Case Fatality Rate: number of deaths compared to / the number of those that are known to have been infected.
Infection Fatality Rate: number of deaths compared to / the number of those that are estimated to have been infected.
Crude Mortality Rate: number of deaths from all-causes compared to / the number of the entire population
MONTY PYTHON HUMOR WITHIN. DON'T PANIC. STAY CALM AND CARRY ON.
Older dated entries are still relevant, and have been updated.
Projected Crude Mortality Rate, deaths from all causes globally per year, is estimated as having increased by 0.020%, due to SARS-CoV-2.
Progression of the Pandemic by Region:
USA Crude Mortality Rate, showing an excess due to COVID-19:
One thing that struck a chord with me, is when Bruce Walker says: “There are currently no highly effective treatments. There are some that have marginal impact, but we really need better drugs.” No mention of the MATH+ treatment developed by the FLCCC, which doesn't require any newly developed pharma drug, which would indeed carry a large price tag. The MATH+ treatment was applied to patients administered to ICU, and reduced mortality by 75% source
Then he says that the reduction in the number of cases is because there is more adherence to mask wearing. Adherence to mask wearing? In the southern states? I seriously doubt that. Here in Brooklyn, less than 20% actually wear a mask correctly.
Then he talks about the duration of antibodies without mention of memory cells. He covers many topics saying there isn't enough evidence to come to a conclusion, yet he talks about COVID-19 effects on the lymph node germinal centers as if they are gospel. There are only some preliminary studies. No comparison is made with other viruses. If you investigate this further, leave me a note in comments section at the bottom of this article. I think this guy gets a lot of corporate funding.
You see him hesitating in his manner, when he talks about finding a population that has sufficient number of persons that can be infected, to test the vaccine. That’s because deep down he knows what’s going down. Herd immunity is happening, de facto.
This is the video I watched: https://www.facebook.com/veritasmedical/videos/374536836892730
This guy with Veritas Medical is making quite a few interesting claims. I'll leave it to you to be the judge. I agree with some of his claims, especially the case-demic, which just highlights what I've also been writing about. However, his refutal of mask wearing doesn't take into account a comparison of populations that did adopt mask wearing with those that didn't. I can't outright refute him without following all his research, time permitting
The first article I turned up, is heading in the direction of Veritas Medical.
PCR detection of viruses is helpful so long as its accuracy can be understood: it offers the capacity to detect RNA in minute quantities, but whether that RNA represents infectious virus may not be clear.
During our Open Evidence Review of oral-fecal transmission of Covid-19, we noticed how few studies had attempted or reported culturing live SARS-CoV-2 virus from human samples.
This surprised us, as viral culture is regarded as a gold standard or reference test against which any diagnostic index test for viruses must be measured and calibrated, to understand the predictive properties of that test. In viral culture, viruses are injected in the laboratory cell lines to see if they cause cell damage and death, thus releasing a whole set of new viruses that can go on to infect other cells.
We, therefore, reviewed the evidence from studies reporting data on viral culture or isolation as well as reverse transcriptase-polymerase chain reaction (RT-PCR), to understand more about how the PCR results reflect infectivity. … Data are sparse on how the PCR results relate to viral culture results. Source: Are you infectious if you have a positive PCR test result for COVID-19?, Center for Evidence Based Medicine 20200805
I couldn't mention the words “herd immunity”, even a month ago, without outcry about how I just want to kill people. So this article has a lot to do with providing support for the idea that herd immunity is actually a factor in this pandemic. I provide support using the scientific method and logical reasoning. However, I think I am misguided in my attempts, when the receiver of the presentation does not function on logic. I'm just not good at creating a feel-good story that can sway the intuitive-visceral types, especially when the media has done such a good job at brainwashing them. That's a job for the marketing department.
I am satisfied I've confirmed herd immunity does happen, and has already happened in many regions for COVID-19. But will it last? All the evidence points to long term immunity, but this conclusion is not 100% certain. In monkeys, the immunity lasts and will not lead a population to have a second wave of infections. Lack of Reinfection in Rhesus Macaques Infected with SARS-CoV-2, Bao et al 20200501
The irony, is that by the time the vaccine arrives in 2021, most regions will already have herd immunity. Still, there are regions that have successfully contained the virus through mask wearing and contact tracing. Vaccines normally take 10 years to develop, so it is impressive that the world has fast-tracked vaccine development into just one year.
Regions that have held out with minimal spread of COVID-19, could now take the Russian vaccine. However, the Russian vaccine was only tested on 76 humans. Phase 3 clinical trials in USA require testing about 3000 people, to verify safety. Sometimes, an adverse effect only occurs in a fraction of subjects. Even if an adverse effect occurs in 1 out of every 5000 persons, and 60% of the human population got the vaccine, it would affect 1 million people… although they would stop vaccinating people before that happened?
Updated September 25:
The slowing of infection rates in regions that have surged in the past suggests that herd immunity to COVID-19 is possible. The best example of herd immunity is Stockholm, Sweden. Preventative regulatory measures in Sweden have been minimal throughout the timeline. There has only been one wave of infections, and now barely a trickle of hospitalizations and deaths.
Another example is NYC, which is easing lockdown measures without a second wave of hospitalizations or deaths. However, NYC is taking intelligent action to re-open the city while reducing the vectors that research has shown to favor viral transmission. So perhaps a second wave has not formed because of the preventative measures. More likely, their big efforts would have made an impact had they pursued them *before* the pandemic.
I could estimate a theoretical upper limit of hospitalizations per capita, or upper limit of deaths per capita, as herd immunity is reached. Does a city's deaths rate and hospitalization rate decrease when approaching herd immunity?
In following the scientific method, I must look for evidence that disproves COVID-19 herd immunity is already occurring. Perhaps I can find a city that has had a large number of hospitalizations and/or a high death toll, and despite this, is now having another wave of infections.
My previous search involved comparing countries. However, the nature of this virus includes a low dispersion factor (K), such that it does not spread evenly across regions. Thus comparing cities, or densely populated regions, is likely more effective.
Among the cities with the highest death tolls per capita, I cannot find one that is currently having a surge in the fatality rate. There is no second wave anywhere. If there was one, it would have to at least be a third of the peak rate to be able to say anything. Cities just have one quick spike in infections.
Searching the news, hoping that the stupidity rate is also slowing, I am pleasantly surprised by a number of articles talking about herd immunity. For example, this this jewel of an article that says “Hark, herd immunity is slowing down the pandemic!”. From MIT no doubt, the people that deal with nuts and bolts and common sense.
Population immunity is slowing down the pandemic in parts of the US, MIT Technology Review 20200811
Related article: Good Covid-19 News From Italy...and Sweden, bloomberg.com 20200804
There are always more infections than the cases accounted for. What I didn't know, is that influenza has a similar percentage of asymptomatic cases as that of COVID-19! I overlooked that the CDC figure for influenza is for symptomatic cases only, and thus a CFR rather than an IFR.
So instead of thinking COVID was about twice as deadly as the flu, I could see that it's much more deadly. I was estimating the COVID-19 IFR as 0.2%, and incorrectly comparing it to the flu CFR of 0.1%-0.18%. The IFR of the flu is about one quarter of its CFR. So while the number of people dead hasn't changed, if every pitch is a person getting infected, influenza simply has a worse batting average than COVID-19.
Given the number of deaths from COVID this year may be double that of a bad flu season, the IFR for COVID-19 could be as low as 0.1%. Also to be taken into account, is the difference in the percentage of a population required for herd immunity. This may be higher for COVID-19 than for influenza, not only because of a difference in transmissibility, or how contagious the disease is, but also because of a difference in the level of pre-existing immunity in the population. The belief that there is no pre-existing immunity to COVID-19 is incorrect.
More evidence to topic previously covered in “COVID-19 Immunity Likely to be Long Lasting”.
“Four independent groups of scientists—based in the U.S., Germany, the Netherlands, and Singapore—have now found that 20 to 50 percent of people who were never exposed to SARS-CoV-2 nonetheless have significant numbers of T-cells that can recognize it. These “cross-reactive” cells likely emerged when their owners were infected by other, related coronaviruses, including the four mild ones that cause a third of common colds, and the many that infect other animals.” Immunology Is Where Intuition Goes to Die, Ed Yong, The Atlantic 20200805
Why do some COVID-19 patients infect many others, whereas most don’t spread the virus at all?, sciencemag.org 20200519
How ‘Superspreading’ Events Drive Most COVID-19 Spread, scientificamerican.com 20200623
Estimating the overdispersion in COVID-19 transmission using outbreak sizes outside China, Endo et al 20200710
If K is small, then most chains of infection die out by themselves and SARS-CoV-2 needs to be introduced undetected into a new country a number of times to have an even chance of establishing itself. “If the Chinese epidemic was a big fire that sent sparks flying around the world, most of the sparks simply fizzled out.” sciencemag.org
The dispersion factor could explain, in part, why some regions are spared, while others are COVID hotspots.
