March 6, 2020

"In a context that includes Ebola and MERS, the Covid-19 death rates are much closer to those of the flu, and it’s understandable why people find the comparison reassuring."

"Compare Covid-19 with just the flu, though, and it becomes clear how different they are. The 61,099 flu-related deaths in the U.S. during the severe flu season of 2017-2018 amounted to 0.14% of the estimated 44.8 million cases of influenza-like illness. There were also an estimated flu-related 808,129 hospitalizations, for a rate of 1.8%. Assume a Covid-19 outbreak of similar size in the U.S., multiply the death and hospitalization estimates by five or 10, and you get some really scary numbers: 300,000 to 600,000 deaths, and 4 million to 8 million hospitalizations in a country that has 924,107 staffed hospital beds. Multiply by 40 and, well, forget about it. Also, death rates would go higher if the hospital system is overwhelmed, as happened in the Chinese province of Hubei where Covid-19’s spread began and seems to be happening in Iran now. That’s one reason that slowing the spread is important even if it turns out the disease can’t be stopped. Could Covid-19 really spread as widely as the flu? If allowed to, sure. The standard metric for infectiousness is what’s called the reproduction number, or R0. It is usually pronounced 'R naught,' and the zero after the R should be rendered in subscript, but it’s a simple enough concept. An R0 of one means each person with the disease can be expected to infect one more person. If the number dips below one, the disease will peter out. If it gets much above one, the disease can spread rapidly...."

From "How Bad Is the Coronavirus? Let’s Run the Numbers/The risks posed by Covid-19 — and the possibilities for getting it under control — become clearer with some simple math" (Bloomberg). The graph shows the estimated R0 for Covid-19 at 2.8 and for seasonal flu at 1.3.

79 comments:

Narayanan said...

Did Mike Bloomberg comment commend Trump for halting flights from China and elsewhere?

Narayanan said...

And comment condemn State Department bureaucrats who put infected passengers on commercial flight

Sydney said...

Yes, it is very contagious. Probably because no one has immunity. It can be spread from persons with no symptoms at all. Thankfully it isn’t very fatal, unless you are elderly or have bad lungs or diabetes. I read the mortality rate in those groups is higher- 10 to 20% instead of 2-3% for the general population. This is why I am not too worried about my children in Seattle. They might get sick, but I expect them to survive. I don’t even expect the, to need hospitalization.

Breezy said...

Until the US gets more wide spread testing underway, the numbers related to US are more guesswork than science.

iowan2 said...

It is already clear that the statistics of this (or any) pandemic will be used in an attempt to rewrite history, and push a narrative.
The numbers are naturally ripe for manipulation. You can sort out categories to either get the low number you seek, or the same sort, using the groups eliminated in the first example to get the high number you seek. The biggest number is, infected but never identified. It's going to be very easy to arrive at your preferred outcome, by arriving at that unknown number by inventing plausible proxies to make the calculation.

Think Climate change statistics. Models of models using proxies that have been adjusted to a secret norm.

rhhardin said...

Go on a cruise somewhere until it subsides.

tim in vermont said...

"The numbers are naturally ripe for manipulation.”

In a week we will know much better.

rhhardin said...

Air travel will be a bother. There's three hours checking in and then two weeks quarantine at the destination. It's faster to drive.

Chuck said...

But Althouse! PDJT has been talking to people — a lot of really great, very special people — and he has s hunch that the numbers are all wrong as to what we should expect.

"Well, I think the 3.4 percent is really a false number. Now, and this is just my hunch, and — but based on a lot of conversations with a lot of people that do this. Because a lot people will have this and it's very mild. They'll get better very rapidly. They don't even see a doctor. They don't even call a doctor," Trump said.

tim in vermont said...

The Italian numbers probably can be used as a proxy for the US and are probably more trustworthy.

"Models of models using proxies that have been adjusted to a secret norm.”

Climate science is like economics, one of the few sciences where a proof begins “assuming that...” These models are the same, we want to know the answers before we can know the answers, so assumptions must be made.

tim in vermont said...

