17 ms·

Coronavirus: Why aren’t death rates rising with case numbers? A UK perspective

86 points by finphil 6y ago

alvah 6y ago
It must have taken a special effort to write all those words without once mentioning the false positive rate of the PCR test (~2.3%), which (unlike earlier in the pandemic) is now in the ballpark of reported case numbers: https://www.medrxiv.org/content/10.1101/2020.04.26.20080911v3 https://www.medrxiv.org/content/10.1101/2020.04.26.20080911v...
- dgfitz 6y ago
  I don’t think I understand. Would factoring that in have significantly affected the thesis of the article?
  - zamadatix 6y ago
    I think the implication is if true false positive rate closely matches the reported positive result rate there haven't actually been a growing number of cases just a growing number of tests. I'm not sure the linked material validates this claim strongly though but I also haven't put in the time to see if it doesn't either.
    - dgfitz 6y ago
      Oh ok I understand now, thanks for explaining!
  - henriquez 6y ago
    I think the GP is suggesting that the actual case rate is lower than the numbers suggest due to the unknown rate of false positives.
- H8crilA 6y ago
  Wow, thank you for that, I had no idea PCR is this inaccurate. The process always created a very "pure" image in my head, and now I feel kind of stupid never checking how inaccurate it is in practice. Of course I'm not a professional in the area. How does it happen on a molecular level that PCR delivers a false positive? Are the primers sometimes broken (matching not exactly what they're supposed to match)?
  - khuey 6y ago
    A properly performed PCR test is essentially 100% specific. False positives come from contamination of samples, mislabelled samples, and other forms of human error.
    - deleted 6y ago
      [deleted]
  - mehrdadn 6y ago
    > Wow, thank you for that, I had no idea PCR is this inaccurate. I'm not sure it really is. Take it with a grain of salt for now. I feel like there's a missing piece of the puzzle here.
- tuna-piano 6y ago
  If the false positive of the PCR test really is 2.3%, how are so many places able to have positivity rates consistently less than that, more like .1%[1]? And how can test pooling in huge numbers (like was done in Wuhan) work? A false positive rate that high doesn't pass the sniff test. [1]https://ourworldindata.org/coronavirus-testing https://ourworldindata.org/coronavirus-testing [2]https://www.nytimes.com/2020/05/26/world/asia/coronavirus-wuhan-tests.html https://www.nytimes.com/2020/05/26/world/asia/coronavirus-wu...
  - wjn0 6y ago
    I'm not sure if this is it, but assuming the correctness of the test is independent of the sample quality, a sample could be split and tested multiple times to obtain a result with a much better FPR.
    - mehrdadn 6y ago
      Anecdotally I've heard this isn't the case, but I don't have links.
    - cameldrv 6y ago
      To my knowledge, the most common failure mode is that the concentration of viral RNA in the sample is below the limit of detection. This could be because the swab wasn't done correctly, the patient wasn't shedding very much virus, the sample was mishandled (heat can break down the sample), or the sample wasn't adequately mixed.
  - goalieca 6y ago
    There is a relatively massive false negative rate.
    - repsilat 6y ago
      Regardless of false negative rate, measured positives are always at least as frequent as false positives.
  - nl 6y ago
- pps43 6y ago
  The tests themselves are fine, false positives are due to human error: "The high specificities (usually 100%) reported in PCR-based tests for SARS-CoV-2 infection do not represent the real-world use of these tests, where contamination and human error produce significant rates of false positives." New York reports positivity rate below 1% for a while now, so false positive rate cannot be 2.3%.
  - cameldrv 6y ago
    If the false positive mechanism is contaminating one sample with another, the false positive rate will depend on the true positive rate in the samples that the lab/testing site is processing. The other possibility would be if positive control amplicon contaminated the lab, which does happen.
    - pps43 6y ago
      The underlying assumption behind false positive rate is that tests are independent and identically distributed. If in practice this is not the case, then false positive rate becomes misleading.
- mehrdadn 6y ago
  Hm, the numbers I've dug up (though rather hastily; I haven't read much of the documents) don't really match 2.3%... they seem to be 0% in their tests. Here [1] is where I think you can find the info for all the FDA-authorized tests. I see mentions of NPA (negative percent agreement) being 100% in their trials in [2] and [3] for example, though the sample sizes don't seem too large (something like 30-50). Any idea what I'm missing, or if it's just because of small sample sizes? (I'm not exactly trained in this, but my impression was PCR was more accurate than that.) [1] https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/vitro-diagnostics-euas#individual-molecular https://www.fda.gov/medical-devices/coronavirus-disease-2019... [2] https://www.fda.gov/media/141951/download https://www.fda.gov/media/141951/download [3] https://www.fda.gov/media/141760/download https://www.fda.gov/media/141760/download
  - nl 6y ago
    This is really useful, since it's the first source that includes the Ct for each(?) test. Combine that with [1] which makes a good argument that some high Ct levels may be too sensitive. Just randomly looking, this test[2] approved in June uses the Ct of 40 which is criticised above. [1] https://www.advisory.com/daily-briefing/2020/09/01/covid-tests https://www.advisory.com/daily-briefing/2020/09/01/covid-tes... [2] https://www.fda.gov/media/139572/download https://www.fda.gov/media/139572/download
- nl 6y ago
  This isn't completely correct. The PCR test can produce high numbers of false positives. It depends on a variable called the "cycle threshold" (Ct), which is the number of times amplification is run. Different tests have different Ct numbers, so some specific tests are overly sensitive. However there is no data on what test is used where, or when tests were changed. https://www.advisory.com/daily-briefing/2020/09/01/covid-tests https://www.advisory.com/daily-briefing/2020/09/01/covid-tes...
