Excess Mortality, Thread

Excess Mortality, Thread:

I have just discovered a major error in the #CoVid data of the NCHS Mortality surveillance data. This is all based on the official NCHSData49.csv as downloaded from here (original downloaded 12/15):

https://www.cdc.gov/flu/weekly/weeklyarchives2019-2020/data/NCHSData49.csv

The data begins in week 40 of 2013 and ends week 49 of 2020. The data looks basically like this:

Yr | Wk | All Deaths | Pneumonia | Influenza | COVID | PIC*

*PIC = Pneumonia, Influenza, or COVID deaths (sum of) 

The first COVID death listed was 2020 Week 6. Pneumonia death (P) = 3799. Influenza death (I) = 520. COVID death (C) = 1. PIC = 4320.

Math check: 3799+520+1=4320 ✅

The math adds up fine until 2020 Week 8. P=3699. I=566. C=4. PIC=4268.

Math check: 3699+566+4=4269 ❌

Here's this problem: Deaths are being classified as PIC deaths, as well as P/I/C deaths. So, in 2020 Week 8, someone was classified as a PIC death AND a P or I death, also.

Someone was counted twice.

But, it gets worse. As the COVID deaths accelerate, the double-counting does, too.

2020 Week 9 - 5 fewer PIC than P+I+C

2020 Week 10 - 19 fewer PIC than P+I+C

2020 Week 11 - 29 fewer PIC than P+I+C

2020 Week 12 - 257 fewer PIC than P+I+C

By 2020 Week 13, the NCHS was double counting 1479 excess deaths.

The following weeks vary from a low of 1548 excess deaths to a high of 7550.

By my calculations, there were 121,888 deaths double counted as COVID and as either Pneumonia or Influenza.

So, what do we do with this knowledge?

My assumption here is that few (if any at all) of these deaths were both COVID and Influenza. Likely, these deaths were COVID / Pneumonia. It would seem reasonable that a death could be from Pneumonia caused by COVID.

Or, perhaps some people died of Pneumonia AND had also tested positive for COVID, thereby were counted as both (even if the cause was the Pneumonia, alone).

So we have two likely scenarios, either (or both) could be true.

One, we have 121,888 fewer Pneumonia deaths.

Two, we have 121,888 fewer COVID deaths.

Possibly, we have a split of both fewer Pneumonia and COVID, but without individual case details, that may never be known.

However, I have discovered a strange anomaly elsewhere. In trying to verify numbers, I found the "NCHS Mortality Report for the Week Ending December 5, 2020 (Week 49) Data as of December 10, 2020"

https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/12112020/csv/nchs-mortality-report.csv

In this chart, they list Total Deaths, Influenza deaths, COVID deaths, and PIC deaths. These numbers all align with the previous chart. But Pneumonia deaths are not listed.

So I check my history to find the original link to the COVID data. It isn't there.

What do we do with this information?

Well, in reviewing the data, the 2020 Week 39 can be safely compared with the Week 39 data from prior years. Since COVID data for those years will be zero, we can make an apples-to-apples comparison of Pneumonia and Influenza.

Week 39 data:

2014 - P=3017; I=6

2015 - P=3057; I=6

2016 - P=2986; I=11

2017 - P=2888; I=19

2018 - P=2814; I=14

2019 - P=2780; I=16

2020 - P=4715; I=3

We can also compare the Week 40 through Week 39 totals of each "Season":

2013-'14 - P=182,691; I=4485

2014-'15 - P=193,237; I=8197

2015-'16 - P=178,002; I=3448

2016-'17 - P=179,621; I=6954

2017-'18 - P=180,137; I=15,620

2018-'19 - P=168,608; I=7175

2019-'20 - P=263,791; I=9415

It appears evident (to me) that we have found our error. Of the 121,888 duplicated deaths, it would seem reasonable that these were additional Pneumonia deaths who ALSO had COVID.

It would appear that we have excess Pneumonia deaths over the standard yearly average.

And it would be reasonable to assume that these additional Pneumonia deaths, who also had COVID, were likely COVID-induced-Pneumonia, rather than stand-alone Pneumonia cases which incidentally had COVID. Nothing else explains the excess mortality of Pneumonia cases.

Additional conclusions from the data -Overall mortality:

Comparing yearly mortality from ALL CAUSES, including PIC, there does seem to be a spike. But is the spike great enough to account for the COVID deaths, which should likely be in excess of the average?

