8 ms·

The obsession with total cases is maddening. First, they are driven significantly by amount of testing. Secondly, whether they lead to complications is signific

by pbreit 6y ago

The obsession with total cases is maddening. First, they are driven significantly by amount of testing. Secondly, whether they lead to complications is significantly impacted by age and health. The recent article routinely fail to acknowledge that age of infection has fallen drastically (from 65 to 35 in Florida, for example). The people getting infected now, the out-and-abouters, are much, much lower risk of complications. Which is why death rates continue down (lowest in US since March).

buhhh 6y ago
> The obsession with total cases is maddening. First, they are driven significantly by amount of testing. I think more significantly they're driven by total cases. Are you suggesting we test less? Also you seem to have a very black and white view of outcomes. It's not clear cut between alive or dead. There's many things that we still don't know about this virus and the harm it causes. https://www.bbc.com/future/article/20200622-the-long-term-effects-of-covid-19-infection https://www.bbc.com/future/article/20200622-the-long-term-ef...
- catawbasam 6y ago
  Cuts on the confirmed cases by age group and to some extent race/gender will help understand upcoming hospitalization and death.
- pbreit 6y ago
  There have been 10 million confirmed cases and probably 10x that many infections with very few reports of longer term adverse impacts.
  - bluGill 6y ago
    Long term effects can take a long time to show up. We don't know what they might be. Of course this is a case where no long term effects are something we are only sure of after currently young people die of old age.
  - piva00 6y ago
    What long term? This disease has existed for about 6 months in the public eye (and a bit longer now that there are cases in Europe being found from October/November) how can you even consider talking about long term effects when we haven't yet lived through the time it can be considered "long term". Or do you work with the concept "long term = next quarter"?
sandworm101 6y ago
>> First, they are driven significantly by amount of testing. That depends which numbers you follow. "Cases" is different than "clinical cases". A clinical case will show some sort of symptom. While asymptomatic spread is almost certainly a thing, symptomatic patients spread much more readily than asymptomatic. So rather than look only a total cases, look for data on clinical cases because those are the ones that are most likely to spread to others. That will normally be patients under treatment rather than the larger number of people who have tested positive, show no real symptoms, and are sitting at home waiting for another test.
HarryHirsch 6y ago
On the contrary, one should absolutely be concerned about the number of total cases. In ~ 15 % of cases the convalescence period is greater than a month, and there is reason to be concerned about CFS in recovered patients. With SARS, the incidence of CFS was 40 %!. If you aren't sufficiently worried, John Campbell has a video about the clinical presentation: https://www.youtube.com/watch?v=U7BbXEOB1gk https://www.youtube.com/watch?v=U7BbXEOB1gk
- buhhh 6y ago
  Sorry, what is CFS? edit: thanks!
  - jahewson 6y ago
    Chronic fatigue syndrome
  - mehrdadn 6y ago
    I think Chronic Fatigue Syndrome? https://www.washingtonpost.com/health/could-covid-19-cause-long-term-chronic-fatigue-and-illness-in-some-patients/2020/05/29/bcd5edb2-a02c-11ea-b5c9-570a91917d8d_story.html https://www.washingtonpost.com/health/could-covid-19-cause-l...
  - catawbasam 6y ago
    probably Chronic Fatigue Syndrome
  - deleted 6y ago
    [deleted]
- eiji 6y ago
  For 2.5 month now we are always two weeks away from a catastrophe with mass graves and hospital parking lots full of dead people. And then two weeks pass and nothing really happens. Reality just doesn't seem to square up with the fearmongering.
  - HarryHirsch 6y ago
ashtonkem 6y ago
When the total number of positive tests and the percentage of tests that are positive both rise, that implies that the issue is not driven by the amount of testing, and in fact you’re seeing community spread.
godshatter 6y ago
I've been watching the number of deaths (although it's a morbid way of looking at it), too. If the number of cases goes up but after a suitable lag time and the number of deaths doesn't, then we are likely just uncovering more people who had it through more thorough testing. If the number of deaths rises, then it's not just that we're testing more - it's spreading more. The logic behind this is that people are going to the hospital whether or not they have been tested, they are not going to stay away because they haven't been. I don't have easy access to numbers of hospitalized patients, so I watch the number of deaths. Right now they have been flattening out or decreasing, as you pointed out. When that changes I'll get worried more. In either case, I am playing it safe by social distancing and wearing my mask and reducing the amount of time I'm in the office.
- jlbnjmn 6y ago
  The death rate is most likely lower due to a higher percentage of the infected being lower risk. White people under 50, to be specific. As many as 50% of new hospitalizations in Texas are under 50. The problem will be if they infect higher risk groups, potentially in catastrophic numbers, and the deaths surge along with cases. Also, deaths remaining somewhat flat is concerning considering the low risk population getting infected.
enraged_camel 6y ago
Hospitalizations have also been rapidly increasing. Houston hospitals expect 100% ICU usage in less than two weeks.
kgwgk 6y ago
> First, they are driven significantly by amount of testing. But that's not the only driver. And when you increase testing and the percentage of positives you find goes up from 5% to 20% (as it's happening in some states) instead of going down you really have a problem. > The people getting infected now, the out-and-abouters, are much, much lower risk of complications. But the people that will now be infected by them (relatives, coworkers, customers) will be closer to the general population and have higher risk.
codyswann 6y ago
That's weird. To me, it makes perfect sense to horse-race total case percentage increase. Young people are generally on the front lines now. Both voluntarily through outings, bars, etc, and front-line jobs, so they are a leading indicator that "things are getting worse." And while that doesn't guarantee that most "at risk" people will get sick and require hospitalization, it's a safe assumption that the probability of that occurring is increasing. It's the same reason you get a mole checked out. Might be nothing now, but it could be something much worse in the near future.
kaitai 6y ago
The number of cases has nothing to do with the amount of testing! The number of reported or confirmed cases is correlated with testing. That's a significantly different statement, and also tautological and essentially vacuous. Average time to death after confirmation of disease is around 13 days, so the death rate today has essentially nothing to do with the number of cases confirmed today. The death rate today has a lot to do with the number of cases confirmed a few weeks ago. One of the reasons the US is doing so incredibly poorly is the incredible sloppiness of the analyses in so much of the media. I don't know if it's willful -- an attempt to pretend that nature will bend to political delusion -- or if it's simple innumeracy.
Izkata 6y ago
> First, they are driven significantly by amount of testing. Daily case numbers in Illinois, at least, have no correlation with the increase in testing. I'm certain all we've found with the extra tests is people who never had it.