“As few as 10 percent of infected people may drive a whopping 80 percent of cases in specific types of situations … SARS-CoV-2’s transmission is not as reliant on superspreading as SARS and MERS were but is far more dependent on it than influenza … Researchers have identified several factors that make it easier for superspreading to happen. Some of them are environmental. For instance, poorly ventilated indoor areas seem especially conducive to the virus’s spread. A preliminary analysis of 110 COVID-19 cases in Japan found that the odds of transmitting the pathogen in a closed environment was more than 18 times greater than in an open-air space.” scientificamerican.com
While asymptomatic spreading makes containment more difficult, a smaller K and an understanding of superspreading events is critical in the success of track and trace efforts.
Their death rate is about three times what they are reporting. So Iran actually has 683 deaths per million, which would put them neck and neck with the UK. However, Iran is just cresting its second peak in daily deaths, so they now look like the top contender for the gold medal.
Populations that have adopted mask wearing, not only do they have less cases, but they also suffer a lesser percentage of cases that end in death.
Covid-19: More cases than UK, Spain, Italy - but South Africa has lower mortality rate - we asked experts why, health24.com 20200723
Face masks could be giving people Covid-19 immunity, researchers suggest, telegraph.co.uk 20200912
This section dedicated to this article: Global Covid-19 Case Fatality Rates, cebm.net 20200609, which has a chart displaying the CFR's by country, including Singapore and Katar, which have only had young populations affected, and thus have very low case fatality rates.
Considering those over the age of 65 are 10 times more likely to die of COVID, Qatar and Singapore are not that out of line. These two countries also have the most thorough testing of any nations, according to the “events per 100 observations” column. However, despite having the most thorough track and trace, I think that for every case they find, they could be missing 2 cases.
Notice my estimate for an IFR of 0.2% is within the bounds of this chart.
Reasons for virus or antibody testing efforts to miss cases:
Even with adequate track and trace testing, cases can still go unnoticed:
My prediction is that herd immunity is being reached, where the pandemic is further widespread than estimated, and herd immunity requires less of the population than estimated. The section on herd immunity threshold covers the phenomena of non-homogenous mediums, and the reduced requirement of natural immunity as opposed to vaccinated immuniy.
Just when I thought everything was right in the world, that herd immunity had been reached in countries with the highest deaths per capita, Spain has to go and ruin everything. Esos Españoles son tramposos!
Spain cases and deaths: https://www.worldometers.info/coronavirus/country/spain
Spain positivity rate: https://ourworldindata.org/grapher/positive-rate-daily-smoothed?tab=chart&country=~ESP
Spain regions of infection:
As for hospitalizations, I can't find anything but a news source showing a doubling in the COVID-19 hospital admissions rate, between July 12-22: Coronavirus crisis in Spain: data from 10 regions shows rise in cases and hospital admissions, elpais.com 20200724
“ It is important not to compare the absolute figures from March and April, given that detection is much better today and a greater percentage of cases are being identified. “In March, for every case confirmed by PCR tests there could have been 10 (if not more) who were not diagnosed. Now we are sure that the number is much lower,” explains Rossell. ”
It's too bad you don't have the data on hospitalizations, señor Rossell. It would be useful to compare the present to the heights reached in March and April. I guess we will just have to use the deaths data as it starts to trickle in.
Is this new wave happening in provinces that were not affected previously? New York Times itemizes the deaths and case counts per individual provinces in the following tables:
The case counts cannot be compared between March/April and the present, so I will once again assume that regions with the highest deaths per capita are near herd immunity.
The action is happening in Aragón, which has had half as many deaths per capita as the worst affected provinces. I can estimate that Aragón needs to approach herd immunity by obtaining a death toll closer to the provinces of Madrid and Castille-La-Mancha. However, the population of Aragón is small compared to other provinces. So based on Aragón, I could predict that the coming wave of daily deaths will be small compared to the height of the epidemic in Spain.
I hope there aren't other provinces that need to turn in a late death toll homework assignment. If the same were to happen in Andalucía, the most populous province of Spain, and also one of the lowest in deaths-per-capita, the situation would elevate Spain to levels greater than any other country.
That would put a big hole in my hypothesis, that herd immunity was close to being reached by countries with the highest deaths per capita. It well may be that a larger tide of cases and deaths is being held back by a new normal of mask wearing and contact tracing. While I have been comparing countries, more accuracy could be had by comparing cities. The results may be rather scary.
But let me not be so fatalistic. Maybe the lack of congruity in the data from different regions of Spain, has more to do with the lack of reporting. Maybe the virus has already spread to all of Spain? Take a look at this article: More Than 90% of People Who Have Tested Positive for COVID-19 in Andalucía Showed No Symptoms, theolivepress.es 20200702 So there, I was being fatalistic for nothing.
Contagions in Spain Multiply by Eight 40 Days After the Tip of the State of Alarm, pledgetimes.com 20200811
This article tells you as a matter of fact, that the increased number of cases is due largely to increased testing, that the number of hospitalizations are nowhere near the peaks reached beforehand, that some small increases are to be expected from the end of the lockdown.
In contrast, articles like this one are scary sensationalism: The number of infections, deaths, hospitalizations and patients in intensive care continues to rise, with the cumulative rate of Covid-19 now nine times higher than what it was in mid-June, elpais.com 20200805
Update 20200823: As expected, no second wave of daily deaths is occurring in Spain. The death rate has increased very slightly, but nowhere near the level of the first wave (not even 1/25th the highest death rate), suggesting that the large increase in cases is an artifact of increased testing. If I looked up hospitalizations, I would see the same.
The population density of Andalucía is very low compared to Madrid, but that of Castille-La-Mancha is even lower. Castille-La-Mancha's largest city has only 150K inhabitants and a density of 150/km^2, which pales to the size of the size and density of the largest city in Andalucia. Yet despite its very low density, Castille-La-Mancha managed to have the highest deaths per capita in all of Spain. Once again, population density and transmission are not showing a correlation, so there must be larger confounding variables.
As covered previously, testing has expanded across USA. There may be no limit to the number of tests that can be conducted on those who present themselves for testing. The matter may be getting people to go and have themselves tested.
In the beginning, with the mass hysteria and panic brought on by the news channels, people went to get tested because they thought they were likely going to die from getting sick with COVID-19. Case Fatality Rates as high as 20% were publicized by the media. “I have a tickle in my throat, OMG, I need to go to the hospital!” In early April in NYC, those frightened individuals were turned away, and told that if they don't have a fever, they don't have COVID-19. That was when there was a testing capacity shortage.
Question at Quora, late April: “If the US medical community is sending people with non-severe symptoms of COVID-19 home without testing, then are the numbers of COVID-19 positive much higher than what’s being currently reported?
Despite the expansion in testing, many states still do not test a sufficient number of cases. The percentage of tests that are positive should remain constantly low, if they are testing a sufficient amount of the population. WHO recommends 5%, assuming surveillance for suspected cases is comprehensive. This means that ideally, the amount of testing would increase or decrease with the amount of existing COVID cases in the population, which would mean tracking an unknown number of cases with time. At least in theory.
If the following chart from Our World In Data is accurate (which is in question), then the steep drop in the testing positivity rate should indicate that testing capacity became nearly sufficient around mid-May. The chart represents the USA average. Individual states have fluctuation in the positivity rate depending on the state and the calendar day, which can be seen at John Hopkins: Which U.S. States Meet WHO Recommended Testing Criteria?.
Mid-May to mid-June was the golden era, where people were sufficiently frightened to go get tested even if they were feeling just-a-bit-off.
Now, the word has spread that the chance of ending up dying or in ICU, is much much lower. People are still panicked, but are willing to wait and see if they are actually sick. Which represents a problem. How are you going to keep the positivity rate low, at the WHO recommended level, if only the bloody sick are showing up to be tested?
An example of this hardship, is the empty testing capacity in Arizona: “Federal, state, and local government agencies continue to provide free diagnostic testing in Maryvale and South Phoenix – the two testing sites launched on Friday. With both sites operating throughout the weekend, there have been minimal wait times and plenty of available appointments. Up to 5,000 tests can be conducted each day – 2,500 at each site – to serve up to 60,000 Arizonans. As of Tuesday morning, only 5,537 of the 20,000 available tests since Friday have been used.” az.gov 20200721
It's really curious that they can't get people in Arizona to use up all the available free tests. It seems they are exhausting the population that have the inclination to get tested. They are offering free tests, but people aren't showing up.
The increase in the positivity rate may not have to do with increased prevalence of the disease, but more to do with social opinion of hospitals and government. People can't stand to deal with bureaucracy so much, that they would rather die of COVID-19.
Another reason people may not want to get tested, is that COVID-19 has a negative stigma associated with it. With all the news of reinfections, people who continue to get sick from COVID, it is easy for many to have the impression that COVID is like a venereal disease that's going to follow you for the rest of your life.
Maybe they want to stay as far away as possible, from people that are going to get tested for COVID-19. Maybe they would rather not know, where knowing means having to isolate yourself for weeks.