Total "Season" Deaths:

2013-'14 - 2,580,853

2014-'15 - 2,750,884

2015-'16 - 2,697,072

2016-'17 - 2,790,278

2017-'18 - 2,835,734

2018-'19 - 2,831,233

2019-'20 - 3,142,232; COVID=203,899

Average deaths 2013-2019 "Seasons" = 2,747,674

2020 "Season" deaths less COVID = 2,938,333

It seems reasonable to assume that overall mortality is in a reasonable range for the year if you exclude the excess deaths caused by COVID.

What can we say about the effect COVID has had on Influenza deaths?

Some might say the Influenza deaths are down due to COVID.

Some would assume this is due to the mask wearing, social distancing, and hand washing.

Others would assume this is due to nefarious counting.

Well, if you compare the total "Season" cases of Influenza between 2019 Week 40 and 2020 Week 39, you would see we're actually up a little from the average of 7646 (2013-2019) to 9415 for the 2019-2020 "Season".

What I would like to see is if there is any rise in excess death from suicide and homicide to see if it correlates to the COVID lockdowns. And also if those excess deaths would offset the COVID deaths in any fashion.

But, I do not have those numbers. Yet.

source:

https://twitter.com/rvolt24/status/1343975559668367360

Excess Mortality, Thread:
I have just discovered a major error in the #CoVid data of the NCHS Mortality surveillance data. This is all based on the official NCHSData49.csv as downloaded from here (original downloaded 12/15):https://t.co/VkzgNfDZO6

— Señor Hilaria (@rvolt24) December 29, 2020

I know you are but what am I?

I've often heard the phrase, "When I became a man I put away childish things," but I never really knew its source. It seems reasonable. It seems accurate. We all begin in a state of childhood, and most of us grow into adulthood.

So, when I came across this again, it included some context I had not heard. It went like this:

"When I became a man I put away childish things, including the fear of childishness and the desire to be very grown up."

Well, that's a decidedly different spin on it. How do I put away childish things yet do not fear being childish? How does a man grow up without retaining the desire to be grown up?

Where does this come from, and what does it mean?

It took very little research to find it. This is from C. S. Lewis, the prolific writer, famous for his children's books in the Chronicles of Narnia series. But he is also a very well known Christian writer; some might consider an important Christian philosopher.

I also recalled the Bible mentioned a strikingly similar phrase in a New Testament verse.

"When I was a child, I talked like a child, I thought like a child, I reasoned like a child. When I became a man, I put the ways of childhood behind me." - 1 Corinthians 13:11

This seems to be very straightforward. Once one becomes a man, childhood ends. So how can such a well-versed Christian writer and thinker like Lewis say something which seems so contradictory to the Bible he knows so well?

The answer is, of course, found in scripture, too. In the same chapter, even. The entire chapter provides the context. Love.

"If I have the gift of prophecy and can fathom all mysteries and all knowledge, and if I have a faith that can move mountains, but do not have love, I am nothing." - 1 Cor 13:2

The entire chapter talks about what you can have or can do, but without love, you have nothing. But what is love? How can you have love? Again, the verse tells you.

"Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It does not dishonor others, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always protects, always trusts, always hopes, always perseveres." - 1 Cor 13:4-7

I'm sure you are asking, "How does love and childishness relate?" Ah, but you've already missed the point. Lewis says to, "put away childish things," but also to "put away" the "fear of childishness." Childishness is centered around unbridled love. The love of the new, or the love of the well known. Just as a child loves a new toy, they also love their old toys. They love a new friend, and they love their 'old' friends. Children are filled with the purest joy. Are we to fear joy? Fear love?

Lewis understood that to fear childishness was to reject love.

Likewise, desiring to be grown is what only children do. They need to grow and mature, so they set about becoming an adult with a seriousness only children can have. Adults have no need for this seriousness. We are already grown. What would adults seek to become - older? We have obtained the heights; we should admire the view.

If our goal is to be seen as adult by other adults, to gain their approval, we aren't seeking love. Love does not boast. Love is not proud. And if other adults judge us for our 'adulthood', then they do not love us.

We should be joyful in our achievement, but we should not fear childishness. Childishness brought us joy once, and it should bring us joy any time we wish.

And here I found the full context of Lewis's quote. And it shows his complete understanding of the scripture about being an adult and about putting away our childish things. It isn't childishness we are to put away. It is the fear of being childish. When we put away the fear, we replace it with love. We cherish childishness.

