What we don’t yet know about the coronavirus

The big question that isn't being answered is - Are the fatalities being caused by the coronavirus or are the people dying from something but have the coronavirus? there is a difference.

Both. Covid-19 is a bad enough pneumonia that it can kill by itself, but that's less often. More often, it's more like the straw that broke the camel's back - the body already has other health issues to deal with, then Covid-19 gets added to that and the cup spilleth over

The big question that isn't being answered is - Are the fatalities being caused by the coronavirus or are the people dying from something but have the coronavirus? there is a difference.

WillB wrote: The number of 18% comes from the "closed cases", i.e. cases which went to the hospital. But that says nothing about the death rate of the disease overall, since everwhere it is confirmed that the vast majority of people experience hardly any or no symptomes at all, so the never appear in your worldometer statistic.

I'm surprised you got any upvotes for that.

It doesn't matter about those who don't make it to hospital. This is how death rates are normally counted for any given illness: those who make it to hospital are diagnosed with the flu (or with Spanish Flu / COVID-19 / tuberculosis / heart disease, etc.), and you work out the death rate from those that die. With any illness, the actual death rate is calculated in this fashion once the pandemic is over. That's the best estimate you can get. (You can't make up calculation based on an unknown variable!) Until then, the best estimate you can make is based on closed cases.

meant to say "counting those testing positive with COVID-19 who die as a pneumonia or cancer stat because it suits them".

WillB -- I've been monitoring the stats for weeks, and the fact is the death rate in Italy is indeed climbing. This means of those testing positive, a greater percentage over time is dying from it. Based on what we've seen in the statistical spread to date, this would also imply that Italy has a high infection rate -- not that that's Italy focus right now given the sheer number of people needing intensive care.

Further, I would flip your other argument on its head, arguing that Germany's method produces misleadingly low numbers -- it's easy to argue an underlying health condition caused the death. It would be much better if all countries counted stats in the same way -- if you've got COVID-19, and you die, you become a stat. It's too easy to argue that you died of the other thing -- and that's exactly what the likes of Russia has been seen doing counting those testing positive with COVID-19 as a pneumonia or cancer stat because it suits them.

The original point was that the death stats in Italy are going up, which is true. It's also true that the deaths stats are going up around the world. Over the last few weeks I've watched it climb from 7% to 8, 9, 10 ... now 18% (that stat means a lot, regardless of techically being the CFR, including that if you end up in hospital with COVID-19 somewhere in the world (yes, it will vary, but we're talking a world average here), you have an almost one-in-five chance of dying).

@williB

According to that logic, anybody could argue that somebody didn't die of corona if they can blame an existing condition instead.

Tora:

Or you could say of the solved cases at the moment, 1 in 20 are dead.

I think the latter is more useful, since it's just talking about the total number of deaths out of the total of solved cases.

Err, no. It is not useful at all, since it only refers to the number of "cases" (i.e. cases that need treatment) and not the number of infections. (I think the technical terms are CFR and IFR (case fatality vs infection fatality rate). Your site just talks about CFR, which is always higher. Also, as I pointed out, the way to count even the case fatality rate can be very different, i.e. the Italian system produces misleadingly high numbers.

@WilliB

"cases in progress* means those who still have the virus, right now.

"cases closed" = finished. Those who survived(virus free), or died.

So, for example let's say a total of 100 people have tested positive for it, and 1 is dead; 19 survive it (are virus free), and 80 still have it.

So:

Total cases = 100

Cases in progress=80

Cases closed = 20 (1 dead, 19 free of the virus and still alive)

You could say of all cases, 1% die, but it's misleading since 80% are still unsolved (we still don't know which way they will go).

Or you could say of the solved cases at the moment, 1 in 20 are dead.

I think the latter is more useful, since it's just talking about the total number of deaths out of the total of solved cases.

The cases in progress are just that, they are unsolved. We have no way of telling if they will live or die, until their cases are solved. Some of them might be not so serious condition, some will be. Perhaps if they get good care , they will survive. If they can't get the care they need, perhaps they will die.

