8 ms·

Ohio Prison Death Updates [pdf]

60 points by burgreblast 6y ago

burgreblast 6y ago
17 days ago we heard that 3,330 inmates tested positive, 96% without symptoms. https://news.ycombinator.com/item?id=22980932 https://news.ycombinator.com/item?id=22980932 There was much speculation, but many people agreed that in 2 weeks we would have super interesting data. It's been 17 days. We have an update from ohio.gov that tested individuals climbed to 7536, 4439 are positive (59%), total 49 deaths (.01) Not an epidemiologist. Does this data fit the Diamond Princess model? Or more broadly, which model fits this data best? Is there other data to show how many became symptomatic? How do we interpret this update, more than 2 weeks after initial reports?
- ecpottinger 6y ago
  Diamond Princess had a far higher percentage of older (over 70) people. I also would like to know if the HVAC system is as centralize in a prison as it is on a cruise ship.
  - vkou 6y ago
    HVAC is not the problem. The problem is that prisoners routinely share common spaces. It doesn't matter how the air circulates, when they all cook, eat, work, shower, and exercise in the exact same communal rooms. Combine that with insufficient sanitation, and it's a miracle that only half of them got sick.
    - RandallBrown 6y ago
      Cruise ships are pretty similar in that people are eating and recreating in the same areas.
    - limaoscarjuliet 6y ago
      HVAC might be a problem, there was a CDC article demonstrating how A/C was attributed to specific cases in China https://wwwnc.cdc.gov/eid/article/26/7/20-0764_article https://wwwnc.cdc.gov/eid/article/26/7/20-0764_article
      - vkou 6y ago
        I agree that HVAC can cause spread. My point is that prison life does not allow for social distancing, and that the HVAC is irrelevant when everyone is living in essentially the same space.
- vondur 6y ago
  I'd like to know the ages of the deceased, and if they had any other serious health issues. If the majority of the deceased are indeed old or in poor health, perhaps isolating those from the general prison population would be a prudent precautionary measure to implement.
- deleted 6y ago
  [deleted]
- brohoolio 6y ago
  I’ve been thinking about the asymptotic cases in situations like this and the Roosevelt. I think if folks are monitored very closely for symptoms we might learn more about how it impacts people and what percentage of cases stay asymptotic.
- cbarrick 6y ago
  The number of "inmates currently Positive for COVID-19" is 1,112, not 4,439. I think you're counting tests, not people. Those numbers double count inmates who receive multiple tests, and it's likely that those who have tested positive will receive frequent retests. FYI there's just under 40k total inmates.
- npunt 6y ago
  There have been other state prisons that have released prisoners that were severe cases, so as to lower their death numbers. Look for that.
- sirsar 6y ago
  > total 49 deaths (.01) If you're going to report other ratios as percentages, could you please be consistent? I initially erroneously read this as 0.01% deaths, which would be an absolutely enormous update, but 1% isn't surprising at all.
- kiba 6y ago
  Don't forget we can't really acquire complete mortality data until the coronavirus run their courses in infected individual.
- Gibbon1 6y ago
  I keep seeing reports that after an outbreak has played out about 25% of infected never show symptoms and 60% have something between a mild cold and a bad case of influenza. The remaining 15% get really sick and ~1% die. If you just look at the stats initially you run into the problem that a lot of infected are preasymptomatic are in the early course of infection. So retrospective stats are very important.
- stx 6y ago
  Keep in mind this is deaths so far. This number will change as some may take more time to die. So maybe the radio could be around 1% to 2%.
- csomar 6y ago
  What's the average number of natural/usual death, though. You have to subtract that. It might be small/none or substantial.
dr_faustus 6y ago
Considering they probably tested everyone so there are no unrecorded cases, a 1% death rate is pretty much in line with studies finding the CFR to be in the 0.5-1.5% neighborhood [1,2]. I would guess they are younger on average, but the prison population probably has some risk factors in terms of nutrition, insufficient Vitamin D, lack of exercise, etc. [1] https://www.bmj.com/content/369/bmj.m1327 https://www.bmj.com/content/369/bmj.m1327 [2] https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v2 https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v...
- skuhn 6y ago