"Critics who treat adult as a term of approval, instead of as a merely descriptive term, cannot be adult themselves. To be concerned about being grown up, to admire the grown up because it is grown up, to blush at the suspicion of being childish; these things are the marks of childhood and adolescence. And in childhood and adolescence they are, in moderation, healthy symptoms.

Young things ought to want to grow. But to carry on into middle life or even into early manhood this concern about being adult is a mark of really arrested development. When I was ten, I read fairy tales in secret and would have been ashamed if I had been found doing so. Now that I am fifty I read them openly. When I became a man I put away childish things, including the fear of childishness and the desire to be very grown up." - C. S. Lewis, Of Other Worlds: Essays and Stories, Part I: 'On Three Ways of Writing For Children'

Walk me through this “Safety Third” thing - re-blog

Ok, I’m going to need you to walk me through this whole “Safety Third” thing one more time. How can safety be anything other than first? Are you seriously suggesting that saving the economy is more important than saving lives? Now, more than ever, safety must be first, whatever the cost! Roger Martin

Hi Roger

What I suggested in my post last week, was that Safety is not a thing to be “ranked,” but rather, a state of mind, to be applied as needed to a myriad of situations in varying amounts. But if we were to rank it, it would rarely be “first.” Were safety truly “first,” no level of risk would ever be encouraged or permitted, and no work would ever get done. Or play, for that matter.

Obviously, this does not mean that Safety isn’t a critical part of living. It is. And there are times, like right now, when extraordinary circumstances compel us to temporarily elevate safety above everything else – even our individual liberty. Which is why I’m hunkered down in my bunker, waiting for the all clear. But the notion of telling people that safety is always first, no matter the cost, is not only untrue, it’s counter-intuitive.

On Dirty Jobs, I was struck by the number of safety professionals who repeatedly insisted that nothing was more important to them, than my personal safety. “Your safety,” they said, over and over again, “is our top priority.”

I usually heard these words moments before I was invited to walk up the cable of a suspension bridge, or field test a stainless-steel shark suit, or climb into a bosuns chair to wash windows at the top of a high-rise. I still hear them today from pilots who invite me to strap myself in as they attempt to defy gravity in a pressurized aluminum tube that travels through the air at 600mph. And now Roger, I’m hearing them from you. You’re telling me safety must always be first, no matter the cost.

Here’s an honest question – would you be OK if the government reduced the posted speed limits by 50%, required all motorists to wear helmets, and outlawed all left turns? If not, why not? Doing so would save almost 40,000 lives a year.

The reason most people would not agree to those new protocols, is because we’ve already come to terms with the human cost of driving the way we want to drive. We believe, collectively, that 40,000 annual deaths are an acceptable price to pay. It’s a steep price, but we pay it, year after year after year. Sure, we’ve made things much [s]afer with safety belts, air bags, ABS brakes, and so forth. But we haven’t done ALL we can to eliminate traffic fatalities. Nor will we. Because when it comes to driving, safety isn’t first.

I’m not trying to be provocative, or insensitive. As I wrote on my first day of quarantine, I have two parents in the at-risk category, and I’m terribly worried about their well-being. But assigning a cost to preserving human life is hardly a new calculus, or a sign of misanthropy. We humans are constantly deciding which calamity to worry about, which disaster to panic over, and which tragedy to outright ignore. Just yesterday, 24,000 people died of starvation. The same will happen tomorrow, and the day after tomorrow, and the day after that. Over nine million a year die of hunger related illnesses. Why is this not a global emergency? Why doesn’t cable news report these tragic deaths every minute of every day, like they do with this virus?

Over the last few weeks, we’ve been inundated with facts, but very little context or perspective. And that lack of context is prompting more and more people to ask the same question I posed here last week – what if the cost of the cure is greater than the cost of the disease? It’s not an unreasonable question, or a heartless one, but people don’t like to hear it. Last night on Tucker Carlson, a former Lt. Governor from Texas named Dan Patrick learned that the hard way.

“Let’s get back to work,” said Patrick, who emphasized that he is a grandparent. “Those of us who are 70-plus, we’ll take care of ourselves, but don’t sacrifice the country. Don’t do that. Don’t ruin this great American dream.”

The backlash has been brutal.

“This crisis is really laying bare the extent to which we are ruled by completely craven psychopaths,” tweeted Micah Uetricht, managing editor at Jacobin magazine.

Democratic Texas state Rep. Donna Howard, a grandparent herself, told Dallas Morning News that “the idea that the only option is for us to sacrifice ourselves is really incredulous to me.”