So you end up with patients coming in via ambulance, because they procrastinated getting tested as long as they could. This in turn, gives you a higher positivity rate, and testing clinics sitting around twiddling their thumbs.
“Why have numbers plummeted so drastically? “We don’t really know why,” says Ryan Kiessling, BRF’s operations manager. “It seems to be fatigue.” That’s probably a pretty good theory. According to a Gallup poll this month, many Americans think the situation in the US is getting better. With more businesses and more recreation areas like beaches opening up again, people are more willing to let their guard down and abandon the wearying habits they’ve kept up for several months: they are increasingly resuming regular activities, and the number of Americans practicing isolation dropped from 75% to 58% in May. And that also means they may view testing with diminished importance. “People are just feeling really tired about anything that has to do with covid at this point,” he says. “They just want it to be over, even though it’s not.” ” The US now has more covid-19 tests than it knows what to do with, technologyreview.com 20200627
In UK, the government is considering keeping kids from going to school, because otherwise they can't also keep the pubs open. It's a matter of national priority. Coronavirus: Pubs in England likely be exempt from any new restrictions, independent.co.uk 20200804 Alcoholics Anonymous is also banned from having home meetings. Let's give a toast to the UK!
NYC went viral this spring. Viruses voted NYC as one of the top vacation spots. The density of unmasked juicy New Yorkers was to die for. Subways packed like sardine cans, small indoor spaces, loads of restaurants and entertainment venues. It was a truly remarkable season.
The deaths peak is over 600% above the normal rate for all causes of death. Now there's a pandemic to write home about!!
The writing has been on the wall for long enough. The solipsistic, being super creative, may be able to persist with cognitive dissonance indefinitely. However, if the scientific method has its due, many of those having come to dubious conclusions driven by fear and self-preservation, will be pressured to invoke imaginative thinking, the likes of which will exclude any personal accountability.
News sources have a financial conflict of interest in cultivating cliffhanger drama for readers to come to day after day. The New York Times, having milked this drama out for as long as possible, is starting to allow some sanity to surface. I find it interesting that an article covering textbook science by two professors of immunology at Yale University, is published in its “opinion” page.
Scared That Covid-19 Immunity Won’t Last? Don’t Be, nytimes.com 20200732
“Dr. Mina had choice words for the physicians who caused the panic over reports of reinfections. “This is so bad, people have lost their minds,” he said. “It’s just sensationalist click bait.”” Can You Get Covid-19 Again? It’s Very Unlikely, Experts Say, nytimes.com 20200722
I don't think herd immunity is something to work towards. It is happening on its own. It can be slowed down with draconian measures, but at too great a cost. Forced lockdowns are more detrimental to the poor than the virus is on all others combined. Compulsory mask wearing takes away freedom. I believe the worse outcome is taking away an opportunity for growth. Progress towards a better society can only take place where individuals have the responsibility to protect each other. Including protecting each other from the pervasive conflict of interest imposed by instinctual behavior and capitalism.
Wow, why did I not see this in the news before? They have data on the number of hospitalizations for USA COVID patients? That could be better than the deaths data, because, among other variables, doctors are learning to better treat the disease.
Apparently, the hospitalizations data comes from a CDC project called COVID-NET: COVID-19-Associated Hospitalization Surveillance Network and has a disclaimer that includes only covering approximately 10% of the US population.
Now, see how nicely that compares with the daily death data? A big hump, followed by a second smaller hump. As expected, the second hump is proportionately smaller in the daily deaths chart. Feel free to replace the word “hump” with “wave”.
Then comes Covidtracking.com from Atlantic Magazine. They are supposedly doing what the CDC could not: tracking all the data. See their message. The hospitalizations chart is different than that from the CDC, perhaps because they are following hospitals in hot spots that the CDC isn't. You can't be too hard on the CDC: Cuts to Prevention and Public Health Fund Puts CDC Programs at Risk,the-scientist.com 20180209
Liz Kalverda, virologist, brought up a good point. If you test positive for COVID-19, does that automatically get you hospitalized? During the beginning of the pandemic, it was a UK policy to hospitalize everyone with COVID, which is probably why they managed to kill so many people. This is likely not the case in USA.
When you are collecting data, you need some semblance of consistency. I don't care how messed up each state's methods are, so long as they continue to be messed up in the same way. Trump has ordered hospitals to send data directly to a company named Teletracking. I can imagine that their funding depends on being agreeable to the Trump administration. Going forward, I don't know if I will trust any data. The Time Magazine article has given its best effort in unbiased reporting of the situation.
New York Times article Where the Virus Is Sending People to Hospitals states: “Public health experts say detailed local data on where people are hospitalized — a real-time measure that does not depend on levels of testing — is crucial to understanding the epidemic, but federal officials have not made this data public.” Can I assume this is because the CDC no longer has access to the data?
Click to sort by columns, and there is a slider at the bottom where you can adjust the dates:
7 Day Rolling Average of Confirmed Deaths Per Million by Country, ourworldindata.org
Another site, providing John Hopkins data:
New Deaths from COVID-19 per Day, normalized by population, 91-divoc.com
In regards to John Hopkins University's use of Worldometer data: “I think JHU has been under a lot of pressure to update their numbers,” he said. “Because of this pressure they have been forced to or incentivized to get data from places that they shouldn’t have, but in general I would expect JHU to be a fairly reliable source.” Quote from Edouard Mathieu, the data manager for Our World in Data (OWID).
Due to the mass-hysteria in the public, misinformation has been spreading that once you have Sars-COV-2 you have it for life.
HIV and chickenpox are proviruses. They integrate into the host DNA. Coronaviruses are not proviruses. Once you are over COVID, you do not have a life-long affliction.
COVID-19 2021 Safety Patch, to be worn at all times:
Liberals don't seem to like this series of posts, even though I'm providing evidence to improve the situation. Perhaps they are convinced I'm trying to trick them? Many liberals have become what they supposedly abhor: close-minded. There's a genetic trait that predisposes someone to be uncomfortable with ambiguity. They are typically conservative, but if you grow up in a liberal environment, you are actually a conservative in liberal clothing.
The article from The Atlantic: COVID-19 Cases Are Rising, So Why Are Deaths Flatlining? has the hypothesis that the reason the number of daily deaths has not increased with time, is that deaths lags cases. This is true, as in the case of Iran covered in a previous entry, the lag was between 4 and 6 weeks. However, Iran was the only country I could find as an example of this. Many other countries had an increased rate of cases, but no increased rate of deaths.
The Atlantic article places too much importance on the lag time, saying “that might explain almost everything”. I think it is more likely, that the increased amount of testing is revealing more cases.
The limited amount of testing in the past did not fully capture the pandemic. The testing capacity was only sufficient for the critically ill. Many less severe cases went undiagnosed, and recovered without treatment. With increased testing, more of these hidden cases were counted. The surge in cases only created the appearance that pandemic was growing, when it had been of great magnitude all along. I've covered other reasons for increasing number of cases relative to deaths, but I believe this one point is overly underestimated.
There may have also been deaths that were not counted as COVID-19 related, because the disease was thought to be only a respiratory infection. However, I think the number of cases of deaths was dwarfed by the number of asymptomatic and untreated cases that went untested early in the pandemic. Countries experiencing a second wave of cases, and no second wave of deaths, were only catching up to a real metric of COVID cases occurring in the population.
In USA, The situation has changed dramatically. Currently, many states, such as New York, have opened up dedicated testing sites and are encouraging everyone to get tested, whether they have symptoms or not.
New York Times has an ongoing map of the current regions worst affected by COVID-19. I'm fairly certain COVID has had time to establish itself in all metropolitan regions of the US for a few months, with the current hot zones being in the south.
Most importantly, the USA outbreak wave of deaths per capita was larger than that of Iran, comparable to countries that did not have a second wave of daily deaths coming out of lockdown. For this reason, I don't expect much of a second wave of USA deaths.
The New York Times opened my eyes to evidence that I overlooked. The percentage of tests positive for COVID should have decreased with additional testing. Instead, it has increased. Spike in U.S. Cases Far Outpaces Testing Expansion So an important pillar of support is knocked out for the improbability of a second wave of daily deaths.
What could be going on here? Looking at the testing data from John Hopkins, not all states are carrying out an equal number of tests per population size. The positivity rate could be affected if the testing was concentrated at the current hot spots, rather than spread homogeneously throughout USA. However, this does not appear to be the case.
This would mean that the actual number of COVID cases is increasing. People are returning to work, returning to restaurants and bars, participating in protests, or enjoying summer gatherings. Doing all the things that the Swedish have been doing all along, and then some.
An actual, real-life surge in the number of cases predicts that more deaths will follow. Maybe USA is bad at taking it easy, and the percentage required for herd immunity will be greater. Good evidence for herd immunity would be a decreasing positivity rate with a constant testing rate. Alternatively, a constant positivity rate with a diminishing testing rate.
Countries with high death rates early in the pandemic did not experience an increase in deaths after easing lockdown, and this could be attributed to herd immunity.