  They tested 7541 people out of 39,082 inmates in quarantine. These numbers aren't inclusive of staff -- 556 tested positive, but how many were tested? Are staff quarantined to prevent spreading the infection out of the prisons? The most recent information I could find says that Ohio has 48,765 inmates in total. They have quarantined 80% of prisoners and tested 15%. Their infection numbers are likely artificially low due to asymptomatic or pre-symptomatic cases.
romaaeterna 6y ago
30 of the deaths are at PCI, which is basically a nursing home for older prisoners. EDIT: “Marion houses a high number of older individuals, many who have pre-existing health conditions. Pickaway houses our long-term-care center similar to a nursing home, and Franklin is our state prison medical center.” Marion is 25% of the deaths. Pickaway 59%. And Franklin 10%.
- elcritch 6y ago
  Then for the general population below whatever that age is (maybe 65?), you'd get roughly `(51-30)/4449 ≈ 0.47% FR` (non-PCI deaths/total positive). It's a bit unclear as it seems the numbers are changing as test results arrive. For the PCI cohort: 30/1258 ≈ 2.38% (deaths/recovered). The 0.47% FR would seem much more plausible given the spread of the virus and the number of asymptomatic cases that appear to exist from serological testing.
  - romaaeterna 6y ago
    You're hugely overestimating still. You seem to assume that all of the over-65s in the system are at PCI. In fact, only a small fraction of older people, even in late decades, need to be in long term medical care.
    - elcritch 6y ago
      True, it's more of an upper-bounds of sort. There's several preprints from European researchers giving IFR's of 0.08% and 0.37%. So it works pretty well from a Fermi estimation method (https://what-if.xkcd.com/84/ https://what-if.xkcd.com/84/) (e.g. Bayesian inference really). Also, the age distribution in prison isn't necessarily the same as that of the general population. There's lots of limitations for a comparison to the general population but it gives some bounds. I'd think the statistic of "average years of life lost" based on expected average of lifetime. Otherwise not sure of a better statistical way to measure age-adjusted IFR, which would be helpful.
      - dmix 6y ago
whycombagator 6y ago
I'd also be interested in how many have detrimental side effects from the virus, after recovery. Mostly all I see from covid numbers are black & white: died/recovered. There was an article recently on HN that talked about the possible lasting effects of the virus[0]. I am interested to know how frequently lasting effects occur [0] https://news.ycombinator.com/item?id=23127167 https://news.ycombinator.com/item?id=23127167
- GloriousKoji 6y ago
  The National Geographic article from a few months ago covers the lasting effects much better. https://www.nationalgeographic.com/science/2020/02/here-is-what-coronavirus-does-to-the-body/ https://www.nationalgeographic.com/science/2020/02/here-is-w...
  - davidw 6y ago
    Given all we're learning, and how fast things are happening, a couple of months ago is a long time.
sdenton4 6y ago
Just as an extra wrench in the works, an unknown number of prisoners have been released or transferred, probably after being deemed higher risk: https://www.google.com/amp/s/thehill.com/regulation/court-battles/494266-judge-says-ohio-prison-hit-by-coronavirus-is-fighting-a-losing%3famp https://www.google.com/amp/s/thehill.com/regulation/court-ba... So death rates may still be reduced by interventions. Take care, arm chair statisticians.
- centimeter 6y ago
  > Take care, arm chair statisticians FWIW, during this whole process, people reasonably described as “arm chair statisticians” have been putting out higher-quality and more accurate statistical analysis than any public-facing government or media source. The only high-quality analysis I’ve seen has been from “amateurs” (I.e. not employed by institutional sources of narrative information) and expensive subscription-only financial analysis services.
  - zzzzzzzza 6y ago
    eh lots of people could tell ihme model was wrong/doing inappropriate curve fitting, but los alamos model for example seems pretty good to me, as an armchair statistician.
  - slg 6y ago
    What is the size of the population of amateurs and what is the size of the population of experts? I am guessing the former is a lot bigger than the latter meaning more outcomes to pick from when retroactively trying to assign credit for accuracy.
    - centimeter 6y ago
      If that’s the case, then I must have a really good selection algorithm, because the people I talk with/pay attention to are pretty uniformly good.
      - 6y ago
mellosouls 6y ago
