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Interesting.

@gnius "Dammit, Jim, I'm a lawyer and engineer, not a doctor!"

So not my wheelhouse, but this seems to find that the IFR may be quite less than originally estimated. Still serious, but not as deadly as originally thought (and perhaps not as deadly because the medical professionals have learned how best to treat this). Is that a correct take away?


The median infection fatality rate across all 51 locations was 0.27% (corrected 0.23%). Most data came from locations with high death tolls from COVID-19 and 32 of the locations had a population mortality rate (COVID-19 deaths per million population) higher than the global average (118 deaths from COVID-19 per million as of 12 September 2020;79 Fig. 3). Uncorrected estimates of the infection fatality rate of COVID-19 ranged from 0.01% to 0.67% (median 0.10%) across the 19 locations with a population mortality rate for COVID-19 lower than the global average, from 0.07% to 0.73% (median 0.20%) across 17 locations with population mortality rate higher than the global average but lower than 500 COVID-19 deaths per million, and from 0.20% to 1.63% (median 0.71%) across 15 locations with more than 500 COVID-19 deaths per million. The corrected estimates of the median infection fatality rate were 0.09%, 0.20% and 0.57%, respectively, for the three location groups. For people < 70 years old, the infection fatality rate of COVId-19 across 40 locations with available data ranged from 0.00% to 0.31% (median 0.05%); the corrected values were similar.
Acknowledging these limitations, based on the currently available data, one may project that over half a billion people have been infected as of 12 September, 2020, far more than the approximately 29 million documented laboratory-confirmed cases. Most locations probably have an infection fatality rate less than 0.20% and with appropriate, precise non-pharmacological measures that selectively try to protect high-risk vulnerable populations and settings, the infection fatality rate may be brought even lower.
 

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Interesting. I hadn't seen this bulletin.
Now I'm not a public health specialist. I'm a virologist and intensivist.
I think trying to guess IFR is less helpful than it may seem. Clearly this virus is not Ebola. But also anyone who's worked in a hospital recently knows that it's transmissible and dangerous. Beyond that, I don't use the IFR to ballpark estimate risk. I care much more about hospitalization rate and in-hospital mortality, especially when broken up by risk group.
Finally, if I had to estimate the impact of COVID-19 on society I wouldn't use overall deaths, or even percent of deaths attributable to virus infection. I think the more important question is this:
Has COVID-19 increased absolute mortality?
In the end, if it happens to be the baddest virus around and results in most deaths this year among a population that had a life expectancy of less than a year, it would not even register.
In other words - would the people who have now died of COVID-19, have died of other things, within a reasonably similar timeline? In that case, does it serve as only a proximate cause of death, rather than an ultimate one? Now, don't get me wrong - I've seen a significant number of relatively young people become critically-ill with COVID-19. But every season we ECMO a couple dozen young patients with influenza and related complications. I've seen young patients die of flu, adenovirus, rhinovirus, RSV, human metapneumovirus, and simple streptococcal pneumonia. COVID is easier to transmit and more dangerous. But I don't think by enough to be statistically significant in terms of absolute mortality risk, at least in the low-risk groups. And in the end, absolute risk is the only thing that matters as far as populations go, although nearly anything can be devastating to an individual.

The above was a longwinded segway to saying that statistics can be easily deceiving. COVID-19 is a huge public health risk. But only history will show whether our handling of the pandemic has produced more damage than it mitigated. How many people will commit suicide this year? How many people will drink themselves into cirrhosis? How many children will suffer significant psychosocial damage. How many adults? How many elderly will die alone and unseen in nursing homes? What is the utilitarian analysis of losing basic freedoms? This analysis is beyond any of us. In the end, we have to try to do our best, mitigate risk the best we can, and hope we don't screw ourselves and each other worse in the process. If there's an upside, we now see how large of a percentage of population will do absolutely anything when prodded with even a modicum of fear. They are fine with destroying lives and livelihood. How much further is it to ask them to kill? We have also seen how many people can be driven to the opposite direction, and will revolt against even the most basic attempts at risk mitigation. Both segments of the population are now in a persistent tantrum. I guess we'll know who wins in a couple of weeks.
 

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There is no realistic comparison of Covid to the annual variations of the Flu viruses in their various manifestations. There is widespread testing for covid, with statistic showing that a very small percent of people who are tested are Covid positive in my state. This includes those with no symptoms at all.

There is NO widespread testing for Flu virus, so the only number for flu cases is for people who have actual symptoms and test positive or not. There are numbers for how many people die annually from the flu. However, there is no way to tell if Covid is actually more dangerous or more contagious. What percentage of people who test positive for COVID die -both those WITH AND WITHOUT SYMPTOMS ? What percentage of people who have active flu die?....since there are no statistics for people who have the flu virus but no symptoms.