- epistasis 6y ago
  I've seen lots of clinics testing numbers, but I've never, literally never seen a PCR test with a FP rate that high. It kind of beggars belief. This article doesn't even deal with SARS-CoV-2, so until it gets peer reviewed and, more importantly, replicated, it should be treated as an extraordinary claim that requires extraordinary evidence.
- rsynnott 6y ago
  I doubt that’s it. Ireland’s positive rate was about 0.2% for a few weeks, now back up to 1.6%.
lukehutch 6y ago
Because the average of infection has dropped by over 20 years.
- mlindner 6y ago
  Correction: Because the average of testing positive has dropped by 20 years. I'd more be asking about the faulty test results.
- coronadisaster 6y ago
  because school started?
ldng 6y ago
Because the image lack a graph of the number of test ? Because tests were scarse at first and only done only to people coming to hospitals and relatives and now anyone can pass one ?
kristianpaul 6y ago
So the metrics where misleading because testing was not constant and/or performed same way across the same population distribution?
saeranv 6y ago
I've been fascinated by the mechanisms behind human facial recognition ever since I read Peter Watts 'Blindsight'. Near the end he introduces an idea similar to the Chernoff face[1], plots of multivariate data in the shape of a human face. The idea is that humans are so keyed into recognizing subtle nuances in facial expressions, we're better at interpreting mulitvariate data graphed as a facial expression. Some interesting parts from this interview: - She surprisingly claims that she's not good at recognizing emotions. - She can recognize adults based on how they looked as children. This suggests there's a sort of 'fuzzing' process that allows her to interpolate aging. [1] https://en.wikipedia.org/wiki/Chernoff_face https://en.wikipedia.org/wiki/Chernoff_face
- CGamesPlay 6y ago
  Did you intend to post this over here? https://news.ycombinator.com/item?id=24427311 https://news.ycombinator.com/item?id=24427311
  - saeranv 6y ago
    Hah, yes, wrong thread.
drummer 6y ago
Because it is just a flu. https://news.ycombinator.com/item?id=23763945 https://news.ycombinator.com/item?id=23763945
- dane-pgp 6y ago
  > (No more than 250,000 deaths from COVID-19 worldwide within a quarter of a year, compared to 1.5 million deaths during the flu wave in 2017/18). Interesting weasel-words and cherry-picking. First, comparing a quarter of a year of Covid deaths against a whole year (or two?) of normal flu, and then subtly shifting between deaths from Covid and deaths during a flu wave (so not caused by the flu?). For a more accurate comparison: "between 291,000 and 646,000 people worldwide die from seasonal influenza-related respiratory illnesses each year"[0] and 907,917 have died from Covid so far this year[1], despite all the extra measures taken to limit its spread and mortality rate. [0] https://www.cdc.gov/media/releases/2017/p1213-flu-death-estimate.html https://www.cdc.gov/media/releases/2017/p1213-flu-death-esti... [1] https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/
  - stateofnounion 6y ago
    > and then subtly shifting between deaths from Covid and deaths during a flu wave (so not caused by the flu?). Newsflash, genius. They are counting every person that died with COVID (or even "presumed" positive) as a death from COVID-19. The actual number of people that were killed directly by COVID is not known, just like we don't measure, test, or track every single person that dies of flu each year. It's an estimate that's arrived at long after the fact by reviewing data.
    - cbsks 6y ago
      In California, deaths are only counted if the death certificate has “COVID-19” as the cause of death. If someone is hit by a car and is also positive for COVID-19, that shouldn’t be counted. > Cumulative number of COVID-related deaths as reported by local health department, beginning March 19, 2020. This determination is made by local health departments based on the cause of death reported on death certificates. It is expected that, to be counted, COVID is the cause of death or at least a contributing factor to the death. COVID-related deaths are also counted in “Positive Cases”. https://covid19.ca.gov/data-and-tools/ https://covid19.ca.gov/data-and-tools/
nl 6y ago
This seems more likely to be the real reason: https://www.advisory.com/daily-briefing/2020/09/01/covid-tests https://www.advisory.com/daily-briefing/2020/09/01/covid-tes... TL;DR: Some (many?) PCR tests are using too high a cycle threshold, which makes them too sensitive. Key quote: Juliet Morrison, a virologist at the University of California-Riverside, said she believes any test with a cycle threshold over 35 is too sensitive. "I'm shocked that people would think that 40 could represent a positive," she said. The following is my commentary, and not specifically in the article above: There were many early tests that were giving false negatives. It looks to me like test manufactures over-compensated to make sure they never give false negatives. There is no data source that I can find that shows what test is used in what area, or what CT is used for what test.
- epistasis 6y ago
  This article is basically bullshit derived from a NY Times article, and I'm really sad that it got published. You know how every once in a while the media publishes an article about something you know and it's riddled with errors that drive a particular narrative? That article is my experience. Research scientists and clinical scientists are worlds apart, and have very different goals in life. I wouldn't trust a cT coming out of any research lab either, but clinical labs are far far more controlled and have far better processes, and have intense validation that shows that their threshold is repeatable, accurate, and a true representation of their limit of detection. No research lab does any of this, and they almost never have extremely basic contamination protections like separate rooms for pre- and post-amplification rooms. I've watched research scientists try to stand up clinical labs during this pandemic, and it has been an education for them to bring their standards up to what is the baseline for clinical testing. Its not unlike giving a butcher a scalpel and expecting brain surgery: there are a lot of the same skills involved but also very different and extremely narrow it's of knowledge.