by pbreit 6y ago

buhhh 6y ago

> The obsession with total cases is maddening. First, they are driven significantly by amount of testing. I think more significantly they're driven by total cases. Are you suggesting we test less? Also you seem to have a very black and white view of outcomes. It's not clear cut between alive or dead. There's many things that we still don't know about this virus and the harm it causes. https://www.bbc.com/future/article/20200622-the-long-term-effects-of-covid-19-infection https://www.bbc.com/future/article/20200622-the-long-term-ef...

catawbasam 6y ago
Cuts on the confirmed cases by age group and to some extent race/gender will help understand upcoming hospitalization and death.
pbreit 6y ago
There have been 10 million confirmed cases and probably 10x that many infections with very few reports of longer term adverse impacts.
- bluGill 6y ago
  Long term effects can take a long time to show up. We don't know what they might be. Of course this is a case where no long term effects are something we are only sure of after currently young people die of old age.
- piva00 6y ago
  What long term? This disease has existed for about 6 months in the public eye (and a bit longer now that there are cases in Europe being found from October/November) how can you even consider talking about long term effects when we haven't yet lived through the time it can be considered "long term". Or do you work with the concept "long term = next quarter"?

sandworm101 6y ago

>> First, they are driven significantly by amount of testing. That depends which numbers you follow. "Cases" is different than "clinical cases". A clinical case will show some sort of symptom. While asymptomatic spread is almost certainly a thing, symptomatic patients spread much more readily than asymptomatic. So rather than look only a total cases, look for data on clinical cases because those are the ones that are most likely to spread to others. That will normally be patients under treatment rather than the larger number of people who have tested positive, show no real symptoms, and are sitting at home waiting for another test.