As mentioned previously, there are factors that favor a declining death rate. One is that doctors have more experience treating the disease. Another is that the most vulnerable were killed off early. Yet another variable, is that the number of deaths was underestimated earlier in the pandemic, so the initial wave in the rear view mirror appears smaller than its actual size.
A next step would be to compare the countries with the highest overall deaths per capita. Do they now have low daily death rates? If USA deaths per capita is getting close to the other big winners, then a second wave in daily deaths is less likely.
Belgium was overestimating deaths, and is thus disqualified. There's no way USA can beat UK, so I'd guess the US still has at most another 200 deaths per million to go. The second wave, if more than a speed bump, will not be as big as the first.
I could be all wrong. Many believe we are nowhere near the level of actual COVID cases required for herd immunity. Maybe the reason that the countries with the most deaths per capita are now having low case and death rates, is that they are following the protocols required for containment, namely mask wearing and contact tracing. So lets take a closer look and see if this may be the case.
Mandatory Face Mask Rules Spread Across Europe Amid Uptick in Coronavirus Cases, time.com 20200724
Face masks: what are the rules in EU countries? cgtn.com 20200704
The World Is Masking Up, Some Are Opting Out, bloomberg.com 20200717
The bloomberg article shows that Sweden is the only country with a continued lack of mask wearing and a cumulative high death toll. Denmark, Norway, and Finland got along without mask adoption by containing the virus with contact tracing after initiating lockdowns and closing borders. Thus only Sweden is a possible example of herd immunity, having few daily cases, where mask wearing is not a factor reducing virus transmissibility.
Sweden's herd immunity appears to have a lower percentage requirement than countries with larger per capita death tolls. Sweden has a reputation of being mostly rural, but this is not the case. The rural population of Sweden adds up to only 13% of the total.
Although never having a lockdown, the government chose select measures to reduce transmission optimizing safety and freedom of choice. Government workers that can work from home continue to be mandated to do so. Outside of government, however, public policy is based on recommendations.
One example, is DIY contact tracing. As of July 20th, Sweden chose to give individuals infected with COVID-19 the responsibility of telling others they have been in contact with. reuters.com 20200720
I had intuitively assumed the death data would be more accurate than number of cases, but I decided to investigate.
In the United States, ”…public health experts say the method used to count deaths from a disease like Covid-19 is decades-old and some amount of uncertainty is simply part of the process. … Many more death certificates show Covid-19 as a cause of death but do not match up to positive coronavirus cases found through disease surveillance. If a person dies from Covid-19 without a lab test, that is a probable death. The C.D.C. has said probable deaths are a standard part of the counting process.“ Is the Coronavirus Death Tally Inflated? Here’s Why Experts Say No, nytimes.com
Both undercounts and overcounts of COVID-19 deaths are possible, Wolfson said, but it's not yet clear which is more likely, or whether they might simply balance each other out. Fowkes said that based on her experience, it's more likely that COVID-19 deaths are being missed than overcounted. That's because New York is among several cities that show spikes in deaths at home, and these anomalous spikes could be due to untested, untreated COVID-19.
Perhaps, the best clue as to whether COVID-19 deaths have been undercounted or overcounted is excess mortality data. Excess mortality is deaths above and beyond what would normally be expected in a given population in a given year. CDC data shows a spike of excess mortality in early 2020, adding up to tens of thousands of deaths.
Some argue that many of these excess deaths are related to COVID-19 lockdowns, not COVID-19 themselves, Faust said, because people fear catching the disease if they go to the hospital for other reasons. A study in the Journal of the American College of Cardiology did find that nine major hospitals saw a 38% drop in emergency visits for a particular kind of heart attack in March. That suggests that people really are delaying or avoiding medical care, which could mean that some of them die of preventable causes.
But non-COVID conditions probably don't explain most excess deaths, Faust said. Only a portion of heart attack visits would have represented lives saved, he said, because doctors must treat perhaps 10 patients to save one life. And other causes of death — such as motor vehicle accidents — are down.
This could change with time, Faust cautioned. For example, if cancer patients forego their treatments for a year, rather than a few months, the impact on their death rates is much more likely to be noticeable in the population-wide data. But for now, he said, “it's unlikely that the coronavirus deaths are being overcounted by a magnitude that explains our observation that something very unusual is going on.”
So the reason for the possible under-reporting of deaths is that ”…many deaths occurred before we were able to test for the disease.“ (Quote from Dr Fauci) What counts as a COVID-19 death?, wtsp.com. Which would mean, that with the current higher level of testing, this under-reporting should be much less or negligible.
Not to be confused with the over-reporting of CASES, covered on May 24th
The amount of tests carried out, increases the number of cases found and reported, and affects the R0 models if they don't take into account the increased testing. The test subjects can range from only the very sick, to anyone that chooses to be tested, mostly depending on test kit availability.
“During the lockdown, India saw hundreds of deaths not due to Covid-19, but as a fallout of the measures taken” Why Covid-19 hasn't been the only killer during lockdown, indiatimes.com “Deprivation and distress caused by the total standstill, as captured starkly in the exodus of migrant workers back to their native places and the long lines for food and relief, were not without their share of tragic outcomes. Research by a group of volunteers shows India saw hundreds of deaths amid the crisis that were not due to Covid-19 directly but as a fallout of the lockdown itself.” The article talks about how the world's poorest are the hardest hit by loss of income.
I'd like to see the lockdown promoting, high-fear-homeostasis persons, promote that idea for the welfare of the poorest. Not going to happen. It will just be an uncomfortable fact brushed aside, while in their minds they continue in virtue. Even if lockdowns were necessary, they would benefit the priveledged at the expense of the poor.
The article cites the following study from The Lancet: Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study. ”…if routine health care is disrupted and access to food is decreased (as a result of unavoidable shocks, health system collapse, or intentional choices made in responding to the pandemic), the increase in child and maternal deaths will be devastating.“ COI: funding by Bill & Melinda Gates Foundation
This is a minor unimportant detail. I want to report for thoroughness.
Update 20200730: This can be automated using OurWorldInData's Data Explorer. There is a slider at the bottom to adjust the dates.
When people get fixated on one way of thinking, they are unable to view data and come to objective results.
Due to lack of full scale testing, the data on the number of cases has been “almost meaningless”. So you have to go by the number of deaths, which at least has a chance of accuracy. 89% of COVID deaths are caused in part by underlying conditions, such as heart disease and cancer, which are the highest ranking causes of death. Time will tell if the CMR crude mortality rate for the entire world goes up significantly due to COVID.
Even if we count all the deaths as just due to COVID, the death rate in the worst affected regions, during the height of the death rate would be around 10 deaths per million per day. Per MILLION. Given the peak death rate doesn't continue, by the end of the year you would have less than one death out of every 1000 persons. Not exactly Black Plague that killed one in three persons in Europe. The following video clip is a historical documentary of the black plague.
People have an instinctual, primordial fear homeostasis. They fear the most miniscule things, because actual things to be afraid of are no longer around in modern society. No lions or hyenas going to hunt you down.
The media, makes money on whatever draws eyes. So they push the pandemic to the fear hungry readers. You can read about how effective a COI is at influencing behavior, here.
The best reason to slow the spread of the virus, is to give the medical field time to learn how to treat the sick. Too often they have been killing patients while trying a therapy that makes their condition worse.
How deadly is the coronavirus? Scientists are close to an answer, nature.com 20200616
This article by Nature magazine is saying that the IFR is 0.6%. I think this will lower in time. People are still in denial, and may overlook a flaw in assessing the data. Remember that some originally said the CFR was 20%. Over time, the scatter plot of claims went down logarithmically.
New estimate by CDC reduces COVID-19 death rate to just 0.26% (IFR) from WHO’s 3.4% (CFR), dental-tribune.com 20200524
I found this older article, that is lower than anything I could find on Google when I was searching in June.
The infection fatality rate of COVID-19 inferred from seroprevalence data, medrxiv.org 20200714
“Across 32 different locations, the median infection fatality rate was 0.27% (corrected 0.24%). Most studies were done in pandemic epicenters with high death tolls. Median corrected IFR was 0.10% in locations with COVID-19 population mortality rate less than the global average (<73 deaths per million as of July 12, 2020), 0.27% in locations with 73-500 COVID-19 deaths per million, and 0.90% in locations exceeding 500 COVID-19 deaths per million. Among people <70 years old, infection fatality rates ranged from 0.00% to 0.57% with median of 0.05% across the different locations (corrected median of 0.04%).”