And one other little glitch is that a lot of health care professionals who work in hospitals have honestly stated that many deaths are listed as caused by Covid but were deaths that were NOT actually caused by Covid.

With no actual "apples to apples" comparison data: All is smoke and mirrors.

I am NOT Claiming that this is not a serious disease. Just that there are no actual facts to determine how serious and how contagious it really is COMPARED to its cousins the annual flu variations. (The flu is serious also for a lot of people, but no one effectively shuts down whole countries because of a flu epidemic.) Note that I am in a high risk group due to age and other health conditions plus having to take a steroid which greatly lowers my immune system. I do not live in fear. I live as realistically as I can while still having "a life."
 

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And one other little glitch is that a lot of health care professionals who work in hospitals have honestly stated that many deaths are listed as caused by Covid but were deaths that were NOT actually caused by Covid.
There is A LOT of misunderstanding and misinformation that has been related to the above concept.
There isn't a conspiracy to call non-COVID deaths COVID, at least widespread.

But I have definitely seen "discussions" on the internet, where people have propagated this nebulous idea that only if the virus directly kills a person can you call that a death due to COVID. That's unadulterated BS that either demonstrates ignorance, or deliberate misinformation. If someone comes into the hospital with severe flu, and gets on a ventilator, gets MRSA pneumonia, and then dies of severe fungal infection of their trashed lungs, the cause of death is still ultimately flu, because they would not have been having these complications if not for the index infection. Just like dying from an infected stump can ultimately be due to diabetes. That's why death certificates have either 4 or 5 lines designated for cause of death, where you classify multiple causes from proximate to ultimate. For example, someone who was shot in the spine and then was confined to the wheelchair, the developed pressure ulcers, and then came into the hospital for infection, the death certificate can state:

Causes of death | Time
Septic shock due to staphylococcus aureus - Days
Decubitus ulcer - Weeks
Paraplegia due to GSW - Months
---------------------------------------
This death would actually be a medical examiner case, and in many jurisdictions would be classified as MURDER.

COVID-19 causes kidney failure, brain dysfunction, pulmonary embolism, and progressive respiratory failure with or without bacterial or fungal superinfection. Just because the proximate cause of death is pneumonia due to pseudomonas, or kidney failure, doesn't make it a non-COVID death.

An incorrectly labeled death certificate would be as follows: woman comes in to give birth, is incidentally found to be COVID-19 positive by testing, then dies of uncontrolled hemorrhage due to undiagnosed placenta previa. If that death certificate said "COVID-19", it would be mislabeled. On the other hand, if you had a pregnant woman come in, incidentally found to be COVID-19 positive, and then died on the 3rd postpartum day of a massive pulmonary embolism, it would be very reasonable to put COVID as a contributing factor.
 

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From the study: "Seroprevalence estimates ranged from 0.02% to 53.40%. Infection fatality rates ranged from 0.00% to 1.63%, corrected values from 0.00% to 1.54%."

Seroprevalence refers to the level of a pathogen in a population, as measured in blood serum. There are a number of problems with using seroprevalence to estimate infection, one of which is the fact that, as the author stated, the estimate range is massive, fully three orders of magnitude.

Alternative approaches use known conditions where exposure to infection levels was highly likely, such as for the 5,000-member crew of the aircraft carrier USS Roosevelt. From that, we know that out of 5,000 people, 850 were infected (17%), and due to the modest offloading most of the way through the infection cycle, we can calculate the actual population infection rate to be around 21.3%.

Given that information, the total U.S. population, number of confirmed, active, recovered, and fatal cases, along with exposure estimates based on decades of historical date with both coronavirus and other pathogens, we can accurately estimate the total exposure rate to date in the U.S. is coming up on 16%.

From that, it's a simple matter to calculate the following:

Mortality Rate (fatalities per resolved case, where resolved includes both recovered and fatal): 4.1%

Case Fatality Rate (fatalities divided by current cases, total -- NOT a very good metric, as it includes active (unresolved) cases that could go either way: 2.7%

Exposure Fatality Rate (fatalities divided by total exposed): 0.4%, and pretty much useless.

Here's what's NOT useless:

Projected date of reaching 60% infected i.e. Herd Immunity: October 24, 2024

That's right: FOUR YEARS from now.

Currently, just 15.6% of those who are going to get it have gotten it. We've a LONG road ahead of us, UNLESS we create an artificial herd immunity via immunization.
 

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There is no realistic comparison of Covid to the annual variations of the Flu viruses in their various manifestations.
Actually, there is, and the results are telling:

Worldwide, COVID-19 has proven to be 67.3 times more deadly than seasonal flu.