HarryHirsch 6y ago

On the contrary, one should absolutely be concerned about the number of total cases. In ~ 15 % of cases the convalescence period is greater than a month, and there is reason to be concerned about CFS in recovered patients. With SARS, the incidence of CFS was 40 %!. If you aren't sufficiently worried, John Campbell has a video about the clinical presentation: https://www.youtube.com/watch?v=U7BbXEOB1gk https://www.youtube.com/watch?v=U7BbXEOB1gk

buhhh 6y ago
Sorry, what is CFS? edit: thanks!
- jahewson 6y ago
  Chronic fatigue syndrome
- mehrdadn 6y ago
  I think Chronic Fatigue Syndrome? https://www.washingtonpost.com/health/could-covid-19-cause-long-term-chronic-fatigue-and-illness-in-some-patients/2020/05/29/bcd5edb2-a02c-11ea-b5c9-570a91917d8d_story.html https://www.washingtonpost.com/health/could-covid-19-cause-l...
- catawbasam 6y ago
  probably Chronic Fatigue Syndrome
- deleted 6y ago
  [deleted]
eiji 6y ago
For 2.5 month now we are always two weeks away from a catastrophe with mass graves and hospital parking lots full of dead people. And then two weeks pass and nothing really happens. Reality just doesn't seem to square up with the fearmongering.
- HarryHirsch 6y ago

ashtonkem 6y ago

When the total number of positive tests and the percentage of tests that are positive both rise, that implies that the issue is not driven by the amount of testing, and in fact you’re seeing community spread.

godshatter 6y ago

I've been watching the number of deaths (although it's a morbid way of looking at it), too. If the number of cases goes up but after a suitable lag time and the number of deaths doesn't, then we are likely just uncovering more people who had it through more thorough testing. If the number of deaths rises, then it's not just that we're testing more - it's spreading more. The logic behind this is that people are going to the hospital whether or not they have been tested, they are not going to stay away because they haven't been. I don't have easy access to numbers of hospitalized patients, so I watch the number of deaths. Right now they have been flattening out or decreasing, as you pointed out. When that changes I'll get worried more. In either case, I am playing it safe by social distancing and wearing my mask and reducing the amount of time I'm in the office.

jlbnjmn 6y ago
The death rate is most likely lower due to a higher percentage of the infected being lower risk. White people under 50, to be specific. As many as 50% of new hospitalizations in Texas are under 50. The problem will be if they infect higher risk groups, potentially in catastrophic numbers, and the deaths surge along with cases. Also, deaths remaining somewhat flat is concerning considering the low risk population getting infected.

enraged_camel 6y ago

Hospitalizations have also been rapidly increasing. Houston hospitals expect 100% ICU usage in less than two weeks.

kgwgk 6y ago

> First, they are driven significantly by amount of testing. But that's not the only driver. And when you increase testing and the percentage of positives you find goes up from 5% to 20% (as it's happening in some states) instead of going down you really have a problem. > The people getting infected now, the out-and-abouters, are much, much lower risk of complications. But the people that will now be infected by them (relatives, coworkers, customers) will be closer to the general population and have higher risk.

codyswann 6y ago

That's weird. To me, it makes perfect sense to horse-race total case percentage increase. Young people are generally on the front lines now. Both voluntarily through outings, bars, etc, and front-line jobs, so they are a leading indicator that "things are getting worse." And while that doesn't guarantee that most "at risk" people will get sick and require hospitalization, it's a safe assumption that the probability of that occurring is increasing. It's the same reason you get a mole checked out. Might be nothing now, but it could be something much worse in the near future.

kaitai 6y ago

The number of cases has nothing to do with the amount of testing! The number of reported or confirmed cases is correlated with testing. That's a significantly different statement, and also tautological and essentially vacuous. Average time to death after confirmation of disease is around 13 days, so the death rate today has essentially nothing to do with the number of cases confirmed today. The death rate today has a lot to do with the number of cases confirmed a few weeks ago. One of the reasons the US is doing so incredibly poorly is the incredible sloppiness of the analyses in so much of the media. I don't know if it's willful -- an attempt to pretend that nature will bend to political delusion -- or if it's simple innumeracy.

Izkata 6y ago

> First, they are driven significantly by amount of testing. Daily case numbers in Illinois, at least, have no correlation with the increase in testing. I'm certain all we've found with the extra tests is people who never had it.