Can you believe that Chuck thinks that lame attempts to destroy Trump are more important than working together to face this challenge? Well, before we can work together, one side will have to do the impossible, to accept that Trump is our duly elected president. That’s a bridge too far.

tim in vermont said...

No model for which the outcomes have political impacts can be trusted to not be jiggered towards some political end through invidious assumptions.

Tom T. said...

Trump's right and Chuck's wrong. We really don't know the denominator here.

Matt Sablan said...

If a lot of people have it and have no symptoms or don't get bad enough to think it is corona and not the common cold or flu, like the media insists, then the mortality rate needs to be adjusted with that in mind. Does the 3.4% number do that? Should we fiddle with it since we know the actual number of infected is larger? What about deaths, have any been misdiagnosed, and should it be higher? The exactness of 3.4% is interesting, but it is a starting point. It might go down, as everyone hopes.

tim in vermont said...

"If a lot of people have it and have no symptoms or don't get bad enough to think it is corona...”

“All will be well if if if, rang the sad bells of Cardiff.” - Bells of Rhymney

tim in vermont said...

Trump is engaging in something known as critical thinking. Chuck has no concept what that is.

Unknown said...

It's not even optimism. If we don't have a good handle on how many people have the coronavirus the actual statistic is completely useless.

Kai Akker said...

Good article. Also the comment from wbfjrr2 at 5:51 pm in the post yesterday about whether the virus will put a stop to campaign rallies. Came late in the discussion and maybe he will re-post here for those who missed it.

A key point in this Bloomberg article struck me, when he identified what factors are under our own control. It is certainly in our power to limit the spread even of a contagious virus. First and foremost, obviously, we should be extra careful about exposing others if we are showing any symptoms.

Mary Beth (the commenter) said...

Chuck said...

But Althouse! PDJT has been talking to people — a lot of really great, very special people — and he has s hunch that the numbers are all wrong as to what we should expect.


He calls it a hunch, but he's looking at the numbers coming out of South Korea. That's the only place that has had aggressive testing. The mortality rate from COVID-19 there is 0.6%.

Beloved Commenter AReasonableMan said...

Aunty Trump said...
Trump is engaging in something known as critical thinking.


AT is just as confused about reality as they are about their own gender.


Birches said...

Good hygiene and good lungs seem to put a stop to this virus's fatal ways. China, Italy and Iran are missing one or both of these things. I am truly bewildered that Chinese smog is not brought up as a reason why so many people have died there.

stevew said...

If you know how many people died from it but don't know how many people have contracted it then you can't calculate a mortality rate. Then add in the factors Matt @6:36AM mentions and the statistical numbers are made meaningless.

Temujin said...

It's time to pull this one out: "Reports that say that something hasn't happened are always interesting to me, because as we know, there are known knowns; there are things we know we know. We also know there are known unknowns; that is to say we know there are some things we do not know. But there are also unknown unknowns—the ones we don't know we don't know. And if one looks throughout the history of our country and other free countries, it is the latter category that tend to be the difficult ones."

Rumsfeldisms in the morning.

We've canceled our trip to Seattle to see our kids and grandkids. We've got both techies and doctors out there. The techies are now working from home (per their company edit). The docs have to continue to do what they do and, yes, they have active patients. All of them are more worried about us, being over 60. So...we're postponing things because of a known unknown. Any upcoming biz trips are also under consideration now. As the economy grinds down to a halt.

IF Dems try to make this their claim to a bad economy, they'll lose in a big way. But I know them and I know they won't be able to help themselves. If anyone thinks Joe Biden can work his magic on Coronavirus, they're not serious human beings and should be placing their hands all over their own faces.

Also- Bloomberg news has, over the last few years, shown itself to be a spreader of questionable facts. I read them with that in mind. Half of what they say may not be correct. Need to find additional sources of this kind of information.

tim in vermont said...

"AT is just as confused about reality as they are about their own gender.”

Sick burn. Real trenchant takedown. I could get you banned from Twitter for that!