Texas state Rep. Gene Wu also ripped Patrick’s remarks in a tweet late Monday. “This statement is repulsive and unfortunately reflective of the attitude many Texas Republicans have regarding people and money.”

What do you guys think? Is it repulsive to suggest that a country’s economy might be more important than saving the lives of thousands of its citizens?

In the comments below, I’ll likely be criticized for comparing this virus to other deadly diseases and hazardous pursuits, but that’s not what I’ve done. I’m simply wondering why the safety of our fellow man is such a fungible thing? It’s a sincere query. No one today is suggesting we should change the way we drive in order to save 40,000 lives, even though we easily could. But many seem to believe our entire economy should be sacrificed in order to save as many lives as possible. People who, like you, seem to believe that safety is always the most important thing.

Anyway, to answer your question, Safety Third was my slightly subversive attempt to start an honest conversation around occupational safety back in 2009, and to acknowledge the unintended consequences of exaggerating the importance of safety on the job. For what it’s worth, it worked. Attached is a short video that spells it out for you.

And here’s one of a hundred articles written by various safety professionals who actually agrees with me. https://bit.ly/2vL04O0

And here’s another one, just so you know I’m not alone… https://bit.ly/2Ue99bF

Be careful out there…

Mike

 

---

Walk me through this “Safety Third” thing - by Mike Rowe, March 24, 2020

Covid Math: Revisited

I first posted "Covid Math" on April 13th of 2020. These were using the statistics known at the time to determine the potential severity of #Coronavirus / #CoVid19 / Sars-CoV-2 / China-Virus, or whatever you want to call it. I am returning to this post in September, after five months, to see how things have held up as predictions. Feel free to read the previous posts and the comparative backgrounds of influenza and H1N1, as I won't be rehashing that data here.

"Finally, what we know of Coronavirus so far"

Again, we are going to use the same data point, but update it with what we know now. So, we still don't know the assumed cases, but we might be able to estimate it better. We have really accurate confirmed cases, hospitalizations, and deaths.

Note: There are still questions about the number of deaths. Some are saying many deaths are not attributable to Covid. Recently, the CDC made a statement that only 6% of recorded Covid deaths were strictly caused by Covid, and the other 94% had comorbidities. I will NOT be separating these at this time. My rationale is that we don't know with any high degree of certainty that those comorbidities would have killed the person if they had not contracted Covid. If they would have lived six months or six years with those other issues, then Covid hastened their demise, and I will not try to parse which issue was the ultimate cause of their death. For instance: an obese person with diabetes and heart issues is likely to die early. If they contract Covid and die, was it the Covid, the diabetes, or the heart issue? If they didn't have those other issues, would they have survived Covid? These are questions we are unable to answer at this time, and we likely will never have an answer. Deaths = deaths.

Covid-19 numbers (as of 9/9/2020):

Medical visits (confirmed tests) - 6,334,158

Hospitalizations - 379,866

Deaths - 189,972

Population (est.) - 318,000,000

In the previous post, I extrapolated out the hospitalizations for a year to be about 374,524. Yet here we are at only 8 months and we have already exceeded that estimate. If we (again) do a simple (linear) extrapolation to one year, we will have had 569,799 hospitalizations. That is nearly twice my original estimate.

If we had extrapolated, again simply (linear), the previous deaths of 22,154 would have been 88,616 deaths, which we are FAR past that number. So we see that the numbers we had early on had not proceeded in a linear fashion, which is to be expected with a virus with a Rate of Infection (R0) of greater than 1.0.

If we compare these numbers back to the H1N1 and seasonal flu, we need to compare the death rates:

Known cases:

Seasonal flu - 38,230 deaths / 29,220,523 cases = 0.13%

H1N1 - 12,469 deaths / 60,800,000 cases = 0.02%%

Covid - 189,972 / 6,334,158= 3.0%

Hospitalized deaths:

Seasonal flu - 38,230 deaths / 496,912 hospitalizations = 7.69%

H1N1 - 12,469 deaths / 274,304 hospitalizations = 4.55%

Covid - 189,972 / 379,866 = 50%

To compare this to the previous post's estimates, the Covid case mortality was previously calculated at 1.98%, and it is now at 3.0%. An additional one-percent morality is pretty serious.

If we continue to assume that cases will continue to increase for the remainder of the year (or until a widely accepted vaccine is available), then we will have to make an assumption of total cases. Again, I will use simple (linear) extrapolation, even though it has been shown to be inaccurate. The reason for this is because new cases appear to be trending downward, so hopefully the estimate will turn out to be higher than what we end up with. I hope.

