7 ms·

The only data that is somewhat reliable in this pandemic is COVID deaths. Testing the population that is very sick / dying is crucial to understanding the base

The only data that is somewhat reliable in this pandemic is COVID deaths. Testing the population that is very sick / dying is crucial to understanding the baseline for the worst part of the problem. Once you have that under control, and we are not nearly there yet, you have to get every first responder tested regularly so you can prevent them from spreading the disease and give them some assurance that coming to work isn’t a death sentence. Next we have to focus on getting a baseline of the population regularly tested to estimate the spread of the disease. This should be randomized and geographically distributed so we can start to obtain reliable data about the spread of the disease and deploy resources proactively.

rantwasp 7y ago
it sounds like you’re advocating for the use of logic. with the current administration this is a strong no-go.
Trasmatta 7y ago
I would say the number of hospitalizations is reliable as well. Those are the only two numbers I've really been paying attention to, because the number of total cases is really just a factor of testing, and doesn't yet give us an accurate picture of the situation.
- explorigin 7y ago
  I disagree. In order for a hospitalization to count, they have to have a positive test. First, we have to factor in test inaccuracy and then the fact that doctors are still triaging tests even if a patient has symptoms. These numbers can't be considered accurate until we have enough tests to test everyone in the waiting room indiscriminately.
  - Retric 7y ago
    We have enough tests to cover people who are candidates for ventilators or have similarly severe symptoms. That’s still a lagging indicator, but not nearly as delayed as deaths.
gumby 7y ago
> The only data that is somewhat reliable in this pandemic is COVID deaths. I agree,, especially as you included the word “somewhat”. We have pretty good numbers on people who died in hospitals, but people who died at home appear to be seriously under counted. Additionally, consequential deaths are currently invisible. These are people who died, say, ecause the coronavirus crowded out their access to hospitals. There’s been a drop in ER visits for things like heart conditions. Some of those people would have recovered fine anyway but some may have arterial blockage that will kill them. You don’t Want these numbers in the primary statistics (as they say nothing about control of the pandemic) but you do want these very hard to track numbers to understating future capacity planning, ethical procedures, and long term economic consequences.
- markrages 7y ago
  You can get part of that with excess death rates. From the weeks overall deaths subtract the average death rate for this week in past years. That should give both people who died at home and consequential deaths.
  - ceejayoz 7y ago
    The NYT has been analyzing that. https://www.nytimes.com/interactive/2020/04/21/world/coronavirus-missing-deaths.html https://www.nytimes.com/interactive/2020/04/21/world/coronav...
  - rckoepke 7y ago
    I'd reckon it's "doable" but not "easy", putting it in the realm of professional epidemiology. People are also dying less in car crashes, pollution-induced asthma, etc. There's quite a bit that may need to be accounted for. I suspect analyses will have decent error bars a year or so from now, but it's unlikely we'll get precise realtime estimates from this methodology. Would love to be proved wrong.
  - autokad 7y ago
    this is not easy, as death rates are going down because people are not out and about.
vikramkr 7y ago
Deaths is a lagging indicator though, so even if it's reliable it comes in a bit late to make any policy changes off of it, and nobody likes waiting for 3 weeks to a month after each little change to see how it's reflected in death rates. Maybe it's reliable in the statistical sense, but not reliable in the sense that a layperson or a politician would be able to rely on it to guide decision making.
- kjakm 7y ago
  >> Maybe it's reliable in the statistical sense, but not reliable in the sense that a layperson or a politician would be able to rely on it to guide decision making. This seems to be what we're relying on in the UK. Hospital admissions for Covid show a good/relatively quick estimate of how measures are working and then a few weeks later a reflection of that trend in deaths confirms it.
pjc50 7y ago
The countries that have fought it most effectively do so by contact tracing: whenever someone is found to have it, test everyone they've come into contact with recently. This works best with really intrusive surveillance of mobile phone locations :(
kurthr 7y ago
I disagree that only deaths are reliable, fully tested patient ICU load is both easily measurable, fairly well controlled, and lower latency (roughly 2-4 weeks shorter!). I do agree that testing the dying is useful although it presents its own statistical challenges (dying with after a car accident with COVID).
yason 7y ago
Deaths can lie too. What does it take for a death to be labelled as covid-19 death? That the person who died was merely tested positive, or do they do autopsies for all those who tested positive? How about covid-19 deaths that aren't counted as covid-19 deaths, for a reason or another? How about people dying less of regular influenza this year because of covid-19 and lockdowns? Even looking back at monthly 2020 deaths in comparison to earlier years might not truly reveal the final impact of covid-19.
- cm2187 7y ago
  In the US, if the person tested positive, it is classified as covid19 death. Also it seems that 98% of covid19 deaths have at least one comorbidity, 75% at least two. So I would expect that in many cases the virus may have just accelerated something that would have happened within a few months anyway. So you kind of need to look at how the full year death rate evolved to have an idea of the net impact of the virus.
  - ajross 7y ago
    That's a misunderstanding of how death works. Everything is a comorbidity on some level. > just accelerated something that would have happened within a few months anyway That's absolutely not what this means. Asthma is a comorbidity. Are asthmatics just a few months from death? I have hypertension, am I about to kick the bucket? Sixty percent of the US population (no doubt including many of the posters on this very thread) are overweight, yet somehow we keep coming back. Almost nothing kills "by itself". Everything adds up, and eventually the body stops working. Other diseases work this way too, yet you don't complain that yearly influenza deaths are inflated. Would you have argued that AIDS deaths were "really" due to the final infection and not HIV?
    - cm2187 7y ago
      The study I got these numbers from doesn't seem to classify asthma or obesity as a comorbidity. The largest ones are hypertension, diabetes, ischemic heart disease, atrial fibrilation, active cancer in past 5y, heart failure, COPD, dementia, stroke and chronic liver disease. Not familiar with all items in this list but some seem pretty serious.

rantwasp 7y ago

it sounds like you’re advocating for the use of logic. with the current administration this is a strong no-go.