Jon Burack said...

As of this morning, I count 89 cases in all of India, Africa, and South and Central America.

https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

It is beginning to look to me like there is a climate relationship here, with warmer climates far less vulnerable. (And generally don't flus fade in warm weather here, too?) It makes me wonder whether this will fade by May. I hope so, but it may still grow huge before then. Might be too early to conclude this connection, but 89 as compared to about 100,000 is a big difference, no?

Michael said...

ARM
You seem frustrated by that low S Korea death toll percentage. Cheer up the one person infected in S Africa may expire giving you a 100% bone.

daskol said...

Precautions such as extra good hygiene, avoiding public gatherings especially if you may feel sick, stop shaking hands, preparations for hunkering down for a few weeks are all cheap and worthwhile in a situation as uncertain as a new bug. At the same time, I am sympathetic to the people railing against the manufactured panic surrounding this public health crisis. The WHO especially has distinguished itself as unworthy of any trust. In this new era of "Epstein didn't kill himself" and "Haney shot himself in the chest," it's hard to ascribe to incompetence what can be explained by conspiratorial malice.

daskol said...

The very likeliest crisis we can expect is that healthcare infrastructure will be highly stressed, and not necessarily across the board but in areas where there is outbreak or panic about it. Minimizing use of healthcare facilities to an extent would make sense. Stock up on all medications you might need, keep extra first-aid and NSAIDs around and try not to get sick: that's where that hygiene practice not only may help slow spread of COVID-19, but is an overall social good at this point. There are many ways that taking inexpensive precautions are beneficial under this kind of uncertainty, including providing some measure of psychological calm that you've done what you can.

Beloved Commenter AReasonableMan said...

Michael said...
You seem frustrated by that low S Korea death toll percentage.


Drago has established a new standard for this blog. If you attribute a belief to someone you must provide a link.

Link, please.

daskol said...

Ghee and powdered butter are, based on my perusal of various prepper materials over the years, overlooked pantry or basement items for hunkering down. Calorie dense and delicious, you can eat deliciously flavorfed popcorn while watching the world burn on TV.

exhelodrvr1 said...

At this point no one has any idea how many cases there have actually been, so it's way to early to do this type of analysis.

daskol said...

We canceled a family gathering, an 80th birthday for my father in law, because the oldsters didn't feel great about coming in to the city for dinner at a restaurant. Yet we have not canceled the larger suburban gathering for my mother's birthday. Is it because she's only 70 and in vigorous health, or is this an expression of how my wife feels about my mother?

JML said...

We have a trip to Alaska booked in mid-May, with a 7 day cruise on the return. Yesterday the Travel Agent just got an upgrade to our cabin and is working on another upgrade. This morning we got an email from the cruise line further explaining the cancelation policy, and giving an added onboard ship credit. I figure if this keeps up, we just might have the ship to ourselves and will be bunking in the Captain's quarters.

daskol said...

It'll be dead calm on that boat, I'd guess.

Ignorance is Bliss said...

Assume a Covid-19 outbreak of similar size in the U.S., multiply the death and hospitalization estimates by five or 10, and you get some really scary numbers...

Multiply the death and hospitalization estimates by 1000 and you get even scarier numbers, with more people dying than getting infected.

Of course, if you are after realistic numbers, instead of scary numbers, you would base your estimates on South Korea's numbers. We are facing the same virus. You might need to adjust the death rate for demographics: do we have a higher percentage of older, sicker people, former smokers, etc.

But our numbers should be fairly close to theirs.

DavidUW said...

South Korea is older and has a much higher smoking rate.

tim maguire said...

Chuck said...
But Althouse! PDJT has been talking to people — a lot of really great, very special people — and he has s hunch that the numbers are all wrong as to what we should expect.


Chuck, you cross further into troll territory every day. Couldn't you once in a while post something honest and useful?

As for this, there have been plenty of statistical analyses of what we know of transmission and all of them conclude that the infection rate is many times the confirmed cases. Since it's much harder to hide a body than a cough, we can assume that, outside China at least, the death rate is close to accurate. Which means Trump is right--the death rate is far lower than what is being reported.