  - stateofnounion 6y ago
    What does any of that have to do with cT as it relates to accurate COVID-19 detection as discussed in the article?
  - 6y ago
daxfohl 6y ago
The strange thing is it's the opposite in Australia. Second wave is much more deadly than the first one. https://www.worldometers.info/coronavirus/country/australia/ https://www.worldometers.info/coronavirus/country/australia/
- pan69 6y ago
  Is that not because Aged Care is hit particularly hard?
  - konjin 6y ago
    Yes, Victoria has managed to combine the economic catastrophe of a New Zealand lock down with the death rate of a Swedish no lock down. And this will continue for at least another month. All in all it's rather amazing how by trying to do everything right the Victorian government has managed to do everything wrong. At least the current government gets to wag its finger at people for wanting such unreasonable things as jobs, leaving your house after work, or sleeping with your partner for the first time in 3 months.
    - ImaCake 6y ago
      This is madness. The lockdown is the only thing that stopped several hundred deaths from becoming several thousand (or much more). No job is worth dying for, and few jobs are worth becoming crippled for. Make no mistake that this virus cripples many survivors.
      - konjin 6y ago
        [[citation needed]]
        ImaCake 6y ago
        This is not a substantive comment. Please defend yourself better.
ck2 6y ago
Steroids. Lots and lots of steroids. The first thing they do now in the hospital is steroids, they learned after NY. In the UK they had the Oxford study https://www.ox.ac.uk/news/2020-06-16-dexamethasone-reduces-death-hospitalised-patients-severe-respiratory-complications https://www.ox.ac.uk/news/2020-06-16-dexamethasone-reduces-d...
- Bekwnn 6y ago
  Yeah, I think it was in a thread on r/askscience with some nurses replying basically stating that the methods of treatment for infected patients has evolved as understanding has grown. Steroids was one item they mentioned, another was avoiding the respirator at almost all costs; which is part of why the demand for them has gone down now.
deleted 6y ago
[deleted]
ummonk 6y ago
Note that this is specific to the UK. In other European countries like Spain, death rates have been rising (with a few weeks lag from case rates). They just are nowhere near the first wave, when death rates were more than 10x what they are now but case rates were lower than today and because of severe under-testing.
- pier25 6y ago
  Death rates on the first wave were a lot more than 10x https://www.worldometers.info/coronavirus/country/spain/ https://www.worldometers.info/coronavirus/country/spain/
  - kmonsen 6y ago
    holy shit that page shows that the US is an anomaly compared to all countries it is normal to compare to. It doesn't help that it is gigantic country where it is hard to limit internal travel, but still we are doing something wrong here.
    - glofish 6y ago
      not sure what you mean by anomaly, US looks a lot like Sweden, a country that looks like will be faring the best counter-intuitive as it may sound today, US might just end up the country that did really well. Most large countries are simply not measuring/admitting the real number of cases.
      - kmonsen 6y ago
        This is false, if you look at expected deaths the US is sky high while all of Europe is under control. If we don't get vaccine then sure all countries might eventually end up the same, but Europe is largely back to normal living with kids back at school with almost no cases. In the US we still have lockdowns and no control at all.
        Fjolsvith 6y ago
pfd1986 6y ago
I must be missing something here: "It is likely that (...) an increasing proportion are young and a declining proportion are older" Don't they have access to this data? How's that a speculation and not a plot?
crowf 6y ago
It's also probably because we know more about how to treat people with the virus. At first ventilators was the go-to plan for people with difficulty breathing, until it was shown that ventilators were either not very useful or even detrimental. At first we didn't realize quite how bad it was for the elderly. The reason that Sweden had so many deaths at first and now virtually none is because there were breakouts in nursing homes at the beginning. Similarly in the US some states (eg. New York, New Jersey) required nursing homes to admit people who have been tested positive for the virus. Now the leaders of those states realize how bad that is and are better protecting the elderly.
- nradov 6y ago
  I recommend reading the latest COVID-19 care protocol from Eastern Virginia Medical School. It has been updated several times and contains details on clinical best practice. https://www.evms.edu/covid-19/covid_care_for_clinicians/#d.en.140202 https://www.evms.edu/covid-19/covid_care_for_clinicians/#d.e...
  - xiphias2 6y ago
    Thanks, here's their summary for prevention: ■ Vitamin C 500 mg BID and Quercetin 250-500 mg BID ■ Zinc 75-100 mg/day ■ Melatonin (slow release): Begin with 0.3mg and increase as tolerated to 2 mg at night ■ Vitamin D3 1000-4000 u/day ■ Optional: Famotidine 20-40mg/day
- berryjerry 6y ago
  There is still no treatment. THe people I know who were positive literally received absolutely no medication and were told to just stay home for 14 days despite having a fever and cough. They don't even consider it worthy of any medication or treatment in the U.S. unless you already are obese, diabetic, or have asthma. I think the actual reason we see cases and not deaths is just more testing is happening. At the start they wouldn't even test you if you had a fever and cough unless you knew someone who also had tested positive. Which meant basically it was impossible to get a test because other sick people had the same problem. I have also heard that there is a significant amount of false positives because they rushed most of these testing processes in order to meet demand. I believe it was news that like people had swabbed pieces of fruit like a papaya or something and sent it in and received a positive test still. It is right that most sick or susceptible people are better protecting themselves as well, as they should.