Trasmatta 7y ago

I would say the number of hospitalizations is reliable as well. Those are the only two numbers I've really been paying attention to, because the number of total cases is really just a factor of testing, and doesn't yet give us an accurate picture of the situation.

explorigin 7y ago
I disagree. In order for a hospitalization to count, they have to have a positive test. First, we have to factor in test inaccuracy and then the fact that doctors are still triaging tests even if a patient has symptoms. These numbers can't be considered accurate until we have enough tests to test everyone in the waiting room indiscriminately.
- Retric 7y ago
  We have enough tests to cover people who are candidates for ventilators or have similarly severe symptoms. That’s still a lagging indicator, but not nearly as delayed as deaths.

gumby 7y ago

> The only data that is somewhat reliable in this pandemic is COVID deaths. I agree,, especially as you included the word “somewhat”. We have pretty good numbers on people who died in hospitals, but people who died at home appear to be seriously under counted. Additionally, consequential deaths are currently invisible. These are people who died, say, ecause the coronavirus crowded out their access to hospitals. There’s been a drop in ER visits for things like heart conditions. Some of those people would have recovered fine anyway but some may have arterial blockage that will kill them. You don’t Want these numbers in the primary statistics (as they say nothing about control of the pandemic) but you do want these very hard to track numbers to understating future capacity planning, ethical procedures, and long term economic consequences.

markrages 7y ago
You can get part of that with excess death rates. From the weeks overall deaths subtract the average death rate for this week in past years. That should give both people who died at home and consequential deaths.
- ceejayoz 7y ago
  The NYT has been analyzing that. https://www.nytimes.com/interactive/2020/04/21/world/coronavirus-missing-deaths.html https://www.nytimes.com/interactive/2020/04/21/world/coronav...
- rckoepke 7y ago
  I'd reckon it's "doable" but not "easy", putting it in the realm of professional epidemiology. People are also dying less in car crashes, pollution-induced asthma, etc. There's quite a bit that may need to be accounted for. I suspect analyses will have decent error bars a year or so from now, but it's unlikely we'll get precise realtime estimates from this methodology. Would love to be proved wrong.
- autokad 7y ago
  this is not easy, as death rates are going down because people are not out and about.

vikramkr 7y ago

Deaths is a lagging indicator though, so even if it's reliable it comes in a bit late to make any policy changes off of it, and nobody likes waiting for 3 weeks to a month after each little change to see how it's reflected in death rates. Maybe it's reliable in the statistical sense, but not reliable in the sense that a layperson or a politician would be able to rely on it to guide decision making.

kjakm 7y ago
>> Maybe it's reliable in the statistical sense, but not reliable in the sense that a layperson or a politician would be able to rely on it to guide decision making. This seems to be what we're relying on in the UK. Hospital admissions for Covid show a good/relatively quick estimate of how measures are working and then a few weeks later a reflection of that trend in deaths confirms it.

pjc50 7y ago

The countries that have fought it most effectively do so by contact tracing: whenever someone is found to have it, test everyone they've come into contact with recently. This works best with really intrusive surveillance of mobile phone locations :(

kurthr 7y ago

I disagree that only deaths are reliable, fully tested patient ICU load is both easily measurable, fairly well controlled, and lower latency (roughly 2-4 weeks shorter!). I do agree that testing the dying is useful although it presents its own statistical challenges (dying with after a car accident with COVID).

yason 7y ago

Deaths can lie too. What does it take for a death to be labelled as covid-19 death? That the person who died was merely tested positive, or do they do autopsies for all those who tested positive? How about covid-19 deaths that aren't counted as covid-19 deaths, for a reason or another? How about people dying less of regular influenza this year because of covid-19 and lockdowns? Even looking back at monthly 2020 deaths in comparison to earlier years might not truly reveal the final impact of covid-19.

cm2187 7y ago
In the US, if the person tested positive, it is classified as covid19 death. Also it seems that 98% of covid19 deaths have at least one comorbidity, 75% at least two. So I would expect that in many cases the virus may have just accelerated something that would have happened within a few months anyway. So you kind of need to look at how the full year death rate evolved to have an idea of the net impact of the virus.
- ajross 7y ago
  That's a misunderstanding of how death works. Everything is a comorbidity on some level. > just accelerated something that would have happened within a few months anyway That's absolutely not what this means. Asthma is a comorbidity. Are asthmatics just a few months from death? I have hypertension, am I about to kick the bucket? Sixty percent of the US population (no doubt including many of the posters on this very thread) are overweight, yet somehow we keep coming back. Almost nothing kills "by itself". Everything adds up, and eventually the body stops working. Other diseases work this way too, yet you don't complain that yearly influenza deaths are inflated. Would you have argued that AIDS deaths were "really" due to the final infection and not HIV?
  - cm2187 7y ago
    The study I got these numbers from doesn't seem to classify asthma or obesity as a comorbidity. The largest ones are hypertension, diabetes, ischemic heart disease, atrial fibrilation, active cancer in past 5y, heart failure, COPD, dementia, stroke and chronic liver disease. Not familiar with all items in this list but some seem pretty serious.