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mekineer.com → health
This site is a branch of
mekineer.com → health
Crude Mortality Rate: number of deaths from infection compared to / the number of the entire population.
Infection Fatality Rate: number of deaths compared to / the number of those that are estimated to have been infected.
Case Fatality Rate: number of deaths compared to / the number of those that are known to have been infected.
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 0.028%, due to SARS-CoV-2.
I want to critique the following article from The Atlantic: COVID-19 Cases Are Rising, So Why Are Deaths Flatlining?. Its main hypothesis, is 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 6 and 8 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. Likely increased number of cases due to increased testing. Or testing of less serious cases, where before they only had enough test kits for the critically ill.
As previously covered, Iran was a special case, because the initial wave was small, and not enough of the population became immune for some amount of herd immunity to take place.
I searched for a COVID deaths map of the United States, and found a few but nothing good enough to show here. Except that I'm fairly certain COVID has reached all metropolitan regions of the US. Also, the outbreak wave was larger than that of Iran. From these findings, I expect no significant second wave of daily deaths in the United States.
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
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.
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.
<hidden Click here for the change in the daily deaths plot since the start of the pandemic>
Here's July 29th figure, recovered via Wayback Machine:
Here's July 1st figure from worldometer.com
Well, the magnitudes are the same, but the new chart has less wrinkles in the plot. They probably assigned the correct dates to all the individual cases, rather than counting them as they were reported.
It’s a bit more deadly than influenza. It’s just politically incorrect to say otherwise. When people get fixated on one way of thinking, they are unable to view data and come to objective results.
The data on the number of cases are “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
This article from June 16, 2020 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 IFR was 20%. Over time, the scatter plot of claims went down logarithmically.
Why herd immunity to COVID-19 is reached much earlier than thought
Herd immunity can be achieved at 43%, new study finds
The study: A mathematical model reveals the influence of population heterogeneity on herd immunity to SARS-CoV-2
Italy's hard-hit region nears 'herd immunity' as more than half of people tested show coronavirus antibodies
Covid-19 immunity could be twice as high as believed, Swedish study finds
Herd Immunity May Be Closer Than You Think, wsj.com
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.
One example where lockdown appears to be effective, is in Iran. It is the only country that had a second wave of daily deaths. 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.
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
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? 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. Texas is one of those states, as shown in the daily cases chart below.
++++ Click Here for an Exception in Florida |
“Late last Friday, the architect and manager of Florida's COVID-19 dashboard (Rebekah Jones) — praised by White House officials for its accessibility — announced that she had been removed from her post, causing outcry from independent researchers now worried about government censorship.” Florida Today
Rebekah Jones: “So normally, when we people think of percent, they take the number of positive people divided by the people tested. That seemed honest and fair. They changed it to the number of new cases per day over the number of negative tests per day, so if you decide you want to get tested five times today, you count five times toward the negative if those are all your results. If I’m positive, I count once.” Tampa Bay Times
I'm left wondering: how many people get tested more than once, ON THE SAME DAY? They come up negative, so they keep testing in case they get a positive? I asked on Quora, and got two different responses. ++++
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.
Excuse the lack of a proper curve fitting. I don't have the data, so I manually drew my own projection below, and it looks like it will not be much more deaths than a bad flu year causes (~800K). If you tell someone on the street that the flu kills 646K on a bad year, and then ask them how many will die this year from COVID, they will say a crazy high number, like 67 million, because that's the scare that mass media has given them. An incredible drama played out. Mass media could have played the violin for any current world tragedy, as there is plenty to choose from. and then that would be the trendy topic.
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?
<hidden Click here for antibody tests with high accuracy> “ Researchers from the University of Washington School of Medicine found that the blood test for SARS-CoV-2 antibodies recently launched by Abbott Laboratories (NYSE:ABT) is highly accurate in detecting antibodies in patients tested at least 17 days after the onset of symptoms. The results found the test has 99.9% specificity, or about one false positive out of a thousand healthy patients, and 100% sensitivity, or a complete lack of false negative results in patients confirmed to have had COVID-19. ” source
“ Researchers with Switzerland-based blood-screening company Quotient say they have developed a COVID-19 antibody test that will quickly and accurately determine whether test subjects have developed antibodies that would make them immune to the virus. Quotient Chief Executive Officer Franz Walt said the test has been shown to have a 100% sensitivity and 99.8% specificity claim ” source
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 (it 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? 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 below, 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.