walterbell 6y ago
From https://www.nytimes.com/2020/08/29/health/coronavirus-testing.html https://www.nytimes.com/2020/08/29/health/coronavirus-testin... ("Your Coronavirus Test Is Positive. Maybe It Shouldn’t Be") > The PCR test amplifies genetic matter from the virus in cycles; the fewer cycles required, the greater the amount of virus, or viral load, in the sample. The greater the viral load, the more likely the patient is to be contagious. This number of amplification cycles needed to find the virus, called the cycle threshold, is never included in the results sent to doctors and coronavirus patients, although it could tell them how infectious the patients are. In three sets of testing data that include cycle thresholds, compiled by officials in Massachusetts, New York and Nevada, up to 90 percent of people testing positive carried barely any virus, a review by The Times found. > ... One solution would be to adjust the cycle threshold used now to decide that a patient is infected. Most tests set the limit at 40, a few at 37. This means that you are positive for the coronavirus if the test process required up to 40 cycles, or 37, to detect the virus. Tests with thresholds so high may detect not just live virus but also genetic fragments, leftovers from infection that pose no particular risk — akin to finding a hair in a room long after a person has left, Dr. Mina said. Any test with a cycle threshold above 35 is too sensitive, agreed Juliet Morrison, a virologist at the University of California, Riverside. “I’m shocked that people would think that 40 could represent a positive,” she said. A more reasonable cutoff would be 30 to 35, she added. Dr. Mina said he would set the figure at 30, or even less. Those changes would mean the amount of genetic material in a patient’s sample would have to be 100-fold to 1,000-fold that of the current standard for the test to return a positive result — at least, one worth acting on. Every published "case" should include the PCR cycle threshold to enable statistical analysis.
- birken 6y ago
  They've talked about this issue a lot on TWIV [1], and apparently many of the most commonly used PCR machines do the maximum number of cycles on every sample and then test to see if the sample is positive or negative. So they couldn't report a cycle count even if they wanted to, the machine doesn't allow it. I don't know what percentage of PCR machines in the wild this applies to, but based on how they talk about it on the podcast, it seems like a lot of them. Maybe the global cycle count for the machine could be adjusted, similar to what you are talking about, but that is different than reporting the cycle count of every positive test. 1: https://www.microbe.tv/twiv/ https://www.microbe.tv/twiv/
spirobel 6y ago
tldr: because the corona thing is just not as dangerous as your government and media would like you to believe. But you shouldnt commit wrong think! Its because we "now better protect the elderly". This is a true fact and questioning it is illegal. This is the new normal now. You will not get your rights back.
- XMPPwocky 6y ago
  > This is a true fact and questioning it is illegal. Doesn't seem like you're using a throwaway for this. Why aren't you concerned for your safety?
  - spirobel 6y ago
    Because I cant be bothered to create one. And I think people that use throwaway on hn are ridiculous.
- etripe 6y ago
  In my experience, no one who's seen what this virus can do to their own age cohort talks like that. I have a (early thirties, no co-morbidity, no pre-existing conditions) brother who was hit particularly hard by covid, from which he's still recovering. Also, I don't know where you are, but what rights have you lost, exactly? My country locked down pretty hard and pretty early, and the only "rights" I've lost are going to crowded spaces and walking around without a mask in populated areas.
  - spirobel 6y ago
    the rights I have lost is that the economy got ruined and my generation has to pay for this bullshit and for the rest of europe because our politicians just love to give away money to strangers. Also the corona rules are used to selectively disallow unwanted protests. There is no scientific proof that the lockdown or the mask did anything. look at sweden:practically no new deaths and almost no new cases. But I guess most people are fine with it. So I better get in line ... or else :-) My parents both had corona and they are fine by the way. Just a mild flu. Actually more like a cold.
ImaCake 6y ago
Hey there is a lot of health misinformation in this thread. Please seek advice from professionals, not potentially biased people on a software start up forum. There is a reason medical professionals are trained not to give advice about your symptoms outside the practice.
- mikeyouse 6y ago
  It’s incredible isn’t it?
- credit_guy 6y ago
  Professionals like Dr Gupta who said for so long at the beginning of the crisis to not wear a mask? https://www.cnn.com/audio/podcasts/corona-virus?episodeguid=3cf1777709183bdf1ad692c7a6e3e51d.mp3 https://www.cnn.com/audio/podcasts/corona-virus?episodeguid=...
  - ImaCake 6y ago
    Turns out science opinion changes with new evidence. When this all started the evidence did not suggest masks would help. Turns out they do, so now the science advice has changed. So your argument is because science is working as intend we should thus not trust it? This is a common anti-science/anti-medicine fallacy.
    - credit_guy 6y ago
      Incorrect. Dr Gupta and others had known all along that masks are useful. They were contradicting themselves when they were telling us "don't use masks, they are useless, we need them for the healthcare personnel". Why did they need them for the healthcare workers if they were useless? They simply decided to lie to us.
pieceofcakedude 6y ago