I can't see the document, but when a similar story recently popped up on here the average age of prisoners was 38. fwiw. edit: the previous story https://news.ycombinator.com/item?id=22941493 https://news.ycombinator.com/item?id=22941493 age stats: https://www.cleveland.com/news/erry-2018/08/84f4aab48f389/ohios-10-oldest-and-10-younges.html https://www.cleveland.com/news/erry-2018/08/84f4aab48f389/oh... (the underlying source is not accessible to me either at the moment)
rayiner 6y ago
It’s an interesting question: how do you figure out whether these numbers are good or bad? Ohio has a prison population of about 44,000. So these numbers (actual plus probable) represent a death rate of 120 per 100,000. That’s ten times the death rate in Ohio as a whole. But it’s about half the death rate of NYC (actual plus probable). What’s the correct reference point? NYC seems like a reasonable reference, given that prison is an inherently high density living situation.
- rtkwe 6y ago
  It's also a place where you have the power to force people to follow distancing and 'shelter in place' as long as it's not a dorm style prison. [0] [0] Though even with those you can isolate it to particular rooms if you have the testing capacity.
lvs 6y ago
This is likely just about population age distribution in prisons vs the general population. 16% of the US population is 65+, but only 2.7% in (federal) prisons. So that must account for a decent chunk of it. https://www.bop.gov/about/statistics/statistics_inmate_age.jsp https://www.bop.gov/about/statistics/statistics_inmate_age.j...
- subsubzero 6y ago
  I agree that the age distribution does not match society in general, but take one thing into account, you have one group of people who have an extremely low death rate not in prison(children and teenagers) so this probably evens things out, extreme old age is not represented in prisons either, 80+ .
deleted 6y ago
[deleted]
kregasaurusrex 6y ago
While this is a small dataset of tested individuals which may be proportionally representative to larger groups, it comes at odds with releasing PII with respect to individual privacy to see potential comorbities (old age, obesity, diabetes, lack of an auto-immune response, etc). We know that people with exposure to recycled airspace and live in close proximity are more likely to transmit covid to one another. Mask wearing and social distancing are actions that will have to be obeyed by everyone as a collective in order to work-- one may never know if they're an asymptomatic super-spreader without widespread testing. Cloth masks aren't for protecting yourself as much as they are everyone around you. Within the data itself, it shows that quarantine and isolation are effective practices against spreading covid in a hotspot. This may be a good stop-gap measure while researchers are able to study it more, but government's responsibility at all levels of keeping people safe in returning to work has has greatly fallen short of expectations.
m0zg 6y ago
I've read somewhere (but don't know if it's true) that prison meals are enriched with vitamins, and in particular with vitamin D. Could someone confirm? Also, there are fewer old prisoners than old people in the general population.
- rwmurrayVT 6y ago
  Personal experience tells me that it's most likely not true. I have seen a great deal of the food that we cooked in federal prison. I'd label the beverages like fruit juice being enriched as a "maybe". We typically had lower quality of the same food stuffs you'd buy at the grocers. Protein/canned vegetables/"fresh" fruit/rice.
subsubzero 6y ago
I think the better report to look into will be Lompac(southern california)[1], they have the higher % of infected prisoners, I think its been roughly 70% of the prison population has tested positive for covid. Analyzing these closed systems for a true death rate seems to be the only way we will get decent data regarding mortality. I don't see govt. officials going door to door in cities asking for people to prick their finger to analyze for covid antibodies. A few things to watch out for is prisoner transfers due to extreme sickness, also getting a age distribution for the prison like others have said here, another thing to note is prison food and env. is bad on health. [1] - https://beta.trimread.com/articles/14963 https://beta.trimread.com/articles/14963
malkia 6y ago
Stab in the dark - AFAIK, Testosterone level in males in Prisons is much higher than usual (I can't back up that claim right now, but have been reading posts related to it). Then there is this - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7185012/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7185012/ just the two clicked together somehow, but might not be related after all..