In the U.S., COVID-19 has proven to be 45.1 times more deadly than the seasonal flu.

We have all the data in the world at our fingertips. To make sense out of it, however, one needs to be more than a journalists (goes without saying), and apparently, a bit more savvy in the art of Data Science than a fair number of doctors and even a few epidemiologists.
 

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There is A LOT of misunderstanding and misinformation that has been related to the above concept.
There isn't a conspiracy to call non-COVID deaths COVID, at least widespread.
sure there is. Maybe not occurring where you are, but throughout the nation it is a problem, sometimes at the state level. there may have been attention drawn to specific cases of covid deaths that resulted from gunshot wounds and motorcycle accidents, and while those stories that have received coverage may only make up a handful of cases, and are therefore not widespread, they occurred because of widespread corruption meant to drive numbers up. Here is an example of how a positive covid case, hospitalization, and death can occur. As far as I know this example didn’t play out at once, but this is a combination of real things that have happened in this country.
First, a state health department offers free McDonald’s to people who get covid tested. Next, someone who is bored takes a drive to go get tested to get their free burger. On their way home, their phone rings because the results are in. The driver reaches down to pick up the phone and as he is given the news that he has covid, has a terrible car accident. EMS shows up and takes him to the hospital for injuries sustained in the accident, and he is listed as a covid hospitalization. He later dies in the hospital because of his injuries, and he is then listed as a covid death.

the criteria for labeling a covid hospitalization or death is very broad. some states, if you die for any reason while you have covid, it’s a covid death. in others,if you die within a certain time period after leaving the hospital for covid, regardless of why you die, it’s a covid death. Here we did not start using death certificate datafor covid deaths until recently. all of the data is a joke.
 

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I would have a great deal more confidence in ANY statistics on COVID if there were no monetary rewards for listing COVID as a cause of death. Hospitals and pharmaceutical companies are basically in the business to make money - large quantities of money. The love of money is the root of all evil - hence the insane desire to posses all the money in the world, regardless of the cost.

The single largest damage point for COVID is the irreparable damage done to the level of trust in the entire medical field. If I were a physician, I would be very concerned as to how to reinstill a level of trust between my patients and myself.

Preachers and other professions have gone through the same wasteland - albeit many for varied reasons. Medical professionals - welcome to the party pal.
 

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Actually, there is, and the results are telling:

Worldwide, COVID-19 has proven to be 67.3 times more deadly than seasonal flu.

In the U.S., COVID-19 has proven to be 45.1 times more deadly than the seasonal flu.

We have all the data in the world at our fingertips. To make sense out of it, however, one needs to be more than a journalists (goes without saying), and apparently, a bit more savvy in the art of Data Science than a fair number of doctors and even a few epidemiologists.
in the US we administer 160 million flu vaccines each year. It’s nowhere close to being 67x more deadly. It’s actually quite possibly less deadly.

I agree with Shooter Granny about the lack of comparison.
 

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Actually, there is, and the results are telling:

Worldwide, COVID-19 has proven to be 67.3 times more deadly than seasonal flu.

In the U.S., COVID-19 has proven to be 45.1 times more deadly than the seasonal flu.

We have all the data in the world at our fingertips. To make sense out of it, however, one needs to be more than a journalists (goes without saying), and apparently, a bit more savvy in the art of Data Science than a fair number of doctors and even a few epidemiologists.
Where are you getting these statistics from? Source?
 

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sure there is. Maybe not occurring where you are, but throughout the nation it is a problem
I do not have those statistics, and neither do you or anyone else making these statements.
sometimes at the state level. there may have been attention drawn to specific cases of covid deaths that resulted from gunshot wounds and motorcycle accidents, and while those stories that have received coverage may only make up a handful of cases, and are therefore not widespread, they occurred because of widespread corruption meant to drive numbers up
That's the same logic people apply when they say that only a handful of gun owners commit mass murder, but that's because of widespread mental illness among gun owners.
First, a state health department offers free McDonald’s to people who get covid tested. Next, someone who is bored takes a drive to go get tested to get their free burger. On their way home, their phone rings because the results are in. The driver reaches down to pick up the phone and as he is given the news that he has covid, has a terrible car accident. EMS shows up and takes him to the hospital for injuries sustained in the accident, and he is listed as a covid hospitalization. He later dies in the hospital because of his injuries, and he is then listed as a covid death.
Not in my hospital.
I would have a great deal more confidence in ANY statistics on COVID if there were no monetary rewards for listing COVID as a cause of death. Hospitals and pharmaceutical companies are basically in the business to make money - large quantities of money.
Healthcare is very expensive. US healthcare CAN be very good, but it's very expensive. Firstly, don't conflate hospitals and pharmaceutical companies. Hospitals spend most money on actual healthcare, followed by staff, facilities, administration, etc. Larger referral centers operate either with relatively thin for-profit margins (<10%) or are not-for-profit altogether. The COVID crisis has screwed hospitals in a major way, because taking care of sick people is expensive and thus not particularly profitable. Doing elective procedures is profitable, and these have been drastically limited this year. There are hospitals who were firing ICU staff during the worst of the burst in late April and May, because they were ostensibly out of money (at least after paying their administration full salaries of course).
The single largest damage point for COVID is the irreparable damage done to the level of trust in the entire medical field. If I were a physician, I would be very concerned as to how to reinstill a level of trust between my patients and myself.
I'm not sure what you expect of an individual doctor if you walk into a conversation already convinced of their bad intentions and lack of trustworthiness.
 