Related article: Covid-19 vs Influenza, entersingularity.com 20200323
Why herd immunity to COVID-19 is reached much earlier than thought, judithcurry.com 20200510
Herd immunity can be achieved at 43%, new study finds, hindustantimes.com 20200625
The study: A mathematical model reveals the influence of population heterogeneity on herd immunity to SARS-CoV-2, sciencemag.org 20200623
Italy's hard-hit region nears 'herd immunity' as more than half of people tested show coronavirus antibodies, foxnews.com 20200610
Covid-19 immunity could be twice as high as believed, Swedish study finds, telegraph.co.uk 20200630
Herd Immunity May Be Closer Than You Think, wsj.com 20200706
The impact of host resistance on cumulative mortality and the threshold of herd immunity for SARS-CoV-2, medrxiv.org 20200716
Natural herd immunity against Covid-19 could develop from just 10% of the population getting infected — not the 60% predicted from a vaccine, dailymail.co.uk 20200714
“ Another new study takes a different approach to estimating differences in susceptibility to Covid-19 and puts the herd immunity threshold even lower. The paper’s 10 authors, who include Gomes and Langwig, estimate that the threshold for naturally acquired herd immunity to Covid-19 could be as low as 20 percent of the population. If that’s the case, the hardest-hit places in the world may be nearing it. ” The Tricky Math of Herd Immunity for Covid-19, wired.com 20200712
Kudos to containment, because nobody needs to get another virus. It's like mosquitoes. Sure you can live with them, but if you can wipe them off the face of the earth, then yeah!
Can the virus be eliminated by containment, stopping the virus, before it can spread? Some countries are having success, while others are not. Countries not having success, won't they spread the virus along eventually? Maybe countries practicing containment will have a mandatory COVID test for anyone traveling across their borders, especially from a country known for having COVID-19. Although, countries with a prevalence of COVID-19 will eventually have herd immunity.
I can imagine those recovered from COVID-19 getting passports, and not have to wear a mask, and other liberties. I can imagine some people getting sick on purpose, just to have the liberty afforded by the passport.
The countries having the best success in containing the virus, are practicing compulsory mask wearing, and contact tracing. Including ones that are not having a lockdown. It appears a lockdown is not necessary for containment. It certainly isn't worth the repercussions on society, including psychological damage from isolation, and the financial hardship suffered by the poorest.
The idea that lockdowns are not effective, doesn't make a lot of sense. But consider that there is a human element. I hypothesize that in countries where citizens are used to following strict orders, like China, a lockdown might be effective. Countries where citizens are used to personal freedom are more likely to break rules and seek the company of their close friends, and contagion mostly happens in close quarters. New Survey Suggests 66 Percent of All New Hospitalizations Statewide Are From People Sheltering at Home, ny1.com 20200607
One example where lockdown appears to be effective, is in Iran. It is the only country that had a second wave of daily deaths when emerging from lockdown. More details in the entry for May 9th.
Related article: Do Lockdowns Save Many Lives? In Most Places, the Data Say No, wsj.com I haven't read it due to paywall.
Update 20200728: Related and likely more accurate than measurements of R0 based on cases, is the hospitalizations data covered on July 28.
One reason.com article from June 30, wants to support my case about lockdowns not being effective. “Did COVID-19 Lockdowns Reach Back in Time to Affect Behavior Before They Were Imposed?”. They present evidence that lockdowns have no noticeable effect on the spread of the virus. See the chart below. Original source of chart, with all the other states ← hover over each state chart to see “shelter started” and “shelter ended”.
My response to this article, is that the chart does not show a sudden drop in R0 after the lockdown day, because not all people take the same amount of time to show symptoms and get tested to be a case.
It's possible that in some states, herd immunity was already taking place before the quarantine lockdown. During the lockdown period, people developed better habits. Then the lockdown was not removed suddenly, but instead a few restrictions were removed with care, making sure not to allow “superspreading” events, like bars and sporting events. This reduced the percentage of the population required for herd immunity, such that R0 has been kept under singularity. Therefore, containment.
Then there's the issue that the value of R0 depends on the change in the number of cases reported over time. Testing capacity has increased over time, so this can make R0 appear to increase, when the actual number of cases is diminishing. This can make R0 itself as useless as the cases data.
You can't really compare numbers from one model to another, so in comparing different countries, you have to make sure the same model was used. “…estimates are very different, and it is probably more useful to look at the trends within each model than to compare reproduction numbers across models.” preventepidemics.org
Also important to note, is that each country's increase in testing ability over time will artificially increase the measured reproductive number. “…results are impacted by changes in testing effort, increases and decreases in testing effort will increase and decrease reproduction number estimates respectively (see Methods or our paper for further explanation).” epiforecasts.io “For example, if numbers of incident infections remain constant but a country begins to find and report a higher proportion of cases, then an increasing value of the reproduction number will be inferred. This is because all changes in the number of cases are attributed to changes in the number of infections resulting from previously reported cases, and are not assumed to be a result of improved testing and surveillance.” welcomeopenresearch.org
While death counts are not entirely accurate, they are more accurate than the number of cases reported for COVID-19. Coronavirus Case Counts Are Meaningless, fivethirtyeight.com Confirmed Coronavirus Cases is an 'Almost Meaningless' Metric, bloomberg.com Daily new cases are not an accurate assessment, because not everyone who is infected with COVID gets tested. Governments are ramping up their testing abilities to test more people, so an increase in daily new cases can misrepresent the progression of the pandemic.
Update 20200611: “Sweden announced its highest daily tally of novel coronavirus infections on Thursday, a record 1,474 new cases that authorities said was due to a long-delayed surge in testing.” Coronavirus cases hit daily record in Sweden as tests ramp up, reuters.com
Update 20200616: “…Prime Minister Stefan Löfven insisted that the situation was improving in Sweden: 'During a period where we have a high number of people being tested, it looks like we have a sudden increase in cases. But the number of people hospitalised for Covid-19 is going down and the number of deaths is going down. So authorities have to start comparing apples with apples, instead of apples and oranges,' he told Swedish Television on Sunday.” Will Sweden's reputation survive its unique coronavirus response?, thelocal.se
Given the downward trajectory of daily deaths, Sweden is on its way to accomplishing herd immunity?
The decrease in daily deaths could also be attributed to the previous deaths of those with terminally ill diseases, like cancer and heart disease, who, being hospital mainstays, were exposed and succumbed to the virus. Perhaps there are now less terminally ill for the virus to prey on.
Doctors may also be doing a better job of treating patients in critical condition, where before their efforts were either futile and/or made the patient's condition worse.
Apart from testing for the virus itself, there is antibody testing. Antibody tests may not be accurate, because those already recovered from the virus will gradually cease to produce antibodies, while still being capable of producing them in case of another exposure to SARS-CoV-2. However, current studies are pointing to a likelihood, that the half life for antibody production is long enough to not affect current antibody tests. Then there is also T cell immunity, which does not require antibodies. I think the daily deaths charts are more indicative of the current state of the COVID threat.
Whilst research by the University of Amsterdam is not encouraging regarding CV19 immunity as it suggests antibodies may only protect for 6 months, (Edridge, et al (2020). Human coronavirus reinfection dynamics: lessons for SARS-CoV-2). Other data, however, is suggesting T cell response may provide long term immunity to COVID19 and indeed that T cells from a previous, different coronavirus respiratory virus outbreak in Germany a year or two ago, already gave immunity to many in Germany. See T cells found in COVID-19 patients ‘bode well’ for long-term immunity.
This may explain why some areas of the world are experiencing the pandemic very differently from others. Particularly encouraging in this respect is the fact that T-lymphocyte immunity against the Middle East Respiratory Syndrome coronavirus (MERS), can be detectable for 4 years. See What policy makers need to know about COVID-19 protective immunity.
This interview with the Chair of Oxford University Medical, Professor Sir John Bell, by former UK Secretary of State for Health, Lord Waldegrave is very informative regarding immunity. Sir John is responsible for the Chadox1 vaccine programme in which the US has just invested $1 billion in return for an option on 300 million of the first 1 billion doses. source
Project fear tells us there is no immunity, we will get it repeatedly and we will all die at least twice. Actually the reports of people getting it twice are pretty iffy and not repeated anywhere else. Best studies show 97% get measurable IgG: maybe the other 3 just didn’t quite tickle the threshold. Even if the antibody levels drop over time, experience with other viruses suggests reinfection will boost immunity before getting sick. So I see no evidence to be scared of getting it twice. Those with shares in drug companies and vaccine manufacturers might try and peddle a different story. As always with dramatic headlines “follow the money”. Dick Stockley, doctor, general practitioner
In conclusion, reinfection with SARS-CoV-2 seems unlikely taking into consideration our knowledge on viral neutralizing antibody duration from past respiratory illnesses, the type of specimen collection and technical errors associated with each component of swab testing, the methods used before discharging these patients, the presence of fecal viral RNA without evidence of replication-competent virus in fecal swabs, and finally the reassurance from the animal study. COVID-19 Reinfection: Myth or Truth?, SN Comprehensive Clinical Medicine
Related Article: Coronavirus hopes and fears center on 'immunity', medicalxpress.com
Dedicated to all you Vader Haters
The Virus Wars website reviews that you breathe in over 100,000,000 viruses every day. “Each of us has more than 10 billion different kinds of antibody – that means there are more different antibodies inside you right now than there are people in the world.” You don't think of people as constantly sick and contagious. Why would those immune to COVID become reinfected and contagious? Don't listen to CDC, they value their jobs too highly to educate the public. They would rather say they don't know.
