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> the USA curve is fearsomely steep This analysis is difficult because it is related to testing capacity. We all know testing capacity was limited early on. It

> the USA curve is fearsomely steep This analysis is difficult because it is related to testing capacity. We all know testing capacity was limited early on. It remains limited, but is growing. The faster capacity grows, the steeper the curve will be. Want to have a less steep curve? Lower the amount of testing. In another comment, you claim looking at the curves leaves out politics completely, but it doesn't. Any politician can make the situation look worse on the curve, but better serve their people, by increasing testing. They can also make their curve look better, but do worse for their people, by claiming their state is unable to purchase tests. This can be a very political game.

notahacker 7y ago
Yep. Ventilator usage [if available] and deaths are more reliable indicators, but they're also lagging ones [and even deaths aren't entirely consistently measured since many of the most severely affected patients exhibit comorbities, and many nations don't test the dead]
- rzzzt 7y ago
  Others do, and that skews the results as well (at the very least, it makes numbers incomparable).
- paganel 7y ago
  > deaths are more reliable indicators They are more reliable than the simple number of cases but in the Italian province of Bergamo (and I suppose in neighbouring Brescia, too) lots of people have started dying before the ambulance even arrives at their homes. Those people will not show up on the official statistics of covid victims, at least not now. A similar thing had started happening in Wuhan once the situation had become really dire, and the closest valid indicator people could find was to look at the number of incinerators and how busy they were (mostly looking at the number, because the incinerators were busy 24/7 anyway).
tobltobs 7y ago
> Want to have a less steep curve? Lower the amount of testing. That works only at the beginning.
- ct0 7y ago
  A more interesting view would be the number of positive tests over the number of tests preformed.
  - ithkuil 7y ago
    Often tests are not performed on a random sample of the population but only on people that are symptomatic. But not all symptomatic people receive tests. Knowing those two number (number of symptomatic people who would have qualified for a test, were it available; number of test performed) could paint q better picture.
    - mynegation 7y ago
      Until recently Ontario had very stringent testing pre-requisites: 2 or more symptoms, history or travel in the last 14 days. Even then, on average, only 2% of tested people tested positively for SARS-Cov-2. In my opinion that makes the notion of much more larger population having it and not noticing due to the lack of testing, at least at this stage, highly unlikely.
      - seanmcdirmid 7y ago
        They should be doing some tests via random sampling anyways just to make sure.
        mynegation 7y ago
        Ideally, yes. But given the limited testing capability that is a politically hard thing to do. Even if 50-75% of cases are asymptomatic (and that is a very big if), that would mean that on average you have a number of asymptomatic people that is a factor of 1 to 3 of confirmed cases. While it would be great to isolate those people, at this point that is still not a huge number that means anything for the response.
DyslexicAtheist 7y ago
once people's minds are made up, it's incredibly difficult to walk them back to a different reasoning. Apart from the lack of early tests the problem is therefore exacerbated by the downplaying of the problem during the critical early stages. It wasn't just lost-time that needs to be made up for but also that mitigations will now become harder to swallow!
DennisP 7y ago
The death curve is also quite steep. Seven days ago we were at 57 total deaths, now it's 276. Daily deaths has gone from eight people seven days ago to 49. https://www.worldometers.info/coronavirus/country/us/ https://www.worldometers.info/coronavirus/country/us/ Here's a good article on estimating current number of cases from number of deaths: https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...
- w1ntermute 7y ago
  The death curve is also deceptive - there were likely many patients who were recorded as dying of the flu, or of influenza-like illness, that actually died of COVID-19, due to a lack of testing. The bottom line is that it’s very difficult to make a conclusive statement based on the data collected prior to widespread testing. As for that Medium article, it’s written by a tech exec with zero education or professional experience in anything related to medicine or the life sciences, so I would treat it with a heavy dose of skepticism. Many of the deluge of preprint articles from academic institutions written by epidemiologists or public health experts would likely be a far better source of info.
  - jacquesm 7y ago
    The death curve is a lot less deceptive than the number of cases.
    - seanmcdirmid 7y ago
      Overall death rate is much less deceptive than known overall virus deaths.
  - DennisP 7y ago
    We have plenty of flu tests. Covid-19 is also pretty distinctive on chest CT scans, if it's advanced enough to kill you. The numbers may be wrong in that article but the math itself seems straightforward. It's certainly true that we need more tests to be sure of the numbers. Here's a pretty interesting simulation from a research group at the University of Basel: https://neherlab.org/covid19/ https://neherlab.org/covid19/
takeda 7y ago
I am worried that we are choosing the second route with articles like this one: https://www.latimes.com/california/story/2020-03-20/coronavirus-county-doctors-containment-testing https://www.latimes.com/california/story/2020-03-20/coronavi...
- watwut 7y ago
  If I understand article right, it is not about choosing. It is about not having resources and ability to do the other route.
  - hanche 7y ago
    The situation is exactly the same in Norway now, for the same reason: Lack of resources.
lokar 7y ago
The graph I think would be helpful would show how many positive tests per day out of a random sample of 1,000 (or whatever) people (non-symptomatic).