Because we're relying on a test which can barely be trusted. It's a research tool and should never be used in a diagnostic capacity. Don't listen to me about it though, that quote is from the PCR test's inventor Kary Mullis. It's bizarre that this isn't mentioned more. There's a rumor that it has a high false positive rate as well. There was a New York Times article that summarized this a few days ago. Again, perplexing why this isn't mentioned and studied more.
- JulianWasTaken 6y ago
  This is false. See e.g. https://www.reuters.com/article/uk-factcheck-pcr-idUSKBN24420X https://www.reuters.com/article/uk-factcheck-pcr-idUSKBN2442....
  - listenallyall 6y ago
    This "fact check" only serves to confirm pieceofcakedude's statement. Not about who said it (who cares?), but about the test not being trustworthy. Reuters states, in the last paragraph, "PCR tests ... show that SARS-CoV-2 viral genetic material is present in the patient" -- not that the PCR test confirms any minimum quantity, enough to cause any adverse effects. This is what the NYTimes reported on, that the amplification necessary to detect the virus was very often so great, implying what existed in the person was so tiny as to be inert. Reuters agrees: "It is important to note that detecting viral material by PCR does not indicate that the virus is fully intact and infectious" Pregnancy tests should return a binary result. Pretty much every other test requires a quantity for context. Imagine a blood-alcohol test that can say yes, alcohol is present, but is unable to distinguish between ingesting a teaspoon of cough syrup vs. drinking a six-pack.
  - pieceofcakedude 6y ago
    Fact checks from zero credibility organizations like Reuters don't hold any weight with me and shouldn't with anyone else. That's not even Mullis' original quote. I'm actually not sure what the fact check proves. Okay fine, let's say Reuters is correct and Mullis never said whatever quote some randoms on Facebook are trying to say he said. Here's a research paper pointing out everything wrong with the PCR test: http://theinfectiousmyth.com/book/CoronavirusPanic.pdf http://theinfectiousmyth.com/book/CoronavirusPanic.pdf Let me know what you think.
mas3god 6y ago
Its much easier to measure deaths than cases
laurencerowe 6y ago
This article could really do with a discussion of how the positive test rate is increasing over the past month, see: https://www.ft.com/content/e26349e5-29d4-4797-96ea-a09aac8cd652 https://www.ft.com/content/e26349e5-29d4-4797-96ea-a09aac8cd...
ageitgey 6y ago
> Cases peaked at 5,451 on April 5, reached a low of 101 on June 10 and very recently have appeared to be rapidly rising again. The most recent rise in cases, to more than 2,600 a day, is particularly unsettling. One thing the article briefly mentioned but didn't really dig into (IMO) is that the peak of 5,451 cases on April 5th is basically a meaningless number and that it is important to try to figure out what the real number should have been. On April 5th, the UK was only doing 16,000 tests a day and had a nearly 40% positive rate for tests. Only very sick people were being tested. That implies that the 5,451 cases detected that day is a vast undercount of the actual number of new cases at that point. It is bad data science to keep reporting that peak case number in comparison with the current case numbers as if it means anything. So how many new cases were there on April 5th? No one knows for sure, but various estimates based on community surveys guess that it was more like 100,000/cases per day. That would be a very different graph than what gets attached to every news story. Compare that with now, where the UK is doing ~200k tests a day (over 10x!). We also have much better community survey data now and can estimate that there are about 3,200/cases a day right now. The daily testing is picking up the majority of those expected cases. So if you actually compare numbers that are comparable (~100k cases/~1000 deaths with ~3k cases/~10 deaths), you get a much better idea of what is actually going on. Demographics are definitely working in our favor now, which keeps death rates lower. But it's not like we have "solved COVID treatment" and can cure everyone now because we know to use steroids. It's mostly that there just aren't nearly as many people getting it right now as there were at the peak. Even if tomorrow we detected 5,451 cases again, there's no reason to expect that the death rate should approach the peak because we are getting much closer at detecting all the sick people than before.
- thu2111 6y ago
  3,200 cases/day is a little more than the daily positive UK RT-PCR tests. But by the government's own admission and recent commentary about cycle counts, it's entirely plausible and in fact likely that 100% of these are false positives. It's the only explanation you need to determine why there are no deaths, although there may well be other correct explanations too. The problem is that the test's sensitivity has been amped up to such a huge level that labs are reporting positive for people who have virtually no virus in their blood, or actually no viable virus at all, and certainly are not infectious let alone at risk. Fortunately the British government in the last few weeks finally understood that RT-PCR tests do in fact have false positives, contrary to what was being regularly claimed back in April. They changed their guidance on September 6th. There's an analysis of this by a scientist here: https://lockdownsceptics.org/when-is-covid-19-not-covid-19/ https://lockdownsceptics.org/when-is-covid-19-not-covid-19/ A useful quote is this one: The number of cycles is not actually specified in the publication. Instead each laboratory must determine their own. A beautiful French study demonstrated the relationship between the number of cycles and the chance that a sample will be from an infectious case. Above 30 cycles and the chances of a test being from an infectious case are only 50/50. Above 34 cycles they are all positive. Another laboratory may find a different cut off. Indeed, a Canadian study found no cases requiring more than 24 cycles were infectious. To put it in perspective, COVID testing labs have routinely been reporting positive at 40 cycles.

