4 ms·

They should be using death rates to estimate the peak, not confirmed cases. Death counts are very accurate if not perfect representation of the situation.

xyzzy_plugh 7y ago
They're not. For a variety of reasons, many deaths are not being reported as caused by Covid-19, but rather other preexisting conditions which may have been complicated by Covid-19. Additionally, as I understand it, some number of deaths require post-mortem testing to confirm that the victim was indeed infected. Given the varied backlog of testing, the morgue backlog (or soon-to-be) and the lack of testing kits, I'd conservatively expect death counts to be lower than actual by anywhere from 10% to 150%. I wouldn't be surprised if a year from now we realize we were off by a factor of 2 or more.
- thebruce87m 7y ago
  You can compare normal death rates from previous years to determine if you are having excess deaths. Here is data from a town in Italy for example: https://www.corriere.it/politica/20_marzo_26/the-real-death-toll-for-covid-19-is-at-least-4-times-the-official-numbers-b5af0edc-6eeb-11ea-925b-a0c3cdbe1130.shtml https://www.corriere.it/politica/20_marzo_26/the-real-death-... “Nembro, one of the municipalities most affected by Covid-19, should have had - under normal conditions - about 35 deaths. 158 people were registered dead this year by the municipal offices. But the number of deaths officially attributed to Covid-19 is 31” There are some caveats with the data of course - I.e. the town might not have any more deaths for the rest of the year since it’s burned through all the people that would have expired anyway, but it’s interesting reading.
  - thu2111 7y ago
    The Corriere article has a major flaw that it's looking at deaths from Jan onwards only. This year is unusual in that there was no flu season, really. Deaths up until the start of COVID-19 were way lower than normal all winter. https://swprs.files.wordpress.com/2020/03/italia-mortalita-marzo-14.png?w=1200&h=686 https://swprs.files.wordpress.com/2020/03/italia-mortalita-m... So even a disease no worse than flu, you'd expect would cause a much higher death rate than normal for this time of year, simply by shifting the curve forward six months. And COVID-19 is likely to be worse than flu. (I say likely because the data quality here is so poor we really have no idea how dangerous it is)
    - thebruce87m 7y ago
      Can you tell me what your graph is supposed to show? Bear in mind that Nembro has a population of 11,616 according to google. That would mean an excess death rate of approx 1000 out of 100,000 if we use the 123 excess deaths from the article. Compare that to 40.2 from here: https://pubmed.ncbi.nlm.nih.gov/31401203/ https://pubmed.ncbi.nlm.nih.gov/31401203/ Now I’m not saying that Nembro is typical or even that all my data is apples to apples, it’s just the only data I’ve found where we can compare death rates in any way. The crude death rate for the whole of Italy here: https://knoema.com/atlas/Italy/Death-rate https://knoema.com/atlas/Italy/Death-rate It’s interesting that you call the data poor - this is exactly the data we should be looking for. I’d love to see this kind of data for the whole of Italy for the last 10 years to compare to the last few months. The other data coming in is the dangerous stuff to me. We can’t tell if someone died of covid, or simply had it when they died. Every country has different testing regimes. Ultimately the death stats will give us the full picture. Differing perspectives welcome.
      - thu2111 7y ago
        The graph is supposed to show mortality vs the 'baseline' (good question how exactly that's calculated, looks like it's probably this one: https://www.euromomo.eu/methods/methods.html https://www.euromomo.eu/methods/methods.html). It shows the impact of prior flu seasons. Winter of 2016 was very bad. 2017 not quite as bad. 2018 about the same. 2019 .... gone. Trend line is below baseline and very significantly so up until the start of COVID-19. There was practically no flu season this year, which means a LOT of people survived the winter who in prior years wouldn't have done. The problem is Corriere is ignoring that in their analysis. Deaths may be higher than expected now, but how much of that is because it was much lower than expected before? I suspect in the next week or so you'll start seeing people doing integration on the graphs to try and figure out what the excess 'vulnerable population' was at the start of the epidemic; i.e. people who would in other years have been taken out by flu but survived this year. The red trend line will shoot up of course. You can see the latest data point all the way at the top right, it's nearly falling off the image.
        7y ago
- thu2111 7y ago
  For a variety of reasons, many deaths are not being reported as caused by Covid-19, but rather other preexisting conditions which may have been complicated by Covid-19 Isn't it the other way around? That deaths are being recorded as COVID-19 even when there were severe underlying conditions and the person probably died of that? The latter seems to be the more common issue. It makes death rates meaningless. What does it mean to say someone died of COVID-19 if they were 89 and had heart disease?
mancerayder 7y ago
Deaths are partly unavoidable, but they're also partly avoidable because if hospitals have ICU /ventilator and bed capacity the death rate goes down. Once they're overrun then the death rate spikes.
- fermienrico 7y ago
  Good point, may be they should use some custom heuristic that takes deaths + confirmed cases + fudge factor.