notahacker 7y ago

Yep. Ventilator usage [if available] and deaths are more reliable indicators, but they're also lagging ones [and even deaths aren't entirely consistently measured since many of the most severely affected patients exhibit comorbities, and many nations don't test the dead]

rzzzt 7y ago
Others do, and that skews the results as well (at the very least, it makes numbers incomparable).
paganel 7y ago
> deaths are more reliable indicators They are more reliable than the simple number of cases but in the Italian province of Bergamo (and I suppose in neighbouring Brescia, too) lots of people have started dying before the ambulance even arrives at their homes. Those people will not show up on the official statistics of covid victims, at least not now. A similar thing had started happening in Wuhan once the situation had become really dire, and the closest valid indicator people could find was to look at the number of incinerators and how busy they were (mostly looking at the number, because the incinerators were busy 24/7 anyway).

tobltobs 7y ago

> Want to have a less steep curve? Lower the amount of testing. That works only at the beginning.

ct0 7y ago
A more interesting view would be the number of positive tests over the number of tests preformed.
- ithkuil 7y ago
  Often tests are not performed on a random sample of the population but only on people that are symptomatic. But not all symptomatic people receive tests. Knowing those two number (number of symptomatic people who would have qualified for a test, were it available; number of test performed) could paint q better picture.
  - mynegation 7y ago
    Until recently Ontario had very stringent testing pre-requisites: 2 or more symptoms, history or travel in the last 14 days. Even then, on average, only 2% of tested people tested positively for SARS-Cov-2. In my opinion that makes the notion of much more larger population having it and not noticing due to the lack of testing, at least at this stage, highly unlikely.
    - seanmcdirmid 7y ago
      They should be doing some tests via random sampling anyways just to make sure.
      - mynegation 7y ago
        Ideally, yes. But given the limited testing capability that is a politically hard thing to do. Even if 50-75% of cases are asymptomatic (and that is a very big if), that would mean that on average you have a number of asymptomatic people that is a factor of 1 to 3 of confirmed cases. While it would be great to isolate those people, at this point that is still not a huge number that means anything for the response.

DyslexicAtheist 7y ago

once people's minds are made up, it's incredibly difficult to walk them back to a different reasoning. Apart from the lack of early tests the problem is therefore exacerbated by the downplaying of the problem during the critical early stages. It wasn't just lost-time that needs to be made up for but also that mitigations will now become harder to swallow!

DennisP 7y ago

The death curve is also quite steep. Seven days ago we were at 57 total deaths, now it's 276. Daily deaths has gone from eight people seven days ago to 49. https://www.worldometers.info/coronavirus/country/us/ https://www.worldometers.info/coronavirus/country/us/ Here's a good article on estimating current number of cases from number of deaths: https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...

w1ntermute 7y ago
The death curve is also deceptive - there were likely many patients who were recorded as dying of the flu, or of influenza-like illness, that actually died of COVID-19, due to a lack of testing. The bottom line is that it’s very difficult to make a conclusive statement based on the data collected prior to widespread testing. As for that Medium article, it’s written by a tech exec with zero education or professional experience in anything related to medicine or the life sciences, so I would treat it with a heavy dose of skepticism. Many of the deluge of preprint articles from academic institutions written by epidemiologists or public health experts would likely be a far better source of info.
- jacquesm 7y ago
  The death curve is a lot less deceptive than the number of cases.
  - seanmcdirmid 7y ago
    Overall death rate is much less deceptive than known overall virus deaths.
- DennisP 7y ago
  We have plenty of flu tests. Covid-19 is also pretty distinctive on chest CT scans, if it's advanced enough to kill you. The numbers may be wrong in that article but the math itself seems straightforward. It's certainly true that we need more tests to be sure of the numbers. Here's a pretty interesting simulation from a research group at the University of Basel: https://neherlab.org/covid19/ https://neherlab.org/covid19/

takeda 7y ago

I am worried that we are choosing the second route with articles like this one: https://www.latimes.com/california/story/2020-03-20/coronavirus-county-doctors-containment-testing https://www.latimes.com/california/story/2020-03-20/coronavi...

watwut 7y ago
If I understand article right, it is not about choosing. It is about not having resources and ability to do the other route.
- hanche 7y ago
  The situation is exactly the same in Norway now, for the same reason: Lack of resources.

lokar 7y ago

The graph I think would be helpful would show how many positive tests per day out of a random sample of 1,000 (or whatever) people (non-symptomatic).