It might be 2%-4% for serious cases (the ones that get reported), but much less than 1% for all cases.

gilbar said...

Let's FACE Facts!

If you're not washing your shoes; you're innumerate, and Part of the Problem!!!!
It is Imperative, that we ALL do pointless and idiot things; like washing our shoes...
Or,
WE ARE ALL GOING TO DIE!!!!

Amadeus 48 said...

This reminds me of MSM people talking about the Mueller investigation. The walls are closing in.

The US is not China. It isn't Iran. It isn't even Italy.There needs to be a much better understanding of the rate of infection, the effect of the end of the "flu season", the rate of mortality in otherwise healthy people, the velocity of vaccine development, etc. There have been 12 deaths in the US. It is a long way to 60,000.

I believe this is a serious problem. There will be many deaths. But the speculation in that article is wild.

Ann Althouse said...

It doesn't matter that you or Trump or anyone else maintains a personal feeling that the best case scenario will happen. You still have to be prepared for what could happen and there's a lot you can to contribute to avoiding the worst case scenario. You have to think about both. Keep your spirits up and do rational, useful things. Trump is doing both these things. The criticism of Trump for being optimistic is stupid, because he isn't working with an eye on the worst case scenario.

gilbar said...

WASH THOSE SHOES, NOW!!!!

Chuck said...

Althouse shame on you. We aren’t criticizing Trump for being optimistic. We are criticizing Trump for his negligence; for his saying things that are wholly untrue, or which amount to terrible epidemiological advice. And we are bashing Trump each and every time that it appears that for political/personal/vanity reasons, Trump is blocking federal officials in the executive branch from speaking truthfully:

https://www.nytimes.com/2020/03/06/opinion/trump-coronavirus-us.html#click=https://t.co/l5zQZa5JqG

Freeman Hunt said...

"He calls it a hunch, but he's looking at the numbers coming out of South Korea. That's the only place that has had aggressive testing. The mortality rate from COVID-19 there is 0.6%."

This rate is almost certainly wrong. It's what you get if you divide deaths by confirmed cases, but the number of confirmed cases is growing, and it takes about two weeks to die of the disease. The deaths number lags significantly behind the confirmed cases number.

daskol said...

Tail risk, or multiplicative risk, is the operative term. It's a simple concept, but hard. It applies to how we might best comport ourselves today anticipating a virus outbreak of uncertain scale and lethality. It also applies to understanding why our gains from globalization were illusory, owing to the fragility introduced into global supply chains as a result of the world's concentrated China risk. It is Nassim Taleb's central insight, and while he occasionally strays into areas where his insight yields strange analysis, you can't say enough how much people need to absorb this lesson. It is counter to the way our minds work, witnessed by the symmetry and false sense of order we inappropriately apply to situations just as Procrustes used to chop the legs off his too-tall guests.

gilbar said...

On Friday, a top Hong Kong university released research that surmised the “fatality risk” for symptomatic Covid-19 patients was 1.4%, based on data its researchers analyzed from the city of Wuhan.
U.S. health officials, in contrast, have said they think the mortality rate for the novel coronavirus is likely between 0.1% and 1%, in part because there could be many unreported cases or asymptomatic carriers of the virus.

Francisco D said...

There is not much point in arguing about COVID-19 statistics.

The numbers are corrupted (intentionally and unintentionally) so any attempt to analyze them is fruitless.

We will figure it out in hindsight.

narciso said...

this is where Bloomberg's Sinophilia, bleeds into his publications, like the Alliance in Firefly, he assumes the Us would be that negligent as China,

lgv said...

Let me preface by saying all numbers from China are unreliable or suspect. The fallacy of extrapolation is used here for some scary effect. It's the same analysis that says the world is running out of (fill in the blank). As we address the problem in any way, e.g. just more testing kits, the fatality rate will begin to diminish. This is why Wuhan fatality rates were so high. The early US deaths are concentrated in an elderly care facility. As the virus spreads to the general population, there will be a normalization of the rate.