86 points by finphil 6y ago

It must have taken a special effort to write all those words without once mentioning the false positive rate of the PCR test (~2.3%), which (unlike earlier in the pandemic) is now in the ballpark of reported case numbers: https://www.medrxiv.org/content/10.1101/2020.04.26.20080911v3 https://www.medrxiv.org/content/10.1101/2020.04.26.20080911v...

dgfitz 6y ago
I don’t think I understand. Would factoring that in have significantly affected the thesis of the article?
- zamadatix 6y ago
  I think the implication is if true false positive rate closely matches the reported positive result rate there haven't actually been a growing number of cases just a growing number of tests. I'm not sure the linked material validates this claim strongly though but I also haven't put in the time to see if it doesn't either.
  - dgfitz 6y ago
    Oh ok I understand now, thanks for explaining!
- henriquez 6y ago
  I think the GP is suggesting that the actual case rate is lower than the numbers suggest due to the unknown rate of false positives.
H8crilA 6y ago
Wow, thank you for that, I had no idea PCR is this inaccurate. The process always created a very "pure" image in my head, and now I feel kind of stupid never checking how inaccurate it is in practice. Of course I'm not a professional in the area. How does it happen on a molecular level that PCR delivers a false positive? Are the primers sometimes broken (matching not exactly what they're supposed to match)?
- khuey 6y ago
  A properly performed PCR test is essentially 100% specific. False positives come from contamination of samples, mislabelled samples, and other forms of human error.
  - deleted 6y ago
    [deleted]
- mehrdadn 6y ago
  > Wow, thank you for that, I had no idea PCR is this inaccurate. I'm not sure it really is. Take it with a grain of salt for now. I feel like there's a missing piece of the puzzle here.
tuna-piano 6y ago
If the false positive of the PCR test really is 2.3%, how are so many places able to have positivity rates consistently less than that, more like .1%[1]? And how can test pooling in huge numbers (like was done in Wuhan) work? A false positive rate that high doesn't pass the sniff test. [1]https://ourworldindata.org/coronavirus-testing https://ourworldindata.org/coronavirus-testing [2]https://www.nytimes.com/2020/05/26/world/asia/coronavirus-wuhan-tests.html https://www.nytimes.com/2020/05/26/world/asia/coronavirus-wu...
- wjn0 6y ago
  I'm not sure if this is it, but assuming the correctness of the test is independent of the sample quality, a sample could be split and tested multiple times to obtain a result with a much better FPR.
  - mehrdadn 6y ago
    Anecdotally I've heard this isn't the case, but I don't have links.
  - cameldrv 6y ago
    To my knowledge, the most common failure mode is that the concentration of viral RNA in the sample is below the limit of detection. This could be because the swab wasn't done correctly, the patient wasn't shedding very much virus, the sample was mishandled (heat can break down the sample), or the sample wasn't adequately mixed.
- goalieca 6y ago
  There is a relatively massive false negative rate.
  - repsilat 6y ago
    Regardless of false negative rate, measured positives are always at least as frequent as false positives.
- nl 6y ago
pps43 6y ago
The tests themselves are fine, false positives are due to human error: "The high specificities (usually 100%) reported in PCR-based tests for SARS-CoV-2 infection do not represent the real-world use of these tests, where contamination and human error produce significant rates of false positives." New York reports positivity rate below 1% for a while now, so false positive rate cannot be 2.3%.
- cameldrv 6y ago
  If the false positive mechanism is contaminating one sample with another, the false positive rate will depend on the true positive rate in the samples that the lab/testing site is processing. The other possibility would be if positive control amplicon contaminated the lab, which does happen.
  - pps43 6y ago
    The underlying assumption behind false positive rate is that tests are independent and identically distributed. If in practice this is not the case, then false positive rate becomes misleading.
mehrdadn 6y ago
Hm, the numbers I've dug up (though rather hastily; I haven't read much of the documents) don't really match 2.3%... they seem to be 0% in their tests. Here [1] is where I think you can find the info for all the FDA-authorized tests. I see mentions of NPA (negative percent agreement) being 100% in their trials in [2] and [3] for example, though the sample sizes don't seem too large (something like 30-50). Any idea what I'm missing, or if it's just because of small sample sizes? (I'm not exactly trained in this, but my impression was PCR was more accurate than that.) [1] https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/vitro-diagnostics-euas#individual-molecular https://www.fda.gov/medical-devices/coronavirus-disease-2019... [2] https://www.fda.gov/media/141951/download https://www.fda.gov/media/141951/download [3] https://www.fda.gov/media/141760/download https://www.fda.gov/media/141760/download
- nl 6y ago
  This is really useful, since it's the first source that includes the Ct for each(?) test. Combine that with [1] which makes a good argument that some high Ct levels may be too sensitive. Just randomly looking, this test[2] approved in June uses the Ct of 40 which is criticised above. [1] https://www.advisory.com/daily-briefing/2020/09/01/covid-tests https://www.advisory.com/daily-briefing/2020/09/01/covid-tes... [2] https://www.fda.gov/media/139572/download https://www.fda.gov/media/139572/download
nl 6y ago
This isn't completely correct. The PCR test can produce high numbers of false positives. It depends on a variable called the "cycle threshold" (Ct), which is the number of times amplification is run. Different tests have different Ct numbers, so some specific tests are overly sensitive. However there is no data on what test is used where, or when tests were changed. https://www.advisory.com/daily-briefing/2020/09/01/covid-tests https://www.advisory.com/daily-briefing/2020/09/01/covid-tes...
epistasis 6y ago
I've seen lots of clinics testing numbers, but I've never, literally never seen a PCR test with a FP rate that high. It kind of beggars belief. This article doesn't even deal with SARS-CoV-2, so until it gets peer reviewed and, more importantly, replicated, it should be treated as an extraordinary claim that requires extraordinary evidence.
rsynnott 6y ago
I doubt that’s it. Ireland’s positive rate was about 0.2% for a few weeks, now back up to 1.6%.

lukehutch 6y ago

Because the average of infection has dropped by over 20 years.

mlindner 6y ago
Correction: Because the average of testing positive has dropped by 20 years. I'd more be asking about the faulty test results.
coronadisaster 6y ago
because school started?

ldng 6y ago

Because the image lack a graph of the number of test ? Because tests were scarse at first and only done only to people coming to hospitals and relatives and now anyone can pass one ?

kristianpaul 6y ago

So the metrics where misleading because testing was not constant and/or performed same way across the same population distribution?