60 points by burgreblast 6y ago

17 days ago we heard that 3,330 inmates tested positive, 96% without symptoms. https://news.ycombinator.com/item?id=22980932 https://news.ycombinator.com/item?id=22980932 There was much speculation, but many people agreed that in 2 weeks we would have super interesting data. It's been 17 days. We have an update from ohio.gov that tested individuals climbed to 7536, 4439 are positive (59%), total 49 deaths (.01) Not an epidemiologist. Does this data fit the Diamond Princess model? Or more broadly, which model fits this data best? Is there other data to show how many became symptomatic? How do we interpret this update, more than 2 weeks after initial reports?

ecpottinger 6y ago
Diamond Princess had a far higher percentage of older (over 70) people. I also would like to know if the HVAC system is as centralize in a prison as it is on a cruise ship.
- vkou 6y ago
  HVAC is not the problem. The problem is that prisoners routinely share common spaces. It doesn't matter how the air circulates, when they all cook, eat, work, shower, and exercise in the exact same communal rooms. Combine that with insufficient sanitation, and it's a miracle that only half of them got sick.
  - RandallBrown 6y ago
    Cruise ships are pretty similar in that people are eating and recreating in the same areas.
  - limaoscarjuliet 6y ago
    HVAC might be a problem, there was a CDC article demonstrating how A/C was attributed to specific cases in China https://wwwnc.cdc.gov/eid/article/26/7/20-0764_article https://wwwnc.cdc.gov/eid/article/26/7/20-0764_article
    - vkou 6y ago
      I agree that HVAC can cause spread. My point is that prison life does not allow for social distancing, and that the HVAC is irrelevant when everyone is living in essentially the same space.
vondur 6y ago
I'd like to know the ages of the deceased, and if they had any other serious health issues. If the majority of the deceased are indeed old or in poor health, perhaps isolating those from the general prison population would be a prudent precautionary measure to implement.
deleted 6y ago
[deleted]
brohoolio 6y ago
I’ve been thinking about the asymptotic cases in situations like this and the Roosevelt. I think if folks are monitored very closely for symptoms we might learn more about how it impacts people and what percentage of cases stay asymptotic.
cbarrick 6y ago
The number of "inmates currently Positive for COVID-19" is 1,112, not 4,439. I think you're counting tests, not people. Those numbers double count inmates who receive multiple tests, and it's likely that those who have tested positive will receive frequent retests. FYI there's just under 40k total inmates.
npunt 6y ago
There have been other state prisons that have released prisoners that were severe cases, so as to lower their death numbers. Look for that.
sirsar 6y ago
> total 49 deaths (.01) If you're going to report other ratios as percentages, could you please be consistent? I initially erroneously read this as 0.01% deaths, which would be an absolutely enormous update, but 1% isn't surprising at all.
kiba 6y ago
Don't forget we can't really acquire complete mortality data until the coronavirus run their courses in infected individual.
Gibbon1 6y ago
I keep seeing reports that after an outbreak has played out about 25% of infected never show symptoms and 60% have something between a mild cold and a bad case of influenza. The remaining 15% get really sick and ~1% die. If you just look at the stats initially you run into the problem that a lot of infected are preasymptomatic are in the early course of infection. So retrospective stats are very important.
stx 6y ago
Keep in mind this is deaths so far. This number will change as some may take more time to die. So maybe the radio could be around 1% to 2%.
csomar 6y ago
What's the average number of natural/usual death, though. You have to subtract that. It might be small/none or substantial.

dr_faustus 6y ago

Considering they probably tested everyone so there are no unrecorded cases, a 1% death rate is pretty much in line with studies finding the CFR to be in the 0.5-1.5% neighborhood [1,2]. I would guess they are younger on average, but the prison population probably has some risk factors in terms of nutrition, insufficient Vitamin D, lack of exercise, etc. [1] https://www.bmj.com/content/369/bmj.m1327 https://www.bmj.com/content/369/bmj.m1327 [2] https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v2 https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v...