Extrapolated 1-year total cases: 9,501,237

Extrapolated 1-year hospitalizations: 569,799

Extrapolated 1-year deaths: 284,958

This is FAR below the worst-case estimates of the April post. We will have far fewer than the 80 million cases predicted. It will be far below the H1N1 60 million cases. It will be fewer than the 29 million cases of seasonal influenza. But because the death rate is higher than anticipated, the case fatality rate will be higher than the original extrapolation, yet lower than the worst-case estimates.

---

source:

https://gis.cdc.gov/grasp/COVIDNet/COVID19_3.html

https://coronavirus.jhu.edu/map.html

https://ycharts.com/indicators/us_coronavirus_hospitalizations

You can kiss my ass - A study in music, theater, and history

 Mozart.

That's right. We're starting with Mozart. There is no better place to begin a story like this than with Mozart.

Anyone with a name like "Wolfgang Amadeus Mozart" is bound for greatness. Anyone christened with the name "Johannes Chrysostomus Wolfgangus Theophilus Mozart" will then rightfully change his name, if only for brevity's sake. For it's not the destiny of "Johannes Mozart" to become great.  No, it's the destiny of one who chooses "Wolfgang", adds to it "Amadeus" (love God), to become great. And part of that destiny is to be extremely non-conformist.

And when this person writes music, because of course he'll write music, he will write some of the greatest masterpieces known to mankind. Music the likes of:

• Serenade No. 13 - "Eine kleine Nachtmusik" (A Little Night Music)
• Symphony No. 41 - "Jupiter"
• Clarinet Concerto
• The Magic Flute
• Requiem
• "Leck Mich Im Arsch" (Lick me in the ass)

There's no need to read that again. You absolutely read that last one correctly. As catchy titles go, that's pretty good. I doubt you'll forget that any time soon. You might even be looking it up online to hear how baudy, even raunchy, that tune might be. Well, I'm sorry, but you may be disappointed. Unless you speak German, it's your standard Mozart fare.

But even if you don't speak German fluently, you might catch words and phrases that make you wonder what it's all about. As if you weren't wondering already.

Leck mich im arsch! Goethe, Goethe! Götz von Berlichingen! Zweiter Akt.

Well, we know the title of the song. But what does Goethe, Johann Wolfgang von Goethe, a German writer who is most well known for his celebrated drama about the devil, Faust, have to do with Mozart and the licking of hindquarters? Well, it has nothing to do with the fact that each of them have the name "Wolfgang" as part of their name, but that's a wonderful coincidence.

No, it has to do with a successful 1773 drama by Goethe about an adventurer-poet named Gottfried. He was known as Götz of the Iron Hand. This drama was based on a real-life military man named Götz von Berlichingen. Thus, we have divined the source of the other name and it's connection to Goethe. But who was Götz ?

Götz was a German Imperial Knight from the 1500's who had an iron hand. I don't mean this figuratively or metaphorically. He lost his hand in battle when he was only 24 and a cannon shot forced his own sword against him. He continued going to battle with the help of a iron prosthetic that allowed him to grip a shield or his horse's reins. He retired from battle 40 years later and died at age 81. He was married twice and had seven sons and three daughters. Apparently losing an arm did not hinder him in any way.

Needless to say, Götz was a bad-ass and more of a man than any of us reading this today.

To put a finer point on the bad-assery of Götz, we must understand a part of Goethe's drama about him, to which Mozart references. Mozart proclaims, "Zweiter Akt!", which means, "the Second Act", again referring to Goethe's drama about Götz of the Iron Hand. While Mozart was mistaken, and the important dialogue takes place in the Third Act, we are quite sure about, without any doubt, which portion he is referring us to.

Götz, in the drama, is under siege by the Imperial Army. He is caught inside his castle and surrounded by the enemy. The captain of the army comes to Götz, who is at a window looking down on the multitude. The captain looks up and asks him to surrender. Götz of the Iron Hand replies as only a man with an iron hand (and possibly brass balls) could. The line goes something like this:

"Me, surrender! At mercy! Whom do you speak with? Am I a robber! Tell your captain that for His Imperial Majesty, I have, as always, due respect. But he, tell him that, he can lick me in the arse!"