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
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. ” source
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 approximately one 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 in the first year! Am I going to be all wrong in having predicted 300K-500K in the first year for COVID? ++Click here for the reason I made a prediction | If you ask most anyone in the present about how many deaths from COVID they would estimate in one year, they will bring up an obscene number, like it's the end of the world, because that's what they are being fed by the media. I asked this question on Quora, and before I added a link to the question description, pointing to the worldometers coronavirus death toll, one guy said 66 million. While I don't have more data behind this, I hypothesize that other conformists following the news would come up with similar estimates.++
Update 20200511, wrong 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
Update 20200511: COVID has an unquarantined R0 of 3.86, and a Symptomatic Case Fatality Rate of 1.3%. However, results are turning up that a large percentage of persons infected with COVID are asymptomatic. Studies show figures of 78%, 96%, and 88%. If we estimate that 75% of the population that is infected with COVID never experience symptoms, then the Infection Fatality Rate is 0.3%, or 3 times as much as influenza's 0.1%
Assuming the virus reached 1-1/R0, or 74% of the population before herd immunity took effect: 7.8 billion x 0.74 x 0.003 = 1.7 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 0.028% for COVID-19, higher than the 0.017% for the Hong Kong Flu.
However, the R0 can be lowered dramatically by practicing precautions. If the R0 is lowered to 2, then there would only be 1.2 million deaths. 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. So it is possible, with changes in socialization, that the pandemic could have an equivalent CMR to the Hong Kong Flu.
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”. Wait, that's even more than the Swine Flu pandemic! Oh, maybe that's because there's always more than one strain of flu virus going around at the same time. With COVID this season, it looks like we will get an additional 646K deaths.
So let's assume we have a year of COVID death toll similar to that of a bad flu year. While flu + pneumonia may be milder than a bad case of COVID, for an equal number of cases of flu and COVID, the bad COVID cases would be less frequent. Otherwise the CDC's flu-deaths-per-year figure is incorrect, inflated for the purpose of selling vaccines (revolving door politics).
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 a Infection Fatality Rate: 0.19%. Not everyone gets infected. For COVID, it has been estimated that 66% would ever be infected. That leaves the Crude Mortality Rate at 0.12%. Influenza is known as having a CMR of 0.1%.
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 | The Prime Minister delegated his decision to the public health agency, which determined that the best course of action was to create herd immunity among those that could best handle the disease. The elderly were advised to stay home. Although, being hard to contain, the virus made its way into nursing homes. Sweden has a large elderly population. Another country that is successfully containing the virus without a lockdown, is Iceland. Iceland was able to contain the virus before it became widespread in the population.++
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 compared to before? Although unlikely as hospitals worldwide are affected.
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.
Based on the following chart, it appears that the death rate among many countries is about to plateau, and follow a trajectory similar to China. I guess the total deaths globally between 300k and 500k in 2020. A lot more than I originally thought when there were only 30K deaths at the end of March. Granted, if the virus mutates to a newly infectious strain, the figure may be higher. I'm counting on doctors getting better at treating people, finding better treatments, and getting more/better supplies.
Some supplements such as garlic, may help prevent or shorten viral infections. However, every viral strain is unique, so what may work for one strain may not work with another.
Other supplements to look into:
Zinc and elderberry lozenges or syrup
https://examine.com/supplements/pelargonium-sidoides, except that the “vast majority” of studies were funded by a company that sells a patented extract.
Theobromine in cocoa outperforms pharmaceutical based cough suppressants. Pharmaceutical cough suppressants are not much more effective than placebo, and I have no idea why people keep taking them, despite the lack of evidence for efficacy.
Bromelain supplement may reduce congestion. I wish more studies were done on it.
If your nose is completely stuffed up, and you can't sleep because breathing through your mouth doesn't work for you, you can use flonase (fluticasone), a nasal spray which is a corticosteroid. If I have remembered the med correctly, it will clear up your sinus in seconds. However, this medication works by reducing the work of your immune system. You get twice the chance of dying or having pnemonia as a complication Although, if you can't sleep, it may be the lesser of two evils.
If you have a CPAP nearby, it can force air through your nose, and keeps the drip at bay until you wake up a couple hours later and blow out a storm.
It may not be good to fast during a common cold, because of studies showing that cellular autophagy metabolism promotes viral reproduction:
Autophagy induction regulates influenza virus replication in a time-dependent manner
Autophagy Promotes Replication of Influenza A Virus In Vitro
However, different viruses may exploit different cellular machinery, so this conclusion may not apply to all viruses.