There appear to be reasons that the outbreak will unstoppable, yet there are also reasons to believe that the fatality rate can be managed downward.

Bruce Hayden said...

Interestingly, there appear to potentially be some genetic components to susceptibility, or at least morbidity, with COVID-19 (caused by the SARS-CoV-2 virus). Most susceptible so far appear to be East Asians (I,e, members of the Oriental race). Cell entry for SARS (caused by SARS-CoV) appears to utilize ACE-2 receptors. Closely related SARS-CoV-2 appears to be following suit. There have been some Orientals who have shown extremely high numbers of ACE-2 receptors in their lungs, and in particular, some Han Chinese. Another factor may be ABO blood type, with those with O blood type apparently showing lesser susceptibility. All good for me (Caucasian w/O+ blood type). Maybe not for my partner (Caucasian w/A- blood) with some lung impairment.

I do question this racial aspect though, with so many Iranians contacting the disease and dying. Iranians are primarily, of course, Aryan (Indio-Iranian) Caucasian.

Still, it appears so far, that COVID-19 is more likely to kill East Asians in general, and possibly Han Chinese in particular. So far. Maybe. While I am neither, there also appears to be a high correlation to age, and for many here, that isn’t good.

Finally, it was originally suggested that SARS-Cov-2 might have been the result of bioengineering I the Wuhan virology lab. But that looks less and less likely to me, and one reason for this, is that if prevalence of ACE-2 receptors increases morbidity, and Han Chinese have a higher prevalence of such, then the researchers would have been researching how to kill themselves, and leave most non-Chinese safely alone. That doesn’t seem very Chinese. Cynically, I would suggest that they would have gone the other way, designing a virus to be less deadly to the Chinese, not more so. On the flip side, if Chinese are more susceptible to this fairly new virus (my memory is that it’s closest relative, the one from Saudi Arabia) was first identified, and genetic sequencing combined with mutation rates suggests, I think, that this branch of the SARS coronavirus under 20 years old, and SARS-CoV-2 itself under a year), then they may have been experimenting on the virus precisely because of their racial sensitivity to it, and they just screwed up, and allowed it to escape captivity. As that friend, who has done some bioengineering has said, reselling lab animals in the local fresh market, instead of destroying them, sounds very Chinese.

President-Mom-Jeans said...

I see our resident autistic pretend republican/lawyer is now shaming Althouse. The very same Althouse that kicked his retarded ass off the blog but apparently now allows him back.

narciso said...

interesting the patient zero in Italy, apparently is Pakistani, not Iranian or even Chinese as first speculated,

Bruce Hayden said...

Let me go on a bit on my last point. There is a saying something to the effect of suggesting that you shouldn’t attribute something to malice, when it can best be attributed to negligence. Inadvertence over advertence. Chance over malice. Which is why I like the selling of infected experimental animals into the wet market by lab employees, instead of killing them, to make extra money, to be one of the most plausible theories that I have heard so far. Of course we don’t know what happened, but I suspect that the Chinese government probably has a pretty good idea by now, and are just not saying, likely, I think, from embarrassment, something that they culturally don’t deal well with. Which suggests that is releas to the rest of the world is being mostly done deliberately, mostly controlled at the top, and they are hoping that the bad parts, the embarrassing parts, of the story, will be missed because everyone is looking the other way when it comes out.

Just a hypothesis.

daskol said...

I think the old saw about never attributing to malice what can be explained by incompetence needs an update for this era in which malice appears increasingly to explain a lot of bizarre shit that's happening right in front of our faces. I don't have any reason to think this applies to the Chinese and this virus, but in general I think that old saw is suspect.

Drago said...

We have reached the point where our admitted Liar and Smear Merchant LLR-lefty Chuck, like everyone else on the far left, couldn't tell the truth about something without self-destructing.

And everyone sees it.

LLR-lefty Chuck, like his lefty pals, have no one to blame for their circumstances other than themselves.