Now, we have no way of knowing if this ever happened, or if it is simply a fantasy of Goethe. But in 1525, Götz fought in the German Peasants' War against the Ecclesiastical Princes of the Holy Roman Empire, during which time he returned to his castle. The Holy Roman Empire won the war, and Götz was called to account for his actions and imprisoned. I doubt there was such a siege on his castle, but there may very well been a frank conversation occur, nonetheless.

Götz wrote an autobiography which wasn't published for over one hundred and seventy years, until 1731. The Biography of Sir Götz von Berlichingen was the basis for Goethe's 1773 play, and the subsequent lyrics for Mozart's lesser known, but equally important, songs.

So that is the story behind the music, the theater, and the history of Götz of the Iron Hand. And if you didn't like it, you can "leck mich im arsch!"

Sorry To Ruin A Good Story

OH SHIT. BLM isn't going to like what I just found out.

I used ONLY publicly available information; including census data, arrest records, federal resources, and independent sources to find this out.

White people and black people have fatal police shootings at the SAME RATE as each other compared to their arrests. That means, if you get arrested, you have an equal chance of being shot by police, REGARDLESS of being black or white.

You read that right.

If you get arrested and WHITE, you have an 11.33 per 100,000 arrests of being shot by the police.
If you get arrested and BLACK, you have a 10.75 per 100,000 arrests of being shot by the police.
You are equivalently equal (if not slightly less) likely; black or white.

These numbers are averaged over 2015 through 2018. Data is incomplete for 2019, and 2020 isn't over.

---

source:
Demographics of the United States
https://en.wikipedia.org/wiki/Demographics_of_the_United_States

US Census
http://data.census.gov

FBI – Uniform Crime Reporting
Arrests by Race and Ethnicity, 2018
https://ucr.fbi.gov/crime-in-the-u.s/2018/crime-in-the-u.s.-2018/topic-pages/tables/table-43

Bureau of Justice Statistics
Contacts Between Police and the Public, 2015
https://www.bjs.gov/content/pub/pdf/cpp15.pdf

Fatal Encounters Dot Org
Downloaded 2020-06-12
https://fatalencounters.org/spreadsheets/

Mapping Police Violence
Downloaded 2020-06-12
https://mappingpoliceviolence.org/s/MPVDatasetDownload.xlsx

Washington Post database of fatal shootings by a police officer; 2015-2020
Downloaded 2020-06-17
https://github.com/washingtonpost/data-police-shootings

Masks work... sort of

So much to say; so little time. It's all about percentages.

N95 masks are 95% effective FOR THE WEARER against 0.3 micron (e.g. virus) particles. They don't protect your eyes (0% effective), which is another point of infection. Some N95's have a one-way valve. This is 0% effective FOR THE PUBLIC.

Surgical masks are are 95% effective FOR THE PUBLIC, and maybe 5% effective FOR THE WEARER.

Cloth masks are maybe 50%-75% effective FOR THE PUBLIC and basically 0% FOR THE WEARER.

So, if 100% of people wore just cloth masks, we might slow the spread by maybe 50%. If 50% of people wear surgical masks (everyone else wears nothing), we might slow the spread by about 45% (probably less). Likely, we'll have 25% of the people wearing a mix of cloth and surgical; so the spread might slow by maybe 10%.

If you are a carrier, masks prevent YOU from infecting others. If you aren't a carrier, masks are NOT EFFECTIVE. If you are concerned about YOU catching the virus, stay home or at least wear the most effective mask you can find plus "social distance" as much as you can.

All that being said, this virus WILL be passed around regardless of whether we wear masks or not. It's just a matter of how fast does it spread. The "R0" is the average number of people infected by each carrier. So, if the zero-mask rate is R0=3, wearing masks might make it R0=1.5. But, until a vaccine is available (don't hold your breath, folks), you will likely get infected. It's just a matter of how long until it's your turn.

Covid Math

Twitter Thread: bit.ly/CovidMath

Why do y'all make ME do the #Math all the time? I'm so f'n #TiredOfBeingRight.

Why we SHOULD take precautions against #CoVid19 #Coronavirus and how is it NOT LIKE the yearly flu numbers - A Thread:

First, "The Flu":
Best numbers available are 2016-2017. More recent numbers are still in the 'estimate' category, so we'll use the '16-'17 numbers as baseline and reference more recent data as estimates only.

All data is US only, unless noted otherwise.

[All text in brackets are later edits.]