It appears the CDC and many states are confounding the number of new cases, by combining positive results from both COVID tests and antibody tests. How Could the CDC Make That Mistake?, the atlantic Someone who has already recovered from COVID, will test positive for antibodies, but that doesn't mean they are a new COVID case, to be reported in statistics for daily new cases.
“The Centers for Disease Control has been lumping together tests for active coronavirus with tests for recovered patients, boosting testing totals but muddying the pandemic’s course.” C.D.C. Test Counting Error Leaves Epidemiologists ‘Really Baffled’,nytimes.com
As the CDC has stated, the high end of a flu year claims the lives of 646K individuals on Earth (between 291,000 and 646,000). How are we doing at the moment with COVID?
If precautionary measures had not been taken, I think the death toll would be greater, but not far beyond 1 million.
I read statements like: “There is no certainty at the moment that being infected with Covid-19 offers permanent, or even temporary, immunity against the virus.” I really doubted this was true, because how can you recover from infection without antibodies? So I asked a virologist, Liz Kalverda. She said:
You have generic immunity which attacks anything non self as well as learned immunity. It takes quite a while to “train” the lymphocytes. Plus babies don't develop this lymphocytes based immunity till they are about 6 months old. Immunity only applies to b and t cells.
So I asked, what about these super accurate antibody tests coming out?
Feeling annoyed at being asked so many questions, she briskly inserts the genetically engineered coronavirus test tube into the centrifuge, and responds:
Ok, long answer…
Antibodies are part of the learned immunity system. The cells involved in immunity are the memory b cells. Your b cells make antibodies which help to clear viruses (which occurs quite late the first time your body experiences a virus). One b cell can make loads of antibodies, so the antibody levels can raise quite fast without there being that many specific b-cells produced. If you don't make enough memory cells the immunity won't last long (if at all).
If you have a really mild case, which the body gets rid of quickly, it may be too quick to have started making antibodies. If the infection lasts a bit longer you may be producing antibodies, but not have enough memory cells to maintain immunity. Once you have recovered fully from the virus, even if you are immune you won't have antibodies, as they are only produced when exposed to the virus.
This is why if you are unsure if you have been exposed to TB, or if the vaccine has taken, they give you the skin test to see if you have an immune reaction to it, as they can't see the antibodies just in the blood normally.
When you have a vaccine it tends to have adjuvants in, which are there to activate your immune systems so you produce the b cells quicker (although newer vaccines work differently).
Therefore if you have the virus, and have been moderately ill for a few days you will probably have antibodies, but may not have immunity. If you have immunity but have not recently been exposed to the virus you may be immune but not show antibodies. This is why antibody testing may be useful to see if you have the disease, but may not show that you've had it, or are that you are in the early stages of the disease. This is why we haven't been successfully using antibody testing, because it is being used on the wrong population of people.
When I asked Guy Grotke, B.S. Biology & Chemistry, How certain is it, that everyone who gets COVID-19 develops antibodies? Is it possible to get over COVID without antibodies?, he answered:
People could make IgM antibodies but not the longer lasting IgG antibodies. This is call “failure to seroconvert”. A lot of immunologists are concerned about this possibility. You also have an innate immune system that could kill of a very light infection with no antibodies at all.
I'm sure there isn't certainty of just about anything, and we should be aware what possibilities exist. However,
…it looks like SARS-CoV-2 probably induces immunity like other coronaviruses. That means that the human body will probably retain a memory of the virus for at least a few years and should be protected from reinfection, at least in the short-term.
“We do not have any reason to assume that the immune response would be significantly different” from what's seen with other coronaviruses, said Nicolas Vabret, an assistant professor of medicine at the Mount Sinai Icahn School of Medicine who specializes in virology and immunology. source
Any city or region or country, who instead of having lockdown chose the goal of achieving herd immunity, may serve as a reference. If their daily-cases and daily-deaths is decreasing with time, the downward trajectory would imply that herd immunity is having its effect.
By the 5th of May, more than 50 countries have made mask wearing compulsory. Austria had a 90% drop in COVID cases two weeks after requiring people to wear face masks. “Czech Republic and Slovakia. As two of the first countries to make masks compulsory in Europe, they now enjoy a small infection rate per capita.”
Most Swedes still do not wear masks: “Many factors would affect the unfolding scene of humankind’s future. But it is not implausible that that scene is better when Swedes mostly do not wear masks on public transportation than when they do.” This is because the Swedish approach is to arrive at herd immunity, where roughly two thirds of the population is immune. “Giesecke argues that the virus is essentially unstoppable, until either herd immunity is reached or an effective vaccine is widely available, perhaps nine to 18 months from now, according to the most hopeful projections. In a letter to the British medical journal Lancet, Giesecke wrote that “everyone will be exposed” and that strict lockdowns only push severe cases into the future.” source
However, could it be possible to reduce R0 below singularity, such that the contagion extinguishes without reaching its potential percentage of the population? There wouldn't be herd immunity, but it wouldn't matter if the virus were to go extinct. Do we really want to cause the extinction of another of God's creations? (Oh yeah, that's sarcasm) In Denmark, lockdown has been eased and through precautions, R0 has been lowered to 0.9. Technically, R0 decreases with time, the greater the percentage of persons are already immune.
Since the start of the pandemic, the death counts from COVID-19 may be under-reported. A few data samples show that all-cause mortality (aka Crude Mortality Rate) has increased significantly more than what is being reported for COVID-19: https://www.weforum.org/agenda/2020/05/covid-19-death-toll-misleading-all-cause-mortality-excess-deaths-pandemic. However, considering 89% of persons had underlying conditions, it's possible COVID took out those that would have died later in the year. The Crude Mortality Rate averaged out over the year may give a more approximate death toll estimate for the COVID-19 pandemic.
Iran lifted its lockdown on April 18th, 2020, and represents the worst case of a second wave of infections that I have found. Other countries have a minor or non-existent second wave. Health authorities in Iran “warned of a second wave of COVID-19 infections”. However, three weeks later, a second wave has not been significant.
Many other countries are easing off their lockdowns without a second wave cnn.comtelegraph.co.uk, including Austria, Switzerland, Germany, Norway, and Denmark. For future reference, you can scan for second waves by country, lookiing at the charts on politico.com or John Hopkins.
Update 20200517: Instead of a second waves ramping up like the first, countries are prepared to take early precautions at the sign of new cases. Instead of waves there will be ripples. China is playing lockdown whack-a-mole in its battle against a second wave of Covid-19 cases, although in regions that did not initially experience an outbreak.
Update 20200605: Iran is having a second wave of COVID-19 cases, but the number of daily deaths has not increased. Maybe they will in another month? Maybe those most susceptible have already succumbed, due to underlying conditions such as cancer and heart disease. Time will tell.
Update 20200622: Unlike the other countries mentioned, Iran is the only one with a second wave in the chart of daily deaths.
I think I figured out why COVID is lasting so long in Iran. R0, the basic reproduction number, or how many people one sick person infects, has not been much over 2 in Iran. The transmission rate is low compared to other countries who's entire population was quickly consumed with viral infection. The candle that burns half as bright, burns twice as long. Note there are some caveats to the R0 modeling, but Iran has kept a *level* rate of testing, compared to USA.
This hypothesis is further confirmed by the relatively low number of daily deaths in Iran compared to other countries that had higher peaks:
This phenomena could hint that herd immunity is taking effect, in countries that have experienced initial outbreaks of higher magnitude.
An explanation of why Coronaviruses are much less likely to mutate successfully, is that the Receptor Binding Site (RBS), which attaches to a receptor on mammal cells, is much larger than for influenza. The RBS must be conserved in a mutation, whereas other parts of the outer shell of the virus can mutate more freely.
Antibodies attach to the outer shell of the virus. With influenza, because the RBS is only a small part of the outer shell, the outer shell can change significantly, necessitating a different antibody to recognize the virus. With coronaviruses, it is more likely that one antibody will cover many strains.
Also, coronaviruses are physically larger than influenza viruses. I hypothesize that the added size brings additional 3 dimensional intricacy, where a random mutation is less likely to be functionally tolerated, resulting in an unviable strain.
Update 20200515: Unlike influenza, coronaviruses have an RNA proofreading mechanism, “which keeps the virus from accumulating mutations that could weaken it … Influenza mutates up to three times more often than coronaviruses do…” source
However, a mutation is still possible, and there is the hope that it does not happen before either a sufficient number of persons have natural immunity, or a vaccine is ready: “ SARS-CoV-2 is new to us … our lack of pre-existing immunity and its high transmissibility relative to influenza … If the pandemic fails to wane, this could exacerbate the potential for antigenic drift and the accumulation of immunologically relevant mutations in the population during the year or more it will take to deliver the first vaccine. Such a scenario is plausible, and by attending to this risk now, we may be able avert missing important evolutionary transitions in the virus that if ignored could ultimately limit the effectiveness of the first vaccines to clinical use. ” source
Update 20200808: There may be a new genetic variant described in the article Discovery and Genomic Characterization of a 382-Nucleotide Deletion in ORF7b and ORF8 during the Early Evolution of SARS-CoV-2, 20200721.