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Worldwide, COVID-19 has proven to be 67.3 times more deadly than seasonal flu.

In the U.S., COVID-19 has proven to be 45.1 times more deadly than the seasonal flu.
As SG pointed out, there is NO wide spread testing for the seasonal flu so there is no way to accurately compare the two.
Since COVID has been politicized and monetized, of course the numbers have pumped up.

Statics...garbage in, garbage out.
 

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I do not have those statistics, and neither do you or anyone else making these statements.

That's the same logic people apply when they say that only a handful of gun owners commit mass murder, but that's because of widespread mental illness among gun owners.

Not in my hospital.

Healthcare is very expensive. US healthcare CAN be very good, but it's very expensive. Firstly, don't conflate hospitals and pharmaceutical companies. Hospitals spend most money on actual healthcare, followed by staff, facilities, administration, etc. Larger referral centers operate either with relatively thin for-profit margins (<10%) or are not-for-profit altogether. The COVID crisis has screwed hospitals in a major way, because taking care of sick people is expensive and thus not particularly profitable. Doing elective procedures is profitable, and these have been drastically limited this year. There are hospitals who were firing ICU staff during the worst of the burst in late April and May, because they were ostensibly out of money (at least after paying their administration full salaries of course).

I'm not sure what you expect of an individual doctor if you walk into a conversation already convinced of their bad intentions and lack of trustworthiness.
1st point- I don’t need the statistics. The policies are what they are, the states are admitting to this.

2nd point-not sure how you think your statement is similar to my paragraph, but it’s not.
3rd point- I wish that were true, but it isn’t. People come into hospitals every day that won’t leave alive.

your reply to old chap- while all that is true, actions have consequences, and the fallout that you mentioned was obvious from the beginning, and that includes the motivation for mislabeling covid hospitalizations/deaths. I hope in the future this will be remembered as a reason to not just push panic porn.
 
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Healthcare is very expensive. US healthcare CAN be very good, but it's very expensive. Firstly, don't conflate hospitals and pharmaceutical companies. Hospitals spend most money on actual healthcare, followed by staff, facilities, administration, etc. Larger referral centers operate either with relatively thin for-profit margins (<10%) or are not-for-profit altogether. The COVID crisis has screwed hospitals in a major way, because taking care of sick people is expensive and thus not particularly profitable. Doing elective procedures is profitable, and these have been drastically limited this year. There are hospitals who were firing ICU staff during the worst of the burst in late April and May, because they were ostensibly out of money (at least after paying their administration full salaries of course).
My wife might have a slightly different view of things after 27 years as an RN ER Supervisor in a major metro ER. I have visited with others who worked under her and almost to a person they agree that staffing at most hospitals is dangerously low.

There were times she came home frustrated because an ER nurse in her charge would have 4 or 5 patients in their care and 3 of them would be critical. Then EMS would arrive with an arrest and everybody just had to drop some patients. The hospitals do everything they can to insure everyone working is at a less than 3 year experience level - meaning they were lowest on the pay scale. Highly trained / experienced nurses were "encouraged" to retire early or otherwise just leave. Admin types were thick as fleas.

I was trained as an engineer and I worked in classified defense department programs for years while going to graduate schools. I don't know much about how to run a hospital, but I do remember an old saying, "Make the main thing the main thing." A hospital exists to care for their community. If those who invest in hospitals want to major on dividends at the expense of the people the facility serves, IMHO they have missed the "main thing."

I'm not sure what you expect of an individual doctor if you walk into a conversation already convinced of their bad intentions and lack of trustworthiness.
I didn't say I expected anything of him. I can say with some certainty that if the medical profession expects to come out of all this unscathed, they are fooling no one but themselves. Mark my words. Or don't. It doesn't matter to me, hence my invitation to join the party of professions who have lost a huge amount of public trust.
 
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