2016-2017 Flu data:
Symptomatic (assumed) - 29,220,523
Medical visits (confirmed) - 13,633,446
Hospitalizations - 496,912
Deaths - 38,230
https://www.cdc.gov/flu/about/burden/past-seasons.html
https://www.cdc.gov/flu/about/burden/2016-2017.html

Population estimate 2016 - 318 million

9% of the population was symptomatic
4% were confirmed medical visits
[0.15%] hospitalized

Of confirmed cases, mortality rate is 0.28%.
Of assumed cases, mortality rate is 0.13%

Second, "H1N1 2009 swine flu" (US only):
Assumed cases: 60.8 million cases
Medical visits [(confirmed)]: Unknown (like Covid19, testing data is incomplete)
Hospitalizations: 274,304
Deaths: 12,469

https://www.cdc.gov/flu/pandemic-resources/2009-h1n1-pandemic.html

Population estimate 2009 - 308 million

20% of the population was symptomatic
0.09% hospitalized

Of assumed cases, mortality rate is 0.021%.

If we assume, like seasonal flu, confirmed mortality is 2X's assumed, the baseline H1N1 "confirmed" mortality would be about 0.04%.

We can already see that H1N1 wasn't that bad compared to seasonal flu. Or was it?

To understand this, you have to understand how many strains of flu virus are out there, in "the wild" if you will. There are four basic types: A, B, C, D.

https://www.cdc.gov/flu/about/viruses/types.htm

Types A & B are your typical human flu viruses. Type C can sometimes cause mild symptoms. Type D mainly affects cattle.

Type A is split into 2 subtypes: H & N. There are 18 H types and 11 N types. Of these combinations, only 131 subtypes have been detected in nature thus far.

These 131 subtypes can be further broken down into 'groups' and 'subgroups'. But for sake of discussion, we will only focus on Type A's 131 subtypes.

Type B is split into 2 lineages: Y & V. These also can be divided by group and subgroup.

Since Type D affects cattle, we will disregard it.
Since Type C is often mild, we will disregard it.
Since Type B is rarely known to cause pandemic, even though severe, we will disregard it.

So, of the 38,230 "flu" deaths, these are attributable to those 131 strains of Type A.

So when you consider that H1N1 was "only" 32% as deadly as the seasonal flu, what you're really saying is that ONE virus is 32% as deadly as [all] 131 viruses [combined].

Or, more accurately, H1N1 (12,469 deaths) is 42X's more deadly than a single seasonal flu virus (292 deaths per virus).

Finally, what we know of the Coronavirus so far:
Symptomatic (assumed) - unknown (incomplete data)
Medical visits (confirmed) - 558,599 (as of 4/12/2020)
Hospitalizations - 93,631
Deaths - 22,154

Again, we will assume some things. One, these numbers are accurate (something we'll discuss later). And two, that symptomatic cases are roughly 2X's the confirmed cases. Each of these assumptions will be vetted later.

Population estimate 2020 - 318 million

0.35% are already symptomatic [(assumed)] at three months in.
0.18% have already been confirmed.
0.029% have already been hospitalized.

[These numbers are for only three months.] Simple extrapolation to a full year means we are looking at [0.12%], or [374,524] people being hospitalized.

So far, it looks like H1N1. Maybe even a little better, right? Not so fast.

Of the confirmed cases, the mortality rate is 3.97%.

Remember, we are assuming symptomatic cases is 2X's the confirmed. So the mortality rate of all symptomatic cases would be 1.98%.

Recap:
Seasonal flu symptomatic mortality rate: 0.13%
H1N1 symptomatic mortality rate: 0.21%
Covid19 symptomatic mortality rate: 1.98%

Do you see the difference yet?

*Elephant in the room*
The numbers.

Here we'll address assumption #1; the accuracy of the numbers.

Many have been saying the numbers are inflated. And they may well be. Some of the reasons for this belief include: inaccurate reporting, intentional skewing, and outright lying.

Inaccurate reporting:
Yes. This is a dynamic situation. We may never know 100% of all the data. Even the seasonal flu data is subject to this. The H1N1 data shows that much of the earliest numbers were full of errors and assumptions. Testing for a novel virus isn't error free.

As with any statistical analysis, you have to bake inaccuracies into the cake. You have to try to keep all of your assumptions the same across data sets. So, we assume there are inaccuracies in the Covid19 data, but we hope similar inaccuracies exist in the H1N1 and flu data.

And we know they both do have similar inaccuracies. Not everyone who gets the seasonal flu reports it. Even of those who see a doctor for it, few get tested. They are often diagnosed without confirmation.

Likewise, there are reports of diagnosis of Covid19 without testing.