saeranv 6y ago

I've been fascinated by the mechanisms behind human facial recognition ever since I read Peter Watts 'Blindsight'. Near the end he introduces an idea similar to the Chernoff face[1], plots of multivariate data in the shape of a human face. The idea is that humans are so keyed into recognizing subtle nuances in facial expressions, we're better at interpreting mulitvariate data graphed as a facial expression. Some interesting parts from this interview: - She surprisingly claims that she's not good at recognizing emotions. - She can recognize adults based on how they looked as children. This suggests there's a sort of 'fuzzing' process that allows her to interpolate aging. [1] https://en.wikipedia.org/wiki/Chernoff_face https://en.wikipedia.org/wiki/Chernoff_face

CGamesPlay 6y ago
Did you intend to post this over here? https://news.ycombinator.com/item?id=24427311 https://news.ycombinator.com/item?id=24427311
- saeranv 6y ago
  Hah, yes, wrong thread.

drummer 6y ago

Because it is just a flu. https://news.ycombinator.com/item?id=23763945 https://news.ycombinator.com/item?id=23763945

dane-pgp 6y ago
> (No more than 250,000 deaths from COVID-19 worldwide within a quarter of a year, compared to 1.5 million deaths during the flu wave in 2017/18). Interesting weasel-words and cherry-picking. First, comparing a quarter of a year of Covid deaths against a whole year (or two?) of normal flu, and then subtly shifting between deaths from Covid and deaths during a flu wave (so not caused by the flu?). For a more accurate comparison: "between 291,000 and 646,000 people worldwide die from seasonal influenza-related respiratory illnesses each year"[0] and 907,917 have died from Covid so far this year[1], despite all the extra measures taken to limit its spread and mortality rate. [0] https://www.cdc.gov/media/releases/2017/p1213-flu-death-estimate.html https://www.cdc.gov/media/releases/2017/p1213-flu-death-esti... [1] https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/
- stateofnounion 6y ago
  > and then subtly shifting between deaths from Covid and deaths during a flu wave (so not caused by the flu?). Newsflash, genius. They are counting every person that died with COVID (or even "presumed" positive) as a death from COVID-19. The actual number of people that were killed directly by COVID is not known, just like we don't measure, test, or track every single person that dies of flu each year. It's an estimate that's arrived at long after the fact by reviewing data.
  - cbsks 6y ago
    In California, deaths are only counted if the death certificate has “COVID-19” as the cause of death. If someone is hit by a car and is also positive for COVID-19, that shouldn’t be counted. > Cumulative number of COVID-related deaths as reported by local health department, beginning March 19, 2020. This determination is made by local health departments based on the cause of death reported on death certificates. It is expected that, to be counted, COVID is the cause of death or at least a contributing factor to the death. COVID-related deaths are also counted in “Positive Cases”. https://covid19.ca.gov/data-and-tools/ https://covid19.ca.gov/data-and-tools/

nl 6y ago

This seems more likely to be the real reason: https://www.advisory.com/daily-briefing/2020/09/01/covid-tests https://www.advisory.com/daily-briefing/2020/09/01/covid-tes... TL;DR: Some (many?) PCR tests are using too high a cycle threshold, which makes them too sensitive. Key quote: Juliet Morrison, a virologist at the University of California-Riverside, said she believes any test with a cycle threshold over 35 is too sensitive. "I'm shocked that people would think that 40 could represent a positive," she said. The following is my commentary, and not specifically in the article above: There were many early tests that were giving false negatives. It looks to me like test manufactures over-compensated to make sure they never give false negatives. There is no data source that I can find that shows what test is used in what area, or what CT is used for what test.

epistasis 6y ago
This article is basically bullshit derived from a NY Times article, and I'm really sad that it got published. You know how every once in a while the media publishes an article about something you know and it's riddled with errors that drive a particular narrative? That article is my experience. Research scientists and clinical scientists are worlds apart, and have very different goals in life. I wouldn't trust a cT coming out of any research lab either, but clinical labs are far far more controlled and have far better processes, and have intense validation that shows that their threshold is repeatable, accurate, and a true representation of their limit of detection. No research lab does any of this, and they almost never have extremely basic contamination protections like separate rooms for pre- and post-amplification rooms. I've watched research scientists try to stand up clinical labs during this pandemic, and it has been an education for them to bring their standards up to what is the baseline for clinical testing. Its not unlike giving a butcher a scalpel and expecting brain surgery: there are a lot of the same skills involved but also very different and extremely narrow it's of knowledge.
- stateofnounion 6y ago
  What does any of that have to do with cT as it relates to accurate COVID-19 detection as discussed in the article?
- 6y ago

daxfohl 6y ago

The strange thing is it's the opposite in Australia. Second wave is much more deadly than the first one. https://www.worldometers.info/coronavirus/country/australia/ https://www.worldometers.info/coronavirus/country/australia/

pan69 6y ago
Is that not because Aged Care is hit particularly hard?
- konjin 6y ago
  Yes, Victoria has managed to combine the economic catastrophe of a New Zealand lock down with the death rate of a Swedish no lock down. And this will continue for at least another month. All in all it's rather amazing how by trying to do everything right the Victorian government has managed to do everything wrong. At least the current government gets to wag its finger at people for wanting such unreasonable things as jobs, leaving your house after work, or sleeping with your partner for the first time in 3 months.
  - ImaCake 6y ago
    This is madness. The lockdown is the only thing that stopped several hundred deaths from becoming several thousand (or much more). No job is worth dying for, and few jobs are worth becoming crippled for. Make no mistake that this virus cripples many survivors.
    - konjin 6y ago
      [[citation needed]]
      - ImaCake 6y ago
        This is not a substantive comment. Please defend yourself better.

ck2 6y ago

Steroids. Lots and lots of steroids. The first thing they do now in the hospital is steroids, they learned after NY. In the UK they had the Oxford study https://www.ox.ac.uk/news/2020-06-16-dexamethasone-reduces-death-hospitalised-patients-severe-respiratory-complications https://www.ox.ac.uk/news/2020-06-16-dexamethasone-reduces-d...