Yancey Ward said...

In logic, there is a thing called faulty generalization- that is what is going on with COVID-19 right now, and both political sides in the US are guilty of it. There are competing political narratives abusing the same statistic- total number of COVID-19 infections. The Right are trying to minimize the infected number- a small number is assumed to limit panic; however, the Left has settled on the number of fatal cases to hype which includes the mortality rate, and this also require a minimization of the total numbered of infected.

Now, part of this is arising because the RT-PCR test to conclusively identify a COVID-19 infection is new, and by its very nature requires the production of certain specific and unique reagents- in other words, you can't just pull shit off the shelf for use and slap together the test. This means that you can't immediately test every case of flu-like symptoms, which number in the millions at any give time during the Winter, because you simply can't produce the needed reagents fast enough at the beginning, which was just 6-7 weeks ago. This means that there is no good handle on the number of people exposed and infected COVID-19.

In the US, the tests have been limited to those with CT-confirmed pneumonia and only those who might have been shown to have a link to someone suspected of being infected with COVID-19; and, also the people in close contact with those same people. In other words, we are looking for our keys where only the streetlamp is giving enough light to see in the US, and the same thing is being done in Italy, for example. This will change when the there is a higher throughput capacity for the RT-PCR testing kits.

The one place that has been agressively testing marginal cases of flu is South Korea, and they are finding that the mortality rate isn't as high as feared from the Wuhan numbers, and the reason is obvious- they are getting a better read on the total number of infected people, not that they are treating the infected better or the South Koreans are less affected by the virus.

Inga said...
This comment has been removed by the author.
Yancey Ward said...

I pointed out in an earlier thread that there are 40-70 million cases of influenza A and B in the US every year, but that this is an estimate only. The CDC doesn't do 40-70 million virus specific tests/year to produce this number- they probably don't do more than 10,000 such tests each year, but use the results from those tests to estimate the disease in the population as a whole. This is an entirely appropriate use of generalization/extrapolation because the CDC has good historic data on who does and does not get tested for influenza.

We don't have this data for COVID-19, but we are all pretending that we know how many people have the disease at any given moment. However, the safe assumption here is that for every person tested and confirmed, there are 10 out there with it you haven't tested and likely won't ever test. A year or so from now, we will have much better data in hand with the knowledge of how to properly use it for extrapolation.

Scott Patton said...

This might be semi off topic, and circumstances permitting, I will duplicate this on a cafe comment.
When young, I was afflicted with fairly severe allergies. While having an allergic reaction, usually from a cat, pollen, cut grass etc., touching my face would exacerbate the reaction immensely, especially around my eyes and nose. In many cases, a touch itself would cause the allergic reaction.
This had the effect of training me to be aware of the cleanliness state of not only my hands, but also my face. If that cleanliness is compromised, a large(ish) portion of my consciousness is occupied with awareness of that contaminated status.
As a beneficial aftereffect, that awareness can be triggered by touching a public door handle, being around someone that appears to be ill and a number of other situations.

Inga said...

“A year or so from now, we will have much better data in hand with the knowledge of how to properly use it for extrapolation.”

I agree.

Unknown said...

Go on a cruise somewhere until it subsides.

You're kidding, right? A cruise is one of the worst things you can do. There's nowhere to run or hide on a ship. You're packed in. If one person has the coronavirus, hundreds of people will get it. That's what happened on the Diamond Princess. For a while there, the Diamond Princess was #2 on the list of the worst places to be for the coronavirus, right after China. Six people died on that ship.

Unknown said...

Picking a nit here, but there's a difference between fatality rate and mortality rate in the literature.

Fatality rate is the percentage of people who have the disease who die. 100 people have the disease, 3 people die, 3% fatality rate.

Mortality rate is the percentage of people in the population who die. 300,000 people in Charlotte, 3 people die, 0.003% mortality rate.

Unknown said...

Interesting that children seem to have an immunity.

daskol said...

picking the wrong nit. mortality rate used here is the people who die in a given population, and the implied population are those who have the virus.