Intentional skewing:
There is money to be made from inflating Covid19 numbers. But again, this is baked into the cake. However, the intentional skewing may be higher in the US and other countries because of the governments throwing money at those "confirmed" cases.

So, let's compare to other countries. We know China has bad data, so we'll throw them out from the start. So let's use several others:
Italy (worst case)
UK (similar to US)
Turkey (possible control group)
India
Malaysia
Japan
Singapore (best case)

We need to compare three things:
Confirmed cases
Confirmed rate (percent of population)
Confirmed mortality rate

Italy: 156363 - 0.26% - 12.7%
UK: 89554 - 0.13% - 12.7%
Turkey: 61049 - 0.073% - 1.96%
India: 9635 - 0.0007% (!) - 3.43%
Malaysia: 4817 - 0.015% - 1.60%
Japan: 7370 - 0.006% - 1.67%
Singapore: 2532 - 0.044% - 0.31%

Analysis:
The confirmed rate as a percent of the population is ALL OVER THE PLACE. In Italy and the UK, you see 'confirmed' cases at rates similar to the US (~0.18%). In all other countries, the rates are much lower. So this appears to confirm that the reported cases are high.

But how high? Can we tell from the other numbers?

First, we have to assume some other factors. One: Turkey, India, and Malaysia likely have terrible reporting and tracking. Their numbers are suspect. If you look at India, their reported cases are staggeringly low.

Another anomaly with India is their death rate is very high for having so few reported. I would bet that all of India's numbers are bad. So we will leave India aside for now.

What about Italy and UK? Their reported cases rate is similar to the US, but mortality is HIGH!

The death rates in Italy and UK are a factor of 10 higher than the US. It is VERY likely that there is something wrong with their numbers. We might assume they would be higher due to some outside factors, but not 10X's more.

What about Japan and Singapore?

Japan and Singapore already have a high level of social distancing and widespread mask use. It would stand to reason that their numbers would be low. And their reported rate is very low. Their reported rate is a factor of 10 lower than the US and the UK.

But their death rates are not so dissimilar to the US, Turkey, and even Malaysia. Singapore has a very low death rate; possibly the lowest in the world. Is there misreporting on the other side? Perhaps Singapore's semi-socialist governance wants to inflate their healthcare?

However, even if we take Singapore's unusually low death rate, it is still higher than the 2009 H1N1 death rate.

More likely, the correct death rate is something along the rate of Japan (which is similar enough to Turkey and Malaysia to give confidence).

[Outright lying:]
[It's absolutely possible that countries are lying about their results. China is a prime example. But the question becomes, who is lying and which direction are thy skewing the numbers? The US, UK, and Italy may be lying to make their numbers higher. Japan and Singapore may be lying to make their numbers lower. But again, this has to be backed into the cake.]

What does that mean?

A mortality rate of 1.6% [(Malaysia / Japan)] is 7.5X's the rate of the H1N1.
And it's 12X's the rate of ALL seasonal flu viruses, combined (remember, there are 131 varieties)!

As for the assumption that symptomatic cases are roughly 2X's the number of confirmed cases, we can make the assumption in any direction, and the outcome will be affected very little. Once we have determined the mortality rate of the virus, very little else matters.

For instance, let's assume the number of symptomatic cases are 5X's (instead of 2X's) the confirmed cases, and the mortality rate is that of Japan (1.67%):

US's assumed symptomatic cases: 2,792,995
Expected deaths: 46,643

That's 2X's the known deaths (which we have already assumed is inflated). If the actual deaths are lower than the reported, then the US mortality rate would be lower than Japan. Does that make sense?

Let's assume it does (which it doesn't): Then what?

If the US assumed symptomatic cases are really that high, and the actual deaths are lower (let's say by half):

11,077 deaths / 2,792,995 cases = 0.04% mortality rate

That is STILL DOUBLE the rate of the H1N1!!!

Recap:
We have QUINTUPLED the symptomatic cases, and we have halved the REPORTED deaths.

And Covid19 is still twice as deadly as anything we've dealt with in a century.

So, even if we play the game of "The numbers are wrong", we still come out with a pandemic on the scale of the 1918 Spanish Flu.

But if we take a realistic look at the numbers being reported around the world, we are looking at a 1.5% - 3% mortality rate.

If we don't act like Covid19 is a big deal (which it is), and we behave like we did under the H1N1 or Ebola pandemics, we will end up with 80 million infected in the US alone. And with a mortality rate of a conservative 1.5%, that's 1,200,000 dead in a year.