skuhn 6y ago
They tested 7541 people out of 39,082 inmates in quarantine. These numbers aren't inclusive of staff -- 556 tested positive, but how many were tested? Are staff quarantined to prevent spreading the infection out of the prisons? The most recent information I could find says that Ohio has 48,765 inmates in total. They have quarantined 80% of prisoners and tested 15%. Their infection numbers are likely artificially low due to asymptomatic or pre-symptomatic cases.

romaaeterna 6y ago

30 of the deaths are at PCI, which is basically a nursing home for older prisoners. EDIT: “Marion houses a high number of older individuals, many who have pre-existing health conditions. Pickaway houses our long-term-care center similar to a nursing home, and Franklin is our state prison medical center.” Marion is 25% of the deaths. Pickaway 59%. And Franklin 10%.

elcritch 6y ago
Then for the general population below whatever that age is (maybe 65?), you'd get roughly `(51-30)/4449 ≈ 0.47% FR` (non-PCI deaths/total positive). It's a bit unclear as it seems the numbers are changing as test results arrive. For the PCI cohort: 30/1258 ≈ 2.38% (deaths/recovered). The 0.47% FR would seem much more plausible given the spread of the virus and the number of asymptomatic cases that appear to exist from serological testing.
- romaaeterna 6y ago
  You're hugely overestimating still. You seem to assume that all of the over-65s in the system are at PCI. In fact, only a small fraction of older people, even in late decades, need to be in long term medical care.
  - elcritch 6y ago
    True, it's more of an upper-bounds of sort. There's several preprints from European researchers giving IFR's of 0.08% and 0.37%. So it works pretty well from a Fermi estimation method (https://what-if.xkcd.com/84/ https://what-if.xkcd.com/84/) (e.g. Bayesian inference really). Also, the age distribution in prison isn't necessarily the same as that of the general population. There's lots of limitations for a comparison to the general population but it gives some bounds. I'd think the statistic of "average years of life lost" based on expected average of lifetime. Otherwise not sure of a better statistical way to measure age-adjusted IFR, which would be helpful.
    - dmix 6y ago

whycombagator 6y ago

I'd also be interested in how many have detrimental side effects from the virus, after recovery. Mostly all I see from covid numbers are black & white: died/recovered. There was an article recently on HN that talked about the possible lasting effects of the virus[0]. I am interested to know how frequently lasting effects occur [0] https://news.ycombinator.com/item?id=23127167 https://news.ycombinator.com/item?id=23127167

GloriousKoji 6y ago
The National Geographic article from a few months ago covers the lasting effects much better. https://www.nationalgeographic.com/science/2020/02/here-is-what-coronavirus-does-to-the-body/ https://www.nationalgeographic.com/science/2020/02/here-is-w...
- davidw 6y ago
  Given all we're learning, and how fast things are happening, a couple of months ago is a long time.

sdenton4 6y ago

Just as an extra wrench in the works, an unknown number of prisoners have been released or transferred, probably after being deemed higher risk: https://www.google.com/amp/s/thehill.com/regulation/court-battles/494266-judge-says-ohio-prison-hit-by-coronavirus-is-fighting-a-losing%3famp https://www.google.com/amp/s/thehill.com/regulation/court-ba... So death rates may still be reduced by interventions. Take care, arm chair statisticians.

centimeter 6y ago
> Take care, arm chair statisticians FWIW, during this whole process, people reasonably described as “arm chair statisticians” have been putting out higher-quality and more accurate statistical analysis than any public-facing government or media source. The only high-quality analysis I’ve seen has been from “amateurs” (I.e. not employed by institutional sources of narrative information) and expensive subscription-only financial analysis services.
- zzzzzzzza 6y ago
  eh lots of people could tell ihme model was wrong/doing inappropriate curve fitting, but los alamos model for example seems pretty good to me, as an armchair statistician.
- slg 6y ago
  What is the size of the population of amateurs and what is the size of the population of experts? I am guessing the former is a lot bigger than the latter meaning more outcomes to pick from when retroactively trying to assign credit for accuracy.
  - centimeter 6y ago
    If that’s the case, then I must have a really good selection algorithm, because the people I talk with/pay attention to are pretty uniformly good.
    - 6y ago