Jessica said...

This is a great article. Please keep them coming, Ann!

gerry said...

...become clearer with some simple math

No wonder mainstream media are so brainfucked about Covid-19 Flu. It involves simple math!

If only their heads could do more than talk.

Bruce Hayden said...

“ However, the safe assumption here is that for every person tested and confirmed, there are 10 out there with it you haven't tested and likely won't ever test. ”

I question that assumption right now in the US. And that is because we are still at point where verified infections are rare enough that the infection can usually be tracked, and so far mostly has a provable recent Chinese connection, mostly within a generation or two. That isn’t lasting, of course, and I expect that by the end of the month, there will be enough people infected that this sort of tracking won’t be feasible. Maybe sooner. I would expect that we are beyond that point in parts of China, both Koreas, Italy, and Iran. Esp I think Iran, where people were licking Shi’a shrines to clean them of the COVID-19 causing virus. One after another.

Michael said...

Maybe we can get Brian Williams to “run the numbers”.

Bruce Hayden said...

“Interesting that children seem to have an immunity.”

What is going to be interesting is the shape of the age curve here. Is it more linear, logarithmic, or exponential. My guess is mildly exponential. Point is that the old are esp vulnerable. Ann and I are just short of 70, which seems to be some sort of magic age for susceptibility. Many others here (probably because we have more time on our hands to squander it on commenting here) are in similar situations.

Which brings up an ancillary question - since many commenters obsessing about virus infection are both old enough to be more vulnerable,, and have more time to obsess about in online, are we maybe exaggerating the problem, despite having a somewhat reduced risk because we tend to have fewer contacts with strangers, day to day?

Yancey Ward said...

"I question that assumption right now in the US. And that is because we are still at point where verified infections are rare enough that the infection can usually be tracked, and so far mostly has a provable recent Chinese connection, mostly within a generation or two.

Bruce, this is because the testing is being limited to people with exactly those provable connections. If you don't have those connections, they aren't testing your illness. They will start testing more tenuous connections as soon as they have throughput to do so.

Yancey Ward said...

If I showed up at Methodist Hospital in Oak Ridge, TN right now with flu symptoms, I would not be tested because I have no recent connections that you describe- they would not waste a test on me right now.

Ray - SoCal said...

On the CDC Testing Snafu, two good articles that match what I was noticing:

A Self-Inflicted Crisis
Overregulation has played a dangerous role in America’s coronavirus outbreak. - City Journal


The United States badly bungled coronavirus testing—but things may soon improve Science Mag

CDC a few days ago stopped updating how many tests they have done, the excuse is since states are doing their own tests.

CDC Cases in US

ZeroHedge noting Report Status Change

I noticed about 3 weeks ago, the US had only done 500 tests with a 2-3 day turn around, CDC had centralized testing, and South Korea could do 10,000 tests a day with a 6 hour turn around.

Good news is this finally got fixed. Obama Era Rule required FDA approval for tests, which resulted in the CDC controlling the tests, and the CDC messed up. While the rest of the world, even the WHO, were way ahead of the US on testing. Amazing.

Sad how Leftist are trying to blame Trump for this. My guess is a lot of CDC actions have been to deflect blame, which is why after Pence took over, communications got centralized.

Mark said...

Ray - no one seems to know about the `Obama Era Rule changes' you speak of.

From NYT 2 days ago:

"Michelle Forman, a spokeswoman for the Association of Public Health Laboratories, whose members had complained that the Food and Drug Administration took too long to approve their tests, said there were some discussions during the Obama administration about whether to tighten restrictions on laboratories that developed their own tests, but “nothing was ever put into place.”

She said the association, which represents state and local government labs, was not aware of any Obama-era rules that changed how the labs were regulated or how applications in a public health crisis were reviewed.

Dr. Luciana Borio, who oversaw public health preparedness for the National Security Council in Mr. Trump’s White House and was previously the acting chief scientist at the Food and Drug Administration under Mr. Obama, also said she was unaware of any such rule changes during the last administration."