Here, we report a 382-nucleotide (nt) deletion in SARS-CoV-2 that truncates open reading frame 7b (ORF7b) and ORF8, removing the ORF8 transcription regulatory sequence (TRS) and eliminating ORF8 transcription. The earliest 382-nt deletion variant was detected in Singapore on 29 January 2020, with the deletion viruses circulating in the country and accounting for 23.6% (45/191) of SARS-CoV-2 samples screened in this study. SARS-CoV-2 with the same deletion has since been detected in Taiwan, and other ORF7b/8 deletions of various lengths, ranging from 62 nt to 345 nt, have been observed in other geographic locations, including Australia, Bangladesh, and Spain. Mutations or deletions in ORF8 of SARS-CoV have been associated with reduced replicative fitness and virus attenuation. In contrast, the SARS-CoV-2 382-nt deletion viruses showed significantly higher replicative fitness in vitro than the wild type, while no difference was observed in patient viral load, indicating that the deletion variant viruses retained their replicative fitness. A robust antibody response to ORF8 has been observed in SARS-CoV-2 infection, suggesting that the emergence of ORF8 deletions may be due to immune-driven selection and that further deletion variants may emerge during the sustained transmission of SARS-CoV-2 in humans.
I'm not completely sure, but I don't think this represents a completely new antigen, rather, an antigen that is somewhat less susceptible to existing antibodies.
R0 (Transmissibility) could be further reduced without a lockdown, by everyone wearing a mask. “In Hong Kong, only four confirmed deaths due to COVID-19 have been recorded since the beginning of the pandemic, despite high density, mass transportation, and proximity to Wuhan. Hong Kong’s health authorities credit their citizens’ near-universal mask-wearing as a key factor” The Atlantic, April 22nd However, the drastically different death tally could be because measures were taken early, well before other countries, or may have a yet unknown explanation. Additional sources: contagionlive.com qz.com
Compare to the Swedish approach, of only sanitizing, hand washing, and social distancing. Could they have been mistaken in their belief that facial coverings are not effective? Or, perhaps they see this virus as not apocalyptical, and don't think it warrants that specific change in lifestyle. Refer to the entry below about Objectivity.
Update 20200502: Sweden is fairing comparably to countries that are observing quarantine and obligatory mask wearing. As can be seen below, their daily death rate is already decreasing. Click here to see a comparison between countries, of the number, per million, of daily deaths. Sweden deaths per capita per day have stayed below those of Belgium, Ireland, United Kingdom, Italy, Spain, and France.
Update 20200505: Belarus, with no social distancing measures, is doing better than other countries in its vicinity, having a very low death rate per capita. Compared to Sweden and Belarus, countries with higher mortality rates have a higher population density. Sweden 22 per km2. Belarus 47 per Km2. Italy 206. Belgium 383. Spain 91. France 122. UK 281. Ireland 72. The plot below of deaths-per-capita vs population-density for a large number of countries does not show any trend. However, urban vs rural distribution is not considered, and neither is the number of days since a quantifiable contagion.
Update 20200515: “ There is no correlation between fatalities and lockdown stringency. The most stringent lockdowns – as in China, Italy, Spain, New Zealand and Britain – have yielded both high and low deaths per million. Hi-tech has apparently “worked” in South Korea, but so has no-tech in Sweden. Sweden’s 319 deaths per million is far ahead of locked-down Norway’s 40 and Denmark’s 91, but it’s well behind locked-down UK’s 465 and Spain’s 569. ” theguardian.com
COVID is different from other viruses in that the sick do not show symptoms in the first 2 to 14 days, with an average of 5 days. Although being asymptomatic during this period, they are contagious. This makes containment difficult, if you are only trying to isolate those showing symptoms.
The countries / cities that fared the best are those whose citizens had advance warning, and took precautions to reduce contagion, early, before a large number of cases took effect. Below a model showing a possible effect of waiting one day:
This article was updated 20200511, with the availability of preliminary data to make at least an educated guess possible.
Previously, I compared COVID to swine flu, but COVID likely has a higher R0 (transmissibility aka "basic reproduction number") and a higher mortality rate. So looking back on the timeline, for a disease with a higher kill rate, is the Hong Kong Flu of 1968.
The mortality rate of the Hong Kong Flu is not given the same metric as is given in the media for COVID. It is given a crude mortality rate (CMR), which is the number of deaths per 100K population per year. Scientists measure the increase in mortality of the entire population from all causes during the pandemic, instead of giving a ratio of deaths to cases of flu. The increase in the mortality rate of the entire population during the Hong Kong Flu was 0.017%, or an additional 16.9 dead per 100K per year. Over three years this amounted to between 500K and two million deaths.
For COVID-19, tons of sites incorrectly give the Case Fatality Rate (CFR), while calling it the Crude Mortality Rate. Lies! That would send the total death toll through the roof. The asymptomatic, and those that the virus never infects are excluded.
Let's say that COVID has a similar CMR to Hong Kong Flu. The population of the earth is 7.8 billion, so in a year the number of dead from COVID would be 1.32 million.
Update 20200511, deleted because Belgium is overestimating deaths:
An estimation for COVID's Crude Mortality Rate can be extrapolated from John Hopkins Data on deaths per 100K population. Belgium is the worse off, at 75 deaths per 100K. Let's make a conservative estimate that they reach 90 per 100K by the end of the pandemic, and that eventually, the rest of the world will be as bad as Belgium. That would mean 7 million deaths.
For Hong Kong Flu, the “Estimates of the basic reproduction number (R0) were in the range of 1.06–2.06 for the first wave and, assuming cross-protection, 1.21–3.58 in the second.” source
COVID has an unquarantined R0 of 3.86, and a Symptomatic Case Fatality Rate of 1.3%. The SCFR is from USA data, so we have to round down for a world average, considering USA contains more unhealthy people. Let's estimate 1%.
A large percentage of persons infected with COVID-19 are asymptomatic. Studies show figures of 78%, 96%, and 88%. If we estimate that 80% of the population that is infected with COVID never experience symptoms, then the IFR Infection Fatality Rate is 0.2%, or four times as much as influenza's worst case of 0.05%.
Assuming the virus reached 1-1/R0, or 74% of the population before herd immunity took effect: 7.8 billion x 0.74 x 0.02 = 11.5 million deaths.
“ Another new study takes a different approach to estimating differences in susceptibility to Covid-19 and puts the herd immunity threshold even lower. The paper’s 10 authors, who include Gomes and Langwig, estimate that the threshold for naturally acquired herd immunity to Covid-19 could be as low as 20 percent of the population. If that’s the case, the hardest-hit places in the world may be nearing it. ” The Tricky Math of Herd Immunity for Covid-19, wired.com 20200712
7.8 billion x 0.20 x 0.02 = 3.12 million deaths. This still doesn't seem right to me. The most extreme low prediction:
7.8 billion x 0.10 x 0.02 = 1.56 million deaths.
In order to make a direct comparison with the Hong Kong Flu, we must calculate the Crude Mortality Rate for COVID-19. Let's consider that all the deaths took place in one year (considering the high transmission rate, and projecting only one viral wave). The global death rate from all causes is estimated to be 7.7 per 1000, or 7700 per 100K population, adding up to 60 million deaths per year for 2020. Thus, the estimated increase in CMR is (1.56/7800) ⇒ 0.020% for COVID-19, higher than the 0.017% for the Hong Kong Flu.
The R0 can be lowered dramatically by practicing precautions, and may make the difference in reducing deaths by millions. Update 20200511: In Denmark, lockdown has been eased and through precautions the R0 has been lowered to 0.9, and if kept at that rate, the virus would extinguish before herd immunity was reached.
Perhaps everyone will be wearing mouth coverings in the future? Social dancing may have a new look, as all will be adorned in hijab. Or perhaps a better treatment will be found for COVID, or the number of daily deaths will be low enough to appease the news media gods, and things will return to “normal” until the next pandemic.
It's good to think in many dimensions. Instead of only trying to keep people safe from COVID, let's make a better world overall. We've been ignoring many of the world's problems, and we go about this in our normal lives. Why is COVID now something urgent, when there's been urgent everywhere around us?
While diseases are not something we have complete control over, there are self-inflicted deaths that we are ignoring. Let's take a long hard look at “normal”. For comparison, the CDC states that globally, there are 1.35 million vehicular accidents every year. Does the population freak out about the risk, like it has with COVID-19? Hardly. The topic doesn't get that level of sensationalist mass media. People will drive to Starbucks for a coffee, just to get out of the house. Somehow, people have lost objectivity, that there is an equal chance of dying from a car accident compared to a viral infection.
In Los Angeles, the quarantine has reduced auto accidents by half, which should help free up hospital beds. ER doctors in some regions are unemployed as hospitals become sedentary. “The reductions in air pollution in China caused by this economic disruption likely saved twenty times more lives in China than have currently been lost due to infection with the virus in that country.” source
CDC states that “between 291,000 and 646,000 people worldwide die from seasonal influenza-related respiratory illnesses each year, higher than a previous estimate of 250,000 to 500,000 and based on a robust, multinational survey”.
