Coronavirus - worldwide spread and control

In Germany, although the government and the Robert Koch Institute wanted the data collected centrally, they have now agreed to decentralized collection, simply because they want a lot of people to use it. Not that we have an app yet, but they're working on it.

 

Indeed. Belgium has been criticised for being over-inclusive in their reporting but even adding in a 25% increase for the UK leaves the per capita death rate still at three quarters of Belgium's.

Meanwhile France only latterly started recording deaths in care homes and as far as I'm aware neither Spain nor Italy included deaths outside hospitals :

https://www.theguardian.com/world/2...g-covid-19-death-rates-across-europe-helpful-

As for China's reported figures - I doubt anyone now believes they're credible.

I suspect we'll only know in retrospect (or maybe never) how countries fared and factors such as demographics and population density may have played a greater role than government policies.

 

What the real rate of infection is currently unknown, the official numbers are done for practical purpose, and are not in any sense representative. In Gangelt, Germany, past infection has been estimated to be 15 or even 20%. Death rate was - so far - 0.37% (with 15%).

I don´t consider myself to be cynical. But he said that frail ones are dying, other ones die on a very low level. He didn´t mention it, but the implication is that this will be in the range of accidents.

Only excess mortality will be able to tell it, but it didn´t appear so far that it is elevated in Sweden, even now, without the months to come (corona deaths are declining in Sweden).


RE: Accidents. It will not be possible to hinder accidents, general speaking, though one can diminish them. And then from a certain amount of intervention on, you will cause more harm than good. On a personal level, if you want, to live means - to a certain degree - to do injustice. This cannot be hindered as well, even if you want it with all your might. This is how life is, and it will never change.

 

If the “goal is to protect vulnerable people”, they’ve already failed at that goal.

https://www.theguardian.com/world/2...as-elderly-pay-price-for-coronavirus-strategy
As per 19 April, 1/3 of all deaths in Sweden have been in care homes. This is despite banning visitors to care homes in Sweden, just like the U.K. has done. Yet carers who are going in and out of care homes every day, and in close contact with elderly people, delivery drivers, elderly people who need to go into hospital, will come into contact with coronavirus through the “herd immunity” policy, and therefore infect those in care homes.

This is exactly what happened in the UK and it is absurd that decision makers could not see this simple conclusion that the rest of us spotted within seconds. Also, how do they know who is vulnerable? It’s not just those in care homes. Why are people with no underlying health conditions and in their 30s, also dying? Why are those who are in their 40s, 50s, 60s, dying? Those people very often aren’t in care homes, so will be exposed to “herd immunity” and therefore the coronavirus fully.

Moreover, just comparing the figures of other nearby countries:

“The death rate in Sweden has now risen significantly higher than many other countries in Europe, reaching more than 21 per 100,000 people, according to figures from Johns Hopkins University, controlled for population.

By contrast, Denmark has recorded more than seven deaths per 100,000 people, and both Norway and Finland less than four.

Sweden has registered 18,640 coronavirus cases and 2,194 deaths among its population of 10.3 million people.

Denmark has had 8,773 cases and 422 deaths in a population of 5.8 million, Norway 7,449 cases and 202 deaths among its 5.4 million people, and Finland 4,576 cases and 190 deaths in its population of 5.5 million.

Denmark and Norway are now beginning to ease their lockdowns, with children returning to school in the past 10 days, in smaller classes with markers to help keep them two meters apart. Salons and other businesses with one-to-one contact will reopen in Norway from Monday. Finland has extended its restrictions until May 13.

Further afield the Czech Republic, which has a similar-sized population -- 10.7 million -- to Sweden, has recorded 7,404 cases and 221 deaths -- around two deaths per 100,000 people. It took a markedly different approach to the pandemic by shutting schools, closing restaurants and bars and most stores, restricting travel and ordering mandatory quarantines for travelers from at-risk regions in early March. It has also made it compulsory for people to wear face masks in public”.

https://amp.cnn.com/cnn/2020/04/28/europe/sweden-coronavirus-lockdown-strategy-intl/index.html?

I don’t think Sweden is doing well by any measure. They’re not really protecting vulnerable people, while generating “herd immunity”, are they. Instead those vulnerable people are dead.

 

I can't open the graph but I guess it is the one that has been shown on German TV the last couple of days?

From what I understand R isn't the only number that the RKI (=our CDC) is looking at. If we had 1 million cases and R was let's say 0,9, it would still be way too many cases to handle. They also improved and upscaled testing in March so that might have had an effect, too?

It's a bit unfortunate that their communication is so incoherent...first it was the doubling time of cases, then hospital capacity and then R that they communicated as the most important factor to decide on measures. And then of course when doubling time slowed down, ICUs remained empty and R became <1 it seems inconsistent to not lift measures.

From what I understand the goal still seems to get into some sort of containment (not only mitigation), where local tracing can stamp out emerging new clusters.

We'll see in 2 weeks if reopening + wearing masks will have an effect.