Inga said...

“Good news is this finally got fixed. Obama Era Rule required FDA approval for tests, which resulted in the CDC controlling the tests, and the CDC messed up. While the rest of the world, even the WHO, were way ahead of the US on testing. Amazing.”
————————————————-
THE FACTS: It’s not true that an Obama-era rule limited laboratories run by companies, universities and hospitals from developing and running tests for the coronavirus during an emergency. No such regulation existed.

The Trump administration’s action Saturday only undid a policy that its own Food and Drug Administration put in place. The new action lets labs develop and use coronavirus diagnostic tests before the agency reviews them. Previously, the FDA had only authorized use of a government test developed by the Centers for Disease Control and Prevention.

Under a 2004 federal law, the FDA has wide power to authorize drugs, tests and other therapies during emergencies. That means no legal authority was hindering the Trump administration when it earlier decided to limit testing to public health labs using the CDC test.

“All they did was reverse a policy that they themselves set,” said Dr. Joshua Sharfstein, an FDA official during the Obama administration who is now a vice dean at Johns Hopkins-Bloomberg School of Public Health.”

https://www.usnews.com/news/politics/articles/2020-03-05/ap-fact-check-trumps-mislaid-blame-on-obama-for-virus-test

mandrewa said...

Things are looking up.

Please watch: Coronavirus Epidemic Update 32: Important Data from South Korea, Can Zinc Help Prevent COVID-19?

It's a very good video, but the important part is the data from South Korea. Basically they have been testing a lot of people for Coronavirus 2019. Far more people than really anywhere else. (Well except maybe for China, but then China lies.)

And South Korea is finding a fatality rate of 0.6%. The modern average fatality rate for influenza (for the last 20 years) is 0.1%. And some particular strains of influenza having a higher fatality rate.

So if this continues, and the South Korean data will probably be the best indication for sometime, then the real mortality rate of Coronavirus 2019 isn't all that much worse than that of influenza.

So basically we are overreacting. This is bad, but not that bad. If the coronavirus spreads as easily as influenza then something like 90% of us will eventually get infected. And something like 200,000 people will die as a consequence.

That's not good news but it's not a disaster either and neither is it a reason for panic.

Of course a person's risk is much higher if that person is elderly and already sick.

mandrewa said...

Well I should have checked my math instead of doing, or not doing, it in my head.

0.006 x 250 million is 1.5 million deaths or thereabout.

Still it's not the disaster that some had been projecting.

Ray - SoCal said...

Seems there is agreement there was an FDA rule with the cdc hindering private lab testing.

This mit technology article mentions the issue, but does not point fingers:
https://www.technologyreview.com/s/615323/why-the-cdc-botched-its-coronavirus-testing/

My take is the fda and cdc are out of control bureaucracies that the Trump administration has light control of. And they were doing their usual empire building that led to this testing SNAFU.

Ray - SoCal said...

Cdc testing seems to have more issues:
https://www.politico.com/news/2020/03/03/cdc-blocked-fda-official-premises-119684

Ray - SoCal said...

CDC had guidelines that restricted testing, which allowed the CoronaVirus to get out of control in the US.

The problems with the CDC and FDA predate the Obama administration. We were so lucky with Ebola, and US preparedness has not improved much since then.

Ray - SoCal said...

My take...

This FDA Testing Requirements is informal, and has been in process for years.

2010 the FDA announced the we’re going to reconsider the policy.
Obama was President
2014 - draft guidelines published
Obama was President
2017 - Draft discussion
Trumps President

https://www.fda.gov/medical-devices/vitro-diagnostics/laboratory-developed-tests

Seems in the us the cdc would develop a Coronavirus test, regulate who will be tested, with the cdc doing the results, and get the FDA to approve the test. And eventually private labs would be allowed to do and develop tests.

So the US had a poor test initially, with few tests done, in the hundreds, while the rest of the world was doing tens of thousands of tests.

Neither the FDA or CDC come off looking good.