mellosouls 6y ago

I can't see the document, but when a similar story recently popped up on here the average age of prisoners was 38. fwiw. edit: the previous story https://news.ycombinator.com/item?id=22941493 https://news.ycombinator.com/item?id=22941493 age stats: https://www.cleveland.com/news/erry-2018/08/84f4aab48f389/ohios-10-oldest-and-10-younges.html https://www.cleveland.com/news/erry-2018/08/84f4aab48f389/oh... (the underlying source is not accessible to me either at the moment)

rayiner 6y ago

It’s an interesting question: how do you figure out whether these numbers are good or bad? Ohio has a prison population of about 44,000. So these numbers (actual plus probable) represent a death rate of 120 per 100,000. That’s ten times the death rate in Ohio as a whole. But it’s about half the death rate of NYC (actual plus probable). What’s the correct reference point? NYC seems like a reasonable reference, given that prison is an inherently high density living situation.

rtkwe 6y ago
It's also a place where you have the power to force people to follow distancing and 'shelter in place' as long as it's not a dorm style prison. [0] [0] Though even with those you can isolate it to particular rooms if you have the testing capacity.

lvs 6y ago

This is likely just about population age distribution in prisons vs the general population. 16% of the US population is 65+, but only 2.7% in (federal) prisons. So that must account for a decent chunk of it. https://www.bop.gov/about/statistics/statistics_inmate_age.jsp https://www.bop.gov/about/statistics/statistics_inmate_age.j...

subsubzero 6y ago
I agree that the age distribution does not match society in general, but take one thing into account, you have one group of people who have an extremely low death rate not in prison(children and teenagers) so this probably evens things out, extreme old age is not represented in prisons either, 80+ .

deleted 6y ago

[deleted]

kregasaurusrex 6y ago

While this is a small dataset of tested individuals which may be proportionally representative to larger groups, it comes at odds with releasing PII with respect to individual privacy to see potential comorbities (old age, obesity, diabetes, lack of an auto-immune response, etc). We know that people with exposure to recycled airspace and live in close proximity are more likely to transmit covid to one another. Mask wearing and social distancing are actions that will have to be obeyed by everyone as a collective in order to work-- one may never know if they're an asymptomatic super-spreader without widespread testing. Cloth masks aren't for protecting yourself as much as they are everyone around you. Within the data itself, it shows that quarantine and isolation are effective practices against spreading covid in a hotspot. This may be a good stop-gap measure while researchers are able to study it more, but government's responsibility at all levels of keeping people safe in returning to work has has greatly fallen short of expectations.

m0zg 6y ago

I've read somewhere (but don't know if it's true) that prison meals are enriched with vitamins, and in particular with vitamin D. Could someone confirm? Also, there are fewer old prisoners than old people in the general population.

rwmurrayVT 6y ago
Personal experience tells me that it's most likely not true. I have seen a great deal of the food that we cooked in federal prison. I'd label the beverages like fruit juice being enriched as a "maybe". We typically had lower quality of the same food stuffs you'd buy at the grocers. Protein/canned vegetables/"fresh" fruit/rice.

subsubzero 6y ago

I think the better report to look into will be Lompac(southern california)[1], they have the higher % of infected prisoners, I think its been roughly 70% of the prison population has tested positive for covid. Analyzing these closed systems for a true death rate seems to be the only way we will get decent data regarding mortality. I don't see govt. officials going door to door in cities asking for people to prick their finger to analyze for covid antibodies. A few things to watch out for is prisoner transfers due to extreme sickness, also getting a age distribution for the prison like others have said here, another thing to note is prison food and env. is bad on health. [1] - https://beta.trimread.com/articles/14963 https://beta.trimread.com/articles/14963

malkia 6y ago

Stab in the dark - AFAIK, Testosterone level in males in Prisons is much higher than usual (I can't back up that claim right now, but have been reading posts related to it). Then there is this - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7185012/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7185012/ just the two clicked together somehow, but might not be related after all..