Some of us are led by people with a lot more sense than Boris Johnson. Here are the dates of when stay-at-home orders started to come out:
March 17 - Bay Area in northern California
March 19 - California state-wide order
March 21 - Illinois, New Jersey
March 22 - New York, Ohio
March 23 - Connecticut, Louisiana, Oregon, Washington -- and the UK
More than 92,000,000 Americans -- more than live in the UK -- got stay-at-home orders before you did.
I am having problems with these statistics in that they do not show the flattening of the curve. While the US is indeed continuing to increase, as shown above, the percentage of the increase is flattening, moreover, new cases are starting to show a reduction, however slight. Take a look at the graph showing daily new cases (US). There are similar charts for other countries.
So, for me, the more informative data at this point is that graph showing Daily New Cases.
Of course, we will not be out of the woods until there is a vaccine (or several) and approved therapeutics available. Even then, the virus will become ubiquitous in the population.
Here's an article that I linked to a century ten days ago. It details some of the questions you're interested in about how SARS-CoV-2 infiltrates human cells but in language geared towards a general audience rather than specialists.
Bear in mind that the article itself is from March 29 and this is a fast-moving field of study.
Thank you!
March 17 - Bay Area in northern California: Mayor of San Fran is a Democrat.
March 19 - California state-wide order: Governor of California is a Democrat
March 21 - Illinois, New Jersey: Governors are Democrats
March 22 - New York, Ohio: Governors are Democrat, Republican respectively
March 23 - Connecticut, Louisiana, Oregon, Washington: Governors are all Democrats
Hmmmm.... there seems to just maybe be a pattern emerging here. If only I could spot it...
Just imagine if the USA had an even vaguely competent leader...
The fact that Boris Johnson has no sense goes without saying @Ruth. I’m most certainly not defending him. He put himself, and others, in harms way and is lucky to be alive. But at least our govt seems to now be following the science.
About time too. We have a lot to learn from Germany at every level of society imo.
I think (and we had a warning about engineers thinking earlier),
We touch 100 [made up figures throughout] surfaces that in turn are touched by 100 people giving 10,000 possible transmissions.
In 99.95% of these cases something went wrong from the viruses point of view (someone washed their hands, someone touched the wrong part of the face, it forgot to get on/off the hand, they swallowed it). Making 5 successful transmissions.
Whereas for the sneezing route it gets to skip half the dangerous (to it) steps. It's much rarer for someone to cough directly up someones nose, perhaps it only happens 10 times, but when that happens 50% of the time it gets lucky.