xyzzy_plugh 7y ago

They're not. For a variety of reasons, many deaths are not being reported as caused by Covid-19, but rather other preexisting conditions which may have been complicated by Covid-19. Additionally, as I understand it, some number of deaths require post-mortem testing to confirm that the victim was indeed infected. Given the varied backlog of testing, the morgue backlog (or soon-to-be) and the lack of testing kits, I'd conservatively expect death counts to be lower than actual by anywhere from 10% to 150%. I wouldn't be surprised if a year from now we realize we were off by a factor of 2 or more.

thebruce87m 7y ago
You can compare normal death rates from previous years to determine if you are having excess deaths. Here is data from a town in Italy for example: https://www.corriere.it/politica/20_marzo_26/the-real-death-toll-for-covid-19-is-at-least-4-times-the-official-numbers-b5af0edc-6eeb-11ea-925b-a0c3cdbe1130.shtml https://www.corriere.it/politica/20_marzo_26/the-real-death-... “Nembro, one of the municipalities most affected by Covid-19, should have had - under normal conditions - about 35 deaths. 158 people were registered dead this year by the municipal offices. But the number of deaths officially attributed to Covid-19 is 31” There are some caveats with the data of course - I.e. the town might not have any more deaths for the rest of the year since it’s burned through all the people that would have expired anyway, but it’s interesting reading.
- thu2111 7y ago
  The Corriere article has a major flaw that it's looking at deaths from Jan onwards only. This year is unusual in that there was no flu season, really. Deaths up until the start of COVID-19 were way lower than normal all winter. https://swprs.files.wordpress.com/2020/03/italia-mortalita-marzo-14.png?w=1200&h=686 https://swprs.files.wordpress.com/2020/03/italia-mortalita-m... So even a disease no worse than flu, you'd expect would cause a much higher death rate than normal for this time of year, simply by shifting the curve forward six months. And COVID-19 is likely to be worse than flu. (I say likely because the data quality here is so poor we really have no idea how dangerous it is)
  - thebruce87m 7y ago
    Can you tell me what your graph is supposed to show? Bear in mind that Nembro has a population of 11,616 according to google. That would mean an excess death rate of approx 1000 out of 100,000 if we use the 123 excess deaths from the article. Compare that to 40.2 from here: https://pubmed.ncbi.nlm.nih.gov/31401203/ https://pubmed.ncbi.nlm.nih.gov/31401203/ Now I’m not saying that Nembro is typical or even that all my data is apples to apples, it’s just the only data I’ve found where we can compare death rates in any way. The crude death rate for the whole of Italy here: https://knoema.com/atlas/Italy/Death-rate https://knoema.com/atlas/Italy/Death-rate It’s interesting that you call the data poor - this is exactly the data we should be looking for. I’d love to see this kind of data for the whole of Italy for the last 10 years to compare to the last few months. The other data coming in is the dangerous stuff to me. We can’t tell if someone died of covid, or simply had it when they died. Every country has different testing regimes. Ultimately the death stats will give us the full picture. Differing perspectives welcome.
    - thu2111 7y ago
      The graph is supposed to show mortality vs the 'baseline' (good question how exactly that's calculated, looks like it's probably this one: https://www.euromomo.eu/methods/methods.html https://www.euromomo.eu/methods/methods.html). It shows the impact of prior flu seasons. Winter of 2016 was very bad. 2017 not quite as bad. 2018 about the same. 2019 .... gone. Trend line is below baseline and very significantly so up until the start of COVID-19. There was practically no flu season this year, which means a LOT of people survived the winter who in prior years wouldn't have done. The problem is Corriere is ignoring that in their analysis. Deaths may be higher than expected now, but how much of that is because it was much lower than expected before? I suspect in the next week or so you'll start seeing people doing integration on the graphs to try and figure out what the excess 'vulnerable population' was at the start of the epidemic; i.e. people who would in other years have been taken out by flu but survived this year. The red trend line will shoot up of course. You can see the latest data point all the way at the top right, it's nearly falling off the image.
      - 7y ago
thu2111 7y ago
For a variety of reasons, many deaths are not being reported as caused by Covid-19, but rather other preexisting conditions which may have been complicated by Covid-19 Isn't it the other way around? That deaths are being recorded as COVID-19 even when there were severe underlying conditions and the person probably died of that? The latter seems to be the more common issue. It makes death rates meaningless. What does it mean to say someone died of COVID-19 if they were 89 and had heart disease?

mancerayder 7y ago

Deaths are partly unavoidable, but they're also partly avoidable because if hospitals have ICU /ventilator and bed capacity the death rate goes down. Once they're overrun then the death rate spikes.

fermienrico 7y ago
Good point, may be they should use some custom heuristic that takes deaths + confirmed cases + fudge factor.