COVID is not like flu, because you can be contagious without first showing symptoms. Additionally, COVID is more contagious than the flu, spreading more easily. I can understand that people are afraid, where in some areas, COVID will be the number one cause of death for many weeks. If COVID ends up killing the same amount of people as flu in a year, it would just have done so more quickly. COVID would burn the timber in a few months, while the flu would keep us warm all year.
By itself, COVID may not be a bad threat, but when it reaches those who already have disease, it makes for deadly cases. Usually, the causes for the highest crude mortality rates are cancer and heart disease. Who is COVID killing? Cancer, heart disease, and diabetes patients. Underlying conditions in general, at a ratio of 89%. Not many healthy people die from COVID-19, no matter how many dramatic stories of a young person dying you may see on the news. When someone is listed as having died from COVID, you may not have the full picture:
If you go to the hospital, chances are you will get more cooties. If you have the flu, you may catch COVID, or if you have COVID, you may also catch the flu. Season with a little pneumonia. A recipe for a very bad case. One shouldn't blame all the deaths exclusively on the COVID virus. COVID-19 is adding another front to the attack.
So maybe, while your immune system is under attack, it's a good idea to stay out of the hospital, far away from other diseases. Doesn't that just make sense? Does Going Into Hospital Make You Sick? talks about hospital readmission rates. Cancer patients are contracting COVID at an alarming rate.
What I'm trying to say here, is that social normalcy is barbaric, and people are in denial of that fact because of an inherent need to think otherwise. An inherent need to live in a fairy tale where they are not actively involved in supporting barbaric practices.
Instead of shooting yourself in the foot, why not focus instead on making the world a better place? We are laying waste to the planet, and we need to change our lifestyles drastically. Instead, we have lockdown because of a stupid virus? Yes it's great that we may wear masks to protect others, but to spend so much energy and attention on just that? Having an intelligent conversation is difficult when reality is politically incorrect. If you are not connected to reality, you will follow the news media mob.
The same crowd following the media mob, will also check in to the local hospital to be treated by “experts”. Because a conformist has a need to trust experts, and likely doesn't spend time reading that experts are clueless about how to treat COVID. In NYC, medical mismanagement and negligence is competing with COVID to see who can kill more patients: dailymail.co.uknypost.com.
Thus the conformist will get in a car to go to the hospital, needlessly increasing the risk of death for everyone while adding more pollution. For a conformist, that's normal, and trying to talk reason into them is like trying to strip away their security blanket.
COVID is bad, but we are only paying attention to it, because the media has focused on it. COVID is sensationalized. They had spread the gospel that the risk of having a severe case, where you require a respirator, is 20%. The 20% figure is incorrect, but people seem to have a primordial need for something to be afraid of, so it stuck. COVID is the shiny new threat to be afraid of.
Covid is the shiny new threat to be afraid of.
Iceland tested a larger percentage of their population than any other country, for active COVID-19 infections. Although not randomly, because people afraid of having COVID were more likely to go and be tested. Of those arriving on open invitation, half affected by COVID had no symptoms, which means that likely, even more carriers without symptoms didn't bother to get tested. They did not follow up with the asymptomatic carriers to find out if they developed symptoms.
The New York-Presbyterian/Columbia University Irving Medical Center, published a study from their labor and delivery unit. 88% of the women that were positive for COVID were asymptomatic. Granted, it's a young segment of the population.
Let's go on a whim, and say that in the general population, only one in four develop symptoms. They are or were at some point, silent carriers. None of them are counted towards the percentage of cases requiring a respirator. Let's say that half of people who develop symptoms actually go to the hospital. There's the bunch like me that get sick and don't go to the hospital, so they don't get counted. That makes one in eight covid cases. In NYC, there are those that go to the hospital and get turned away because they don't have a fever, like my roommate. They are told that because they don't have a fever, they don't have the virus, which is completely bogus. That leaves one in sixteen covid cases.
Back to the 20% figure, that the media has been terrifying people with. If 20% of the 1/16th COVID cases at the hospital end up needing a respirator, you are now at one in eighty cases that require a respirator. There has been many estimates for the Case Fatality Rate, ranging from 1% to 5%. Let's take 3%, and divide this by 16 for our guess of an IFR Infection Fatality Rate: 0.19%.
So the ones that stay in the hospital could be thought of as having a mild case of COVID that the body is fighting off with a fever. They are ok, but they have a weakened immune system. Chances are, they will catch whatever else is going around, and get really really sick. Going to the hospital increases the chance severe illness and chance of death. Can you see how the chance of dying from COVID would be both overblown and self inflicted?
People are suffering by other means as well, not just from this COVID virus. So please, if you want to be a humanitarian, look at the big picture and stop being a drama-seeker. Drama seekers are just as responsible as mass media in spreading misinformation. Instead, research the facts and draw your own conclusions, without fearful emotions or political affiliations clouding your judgement, and be open to change. Make the world a better place.
Most politicians want to ride this wave, where they can be seen as taking command of the situation. It's very fashionable right now to protect against COVID. Fashionable to have a police state.
Not all countries are taking freedom away from its citizens. For example, Swedish Prime Minister Stefan Löfven made the following statement: “Us adults need to be exactly that: adults. Not spread panic or rumours. No one is alone in this crisis, but each person carries a heavy responsibility”. click for more about this decision
If you want to raise a child to be a responsible adult, you must treat them as capable of handling responsibility. Sometimes this involves risk. If you want to have a nation of responsible adults, you will have to give them the freedom to make mistakes. Think of God and free will. “The Swedish model of collective action also has important lessons that go far beyond public health efforts.” What Sweden Can Teach Us About Coronavirus, politico.com
Many will want to take away the freedom of the individual to leave their house, because of the potential that this individual could spread or contract the virus, affecting others in time. What holds more value? Safety, or freedom? People have different value systems. I want the individual to have freedom, and the education to take care of themselves and others.
Based on the projected schedule for Wuhan, China, one could estimate a cycle of 3 to 4 months before precautions are lifted, and civilization mostly goes back to normal. For NYC, that could be the end of May. However, NYC is not Sweden or Iceland. Nor does it have a quarantine that is as strict as China's.
I don't care if we continue to stay locked down or not. I could care less if we continue to stay locked down indefinitely. However, my opinion is that based on the facts, I don't think it's necessary. I think mask wearing, and good hygiene practices, is the key to reducing R0 to less than singularity. I think it is up to any particular country or region to decide if they want to make mask wearing compulsory, or work towards herd immunity.
If anyone hasn't gotten my point yet, it's that there are much more important matters to focus on besides COVID-19, including the corruption of society towards an unsustainable and unhappy future. If you see humor within this rather serious article, it's because I need it. I've tried to uncover as much of reality as possible, in order to educate myself and others. We have nothing to fear, but fear itself. Fear is keeping us from being objective. Fear is keeping us locked down, and fear is keeping us from changing towards a better future.
For those who are using COVID-19 as a means to an end, as in, politically, to actuate changes they think are important, I say that the ends don't justify the means. Honesty and integrity. Humility and equality.
This article was not updated with more accurate information that came in the following month.
The large Infograph comparing historical pandemics, shows Swine Flu having 200K deaths. In actuality, Swine Flu likely caused around 300K deaths, with a range from 150K to 580K.
Is Coronavirus more contagious than Swine Flu? It depends on when the R0 (contagiousness or transmissibility) measurement was taken. In Wuhan without containment, the R0 is estimated to be around 3.86. After lockdown, R0 fell dramatically.
Compared to other viruses, someone with COVID is contagious in the first few days, without showing any symptoms. This makes quarantine much more difficult. Where the sick are isolated at the onset of both symptoms and contagiousness, R0 is dramatically reduced.
A different metric for viruses is the Case Fatality Rate. Update 20200414: The fatality rate for COVID is 0.5% best measured in the country whose testing has had the broadest reach: Iceland. This is quite different from the 20% CFR mass media was shamefully broadcasting. Another lie.
Do they actually know how many people have contracted coronavirus? No, they don't. They don't test everyone. In the USA, they turn away people that don't have a fever, then have the nerve to say that most people that get coronavirus get a fever. “Iceland lab's testing suggests 50% of coronavirus cases have no symptoms” https://www.cnn.com/2020/04/01/europe/iceland-testing-coronavirus-intl/index.html
The difference that stands out, is that many hospitals are overrun compared to the time of the swine flu. See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6669026 and http://www.cidrap.umn.edu/news-perspective/2009/05/worried-well-overload-gives-taste-pandemic-scenario But how much of that may be attributed to cuts in hospital readiness, after cuts in funding or privatization? It should not be overlooked that hospitals are affected worldwide.
When they say that hospitals are overrun, what exactly does that mean? CNN covered a hospital in Brooklyn, one of the hardest hit. The hospital has a 300 bed capacity, and 100 beds were filled with coronavirus patients. So it seems it doesn't take much to overrun a hospital. They are usually running near capacity.