Of course this is only referring to those who were tested in the first place.

So your figures about the cases "in progress" refer to those who went to a hospital, not to all who have virus.

Well yeah, that's why the actual name of the mortality rate is the Case Fatality Rate (CFR), which is the number of deaths in comparison to the number of diagnoses. They can never know how many people actually get a disease, and therefore they would be creating statistics based on guesses, which of course wouldn't make it a statistic. Just a guess.

Obviously, different countries have different rates. In Germany it is extremely low. In Italy / Spain, it is extremely high.

The different rates can be explained to a large degree by the different way of accounting. I.e. in Germany, they only count it as a Corona fatality, if really Corona was the only or main cause of death. In Italy (and I assume Spain) the policy is to count everything as a "Corona death" if the patient ALSO had Corona in addition to whatever else the problem was. So if you die in an Italian hospital of cancer or a heart attack, it is counted as a "Corona death" if automatically, if there was also Corona present. Fwiw.

@williB

I hear you man!

Unless we have 100% testing, we will never know the true death rate, nor the total numbers infected.

We probably won't even know after this is all finished, since the majority will probably never be tested, especially in developing countries, or in countries that choose to minimise testing like Japan.

I'm just saying that of the cases that are tested world wide, and then solved, there is an 18% death rate.

Those who have been tested and who currently have the virus will move to the "solved" category, once they are clear of the virus. At the moment, 82% of the "clear of the virus" (solved category) survive and 18% don't. The rest are still in the "Cases in progress" category.

Obviously, there are far more cases world-wide that haven't been tested at all.

In a way, all the statistics are kind of meaningless, unless everybody can be tested. What we are looking at is the statistics regarding those who have been tested.

Tora:

NB: same, of course, for the cases "Solved" in your statistics.

Tora:

The 18% are the deaths of those cases that are solved, not the ones in progress (I.e who have the virus at present)

I don´t what the misunderstanding here is. We currently DO NOT KNOW who "has the virus at present", because by far most people have very mild or no symptoms, so do not go to a hospital.

So your figures about the cases "in progress" refer to those who went to a hospital, not to all who have virus.

Viruses enter the body and infect cells, using them as factories to make many millions of copies of themselves, so the number of virus particles that first enter the body has little effect on the eventual amount of virus in the system.

This isn't actually true, intriguingly enough. There have been tests with varying infectious doses of influenza virus, and the severity of corresponding symptoms correlated directly with the size of the initial infectious dose. It's reasonable to believe that SARS2 behaves similarly, which is why healthcare workers may be at higher risk due to their initial exposure potentially being larger.

WilliB

The 18% are the deaths of those cases that are solved, not the ones in progress (I.e who have the virus at present) The cases in progress are move to the "solved" category once the virus is no longer present, or the person is dead.

At the moment, of the completed cases (solved) there is an 18% death rate.

Obviously, different countries have different rates. In Germany it is extremely low. In Italy / Spain, it is extremely high.

I don't know how much clearer I can make that. All the numbers are on the front page of:

https://www.worldometers.info/coronavirus/

You can also sort by country as well. It's all downloadable.

Tora:

I looked at your https://www.worldometers.info/coronavirus/ site.

The number of 18% comes from the "closed cases", i.e. cases which went to the hospital. But that says nothing about the death rate of the disease overall, since everwhere it is confirmed that the vast majority of people experience hardly any or no symptomes at all, so the never appear in your worldometer statistic.

Tora:

Those numbers are saying that so far that 82% of people survive.

The concerning thing is that just a week or so ago it was a 90% survival rate. Yesterday was 83% And few days ago, 84.

Where do you get those numbers from? It seems to me, they are referring to people who are hospitalized, not to everyone who is infected. Those numbers seem to be more around the 1% level, no?

@Jimizo You have : Total cases = All cases so far. Active cases= in progress (not solved) Closed cases = those that are solved, i.e. includes those no longer have traces of the virus (alive) and those who are no longer with us (dead)

I believe it's worth examining the death rate of the closed cases, since these cases are "solved".