 

From my perspective all we can hope to do is go by orders of magnitude. Anything more precise is uninterpretable. And we have the orders of magnitude data very clear. China, New Zealand, South Korea, Europe, USA. UK and much of the rest of Europe have allowed the epidemic to spread in a way that will do far more harm to health AND the economy as for China and NZ. The Chinese figures might be too low by a factor of two but that is not an order of magnitude. Italy maybe did not have time to act, although if the connection of Milan to Wuhan is well known I rather doubt even this. UK is maybe unusual in that it deliberately decided to take the wrong course despite it being blindingly obvious that it would be worst both for health and economy. And it is not just me saying that. It is most experts in the UK other than those who swayed the vote in the government committee.

 

Did no one consult/implement the 'plan' (ie since it was written in 2013 and updated in 2017)?

https://www.gov.uk/guidance/pandemic-flu

 

Ben De Peer is news editor at C4 news:
https://twitter.com/user/status/1254007382620995584

All very familiar. Notable that Anthony Costello, like Jonathan, is emeritus Professor and therefore no fear of repercussions.

 

I didn´t provide a link (which is my fault). It´s from Epidemiogische Bulletin 16/2020 (an RKI=CDC puplication).

In my view their communication is a disaster, probably they themselves don´t really know what´s they should think. This is to some degree understandable, as the situation is complex with a lot of unknowns, but even therefore it would be utterly important to determine which parameters do matter, and may indicate which scenario.

The first strategy obviously shifted away without announcement or correction. This is not OK. Not only the people need to know what we are making fore, also the captain should know what he is doing, as far as it is possible.

I agree, also in the wider scope of Europe (with its different numbers and measures), and of the world.

 

The new goal is now when the number of new infections per day is only a couple of hundred, rather than around 2000 as it is now. Each new goal does create the impression that when it's reached we can all get back to normal, which is unfortunate.

 

But the number of corona-deaths reflect only people who have died AND have been tested positive.

To estimate if they really died from corona or if they would have died anyway can only be decided from excess mortality within some time frame, say 6 months or a year or so. The current number of "corona-deaths" doesn´t tell much.

Therefore it is also no argument that there are more dead people who could have been tested positive, if they only had been tested.


Then the cases listed, without the number of tests done this number is completely clueless. If you test a lot of people you get a lot of positives. If you test only few people you get only a few positives.

Even for one country the number of cases does not appear to serve for a coherent comparison in the course of time, because the number of testing went up. There is bad communication and even thinking at work.


So I have to say that I disagree with your assessment, though I admit that the situation is unclear. I think the Swedish numbers are not of concern (and deaths are rapidly declining!), but the numbers of Italy, Spain, UK and US may be, but even this might be not clear.

In Spain there are now about 20.000 corona deaths, and we should expect about 600.000 deaths every year, I very roughly guess. This makes 200.000 deaths for every four months time.

What I am concerned about is,

• that there have happened other deaths (non-corona deaths), because people didn´t went into the hospitals (being afraid or whatever) or didn´t get the help they needed.
• that the measures themselves cause positively new illnesses (including in children, also from there parents, which will be a live long experience).
• that the social costs will affect the health care in the future negatively, causing illnesses and deaths in the future.

These points are part of the equation (and the first two points contribute to any excess mortality now). Therefore it is irresponsible not to communicate the preliminarity of the current known numbers. In my view Sweden behaves especially wise, though the situation might not be comparable with the one in Spain, for so far unknown reasons.

 

Seems to me countries you list as orders of magnitude better in their response are the outliers. China's figures are dubious at least; S Korea had the benefit of previous experience in dealing with SARS (1) and according to some accounts were lucky enough to have been 'game planning' an ideal response at a time when the WHO still considered the risk of a pandemic to be low. New Zealand of course has the benefits of being an isolated island with a tiny population and who had the time to witness what hadn't worked elsewhere.

The pandemic has pretty much followed a similar path elsewhere regardless of whether or not individual countries took the 'wrong course'.

 

This is Ed Conway, sky news Economics editor:

https://twitter.com/user/status/1255147479466565636


https://twitter.com/user/status/1255148119416700929


I did see a reference to this in a sky news article which I posted on this thread earlier, that the excess deaths in other European countries (Spain, Italy, France), although they went high, they then came back to normal levels quite quickly. Whereas in the U.K. - 2 weeks later our excess deaths are still really high.

Why? What on Earth is going on? This is the Z score mortality measure. I don’t know exactly what that means and would appreciate some input. (Edit; I remember now when I looked it up, the number of standard deviations from the mean!). Anyway, why is it so high?

 

Further to my post yesterday (I think it was) about Greggs opening, we now have this from the deputy political editor of Sky News:

https://twitter.com/user/status/1255175690015686657


So honestly, the lockdown is easing, isn’t it, without actually officially easing. It’s not just about “essentials” anymore. Is this the right time to be doing this?

 

Wessely’s name appears on a number of publications that have been used as evidence for “SPI-B” who are the SAGE subcommittee on behavioural and social interventions. Rubin’s name crops too.

https://assets.publishing.service.g...t_data/file/873741/09-spi-b-evidence-list.pdf

I found out about this in the following article in the The Guardian:
https://www.theguardian.com/comment...wing-the-science-coronavirus-advice-political