@Tora

I’m asking where you are getting the 18% death rate from. Are you talking about all cases? Those who end up in hospital? Those in ICU? Also, I think you have got your maths wrong in terms of outcomes but I can’t be sure until you clarify what you are talking about.

Throwing around 18% death rate figures without clarification causes panic.

@Jimizo

Here: https://www.worldometers.info/coronavirus/

I'm not saying it's going to stay like that, but it's still concerning.

I just think that to calculate the death rate so far in an honest way we need to count cases that have an outcome.

Those numbers are saying that so far that 82% of people survive.

Are you sure it’s an 18% death rate? Please clarify what you mean and give us the figures.

For more of a clue to the destructive nature of this virus, I think it's really important to consider the "closed cases"

Those numbers are saying that so far that 82% of people survive.

The concerning thing is that just a week or so ago it was a 90% survival rate. Yesterday was 83% And few days ago, 84.

I know you are all going to say that we are early into this crisis and we can expect the raito of deaths vs closed cases for come down, but the fact is, they are just continuing to go UP.

The reason is, of course,that advanced healthcare systems in Europe and the US are one by one failing to cope. Japan will also fail to cope. Now, imagine the state of healthcare systems in the developing world and you can see where this is headed.

The only places that are coping so are: Germany, Taiwan, Singapore and S. Korea. The reason? They got on top of this really early with policies of trace, test, isolate. That's the only way we can beat this without draconian measures that China took. But even with a policy of full lock down, you're still going to be back to square one once restrictions are lifted. Unless of course, we get that vaccine, the virus runs it's course, or we get herd immunity.

We live in very interesting times.

1glenn:

On another subject, the article states that 127,000 people have recovered, and perhaps millions more never knew they had the virus in the first place.

That is an important point. Seeing that the majority of people (especially young people) show no symptoms at all, how do we even know how far the bug has spread already? Only once quick and cheap tests are available will we know. It is possible that the biggest part of the wave has already washed through the population.

On the subject of how dangerous this flu is to young people, The Guardian reported last weekend that the average age of those who succumbed in Northern Italy was 78.5. Speaking as a senior citizen myself, I am glad that this contagion is less severe among the young. No one is in a hurry to meet his maker, but it seems a shame when the young are deprived of their lives.

On another subject, the article states that 127,000 people have recovered, and perhaps millions more never knew they had the virus in the first place. We currently have a ridiculously severe shortage of everything needed to fight this flu over here in the states. With regard to Personal Protection Equipment (PPEs), it occurs to me that if those who have recovered and/or developed antibodies to this flu would volunteer as possible for the most critical jobs for which they can be useful, it would help alleviate the shortage of PPE, since they theoretically have immunity. Especially among doctors and nurses, those who fully recover could be tremendously useful.

Idon't understand the last sentence here. If we define "safer" as "less likely to die" then I thought all the statistics so far supported the premise that yes, younger people (say under 40) are indeed safer than older people.

Have I missed something?

That is an answer for a different question

Just how much safer they are is still unanswered.

Without a proper epidemiological analysis it is very little what you can say. Yes, it appears young people are "safer" but we still can't say how much. two times? three? ten? We will have to wait until everybody can be tested and we know exactly how many people got infected without giving symptoms.

Watched Contagion 2011 last night. Good to educate yourself on what’s coming next and how spreading works in detail.

Does the virus spread more slowly in hot places?

Some experts had hoped that the onset of summer will naturally slow the virus. But the European Centre for Disease Control said on Wednesday that it is unlikely to diminish its spread. The WHO has also said that the virus can be transmitted in all areas, including hot and humid climates.

Yes and no. The virus may be no more virulent in hot vs cold climates, but peoples behaviour changes according to the season, making transmission in cold climates more likely.

Eg, in Winter, people cluster together inside, natural immune responses are mildly suppressed in winter, and common colds etc which normally circulate in winter can give a person battling one of those two things to deal with rather than one.

Furthermore, bacteria and virii tend to survive on exposed surfaces for longer in cold climates.