Bekwnn 6y ago
Yeah, I think it was in a thread on r/askscience with some nurses replying basically stating that the methods of treatment for infected patients has evolved as understanding has grown. Steroids was one item they mentioned, another was avoiding the respirator at almost all costs; which is part of why the demand for them has gone down now.

deleted 6y ago

[deleted]

ummonk 6y ago

Note that this is specific to the UK. In other European countries like Spain, death rates have been rising (with a few weeks lag from case rates). They just are nowhere near the first wave, when death rates were more than 10x what they are now but case rates were lower than today and because of severe under-testing.

pier25 6y ago
Death rates on the first wave were a lot more than 10x https://www.worldometers.info/coronavirus/country/spain/ https://www.worldometers.info/coronavirus/country/spain/
- kmonsen 6y ago
  holy shit that page shows that the US is an anomaly compared to all countries it is normal to compare to. It doesn't help that it is gigantic country where it is hard to limit internal travel, but still we are doing something wrong here.
  - glofish 6y ago
    not sure what you mean by anomaly, US looks a lot like Sweden, a country that looks like will be faring the best counter-intuitive as it may sound today, US might just end up the country that did really well. Most large countries are simply not measuring/admitting the real number of cases.
    - kmonsen 6y ago
      This is false, if you look at expected deaths the US is sky high while all of Europe is under control. If we don't get vaccine then sure all countries might eventually end up the same, but Europe is largely back to normal living with kids back at school with almost no cases. In the US we still have lockdowns and no control at all.
      - Fjolsvith 6y ago

pfd1986 6y ago

I must be missing something here: "It is likely that (...) an increasing proportion are young and a declining proportion are older" Don't they have access to this data? How's that a speculation and not a plot?

crowf 6y ago

It's also probably because we know more about how to treat people with the virus. At first ventilators was the go-to plan for people with difficulty breathing, until it was shown that ventilators were either not very useful or even detrimental. At first we didn't realize quite how bad it was for the elderly. The reason that Sweden had so many deaths at first and now virtually none is because there were breakouts in nursing homes at the beginning. Similarly in the US some states (eg. New York, New Jersey) required nursing homes to admit people who have been tested positive for the virus. Now the leaders of those states realize how bad that is and are better protecting the elderly.

nradov 6y ago
I recommend reading the latest COVID-19 care protocol from Eastern Virginia Medical School. It has been updated several times and contains details on clinical best practice. https://www.evms.edu/covid-19/covid_care_for_clinicians/#d.en.140202 https://www.evms.edu/covid-19/covid_care_for_clinicians/#d.e...
- xiphias2 6y ago
  Thanks, here's their summary for prevention: ■ Vitamin C 500 mg BID and Quercetin 250-500 mg BID ■ Zinc 75-100 mg/day ■ Melatonin (slow release): Begin with 0.3mg and increase as tolerated to 2 mg at night ■ Vitamin D3 1000-4000 u/day ■ Optional: Famotidine 20-40mg/day
berryjerry 6y ago
There is still no treatment. THe people I know who were positive literally received absolutely no medication and were told to just stay home for 14 days despite having a fever and cough. They don't even consider it worthy of any medication or treatment in the U.S. unless you already are obese, diabetic, or have asthma. I think the actual reason we see cases and not deaths is just more testing is happening. At the start they wouldn't even test you if you had a fever and cough unless you knew someone who also had tested positive. Which meant basically it was impossible to get a test because other sick people had the same problem. I have also heard that there is a significant amount of false positives because they rushed most of these testing processes in order to meet demand. I believe it was news that like people had swabbed pieces of fruit like a papaya or something and sent it in and received a positive test still. It is right that most sick or susceptible people are better protecting themselves as well, as they should.

walterbell 6y ago

From https://www.nytimes.com/2020/08/29/health/coronavirus-testing.html https://www.nytimes.com/2020/08/29/health/coronavirus-testin... ("Your Coronavirus Test Is Positive. Maybe It Shouldn’t Be") > The PCR test amplifies genetic matter from the virus in cycles; the fewer cycles required, the greater the amount of virus, or viral load, in the sample. The greater the viral load, the more likely the patient is to be contagious. This number of amplification cycles needed to find the virus, called the cycle threshold, is never included in the results sent to doctors and coronavirus patients, although it could tell them how infectious the patients are. In three sets of testing data that include cycle thresholds, compiled by officials in Massachusetts, New York and Nevada, up to 90 percent of people testing positive carried barely any virus, a review by The Times found. > ... One solution would be to adjust the cycle threshold used now to decide that a patient is infected. Most tests set the limit at 40, a few at 37. This means that you are positive for the coronavirus if the test process required up to 40 cycles, or 37, to detect the virus. Tests with thresholds so high may detect not just live virus but also genetic fragments, leftovers from infection that pose no particular risk — akin to finding a hair in a room long after a person has left, Dr. Mina said. Any test with a cycle threshold above 35 is too sensitive, agreed Juliet Morrison, a virologist at the University of California, Riverside. “I’m shocked that people would think that 40 could represent a positive,” she said. A more reasonable cutoff would be 30 to 35, she added. Dr. Mina said he would set the figure at 30, or even less. Those changes would mean the amount of genetic material in a patient’s sample would have to be 100-fold to 1,000-fold that of the current standard for the test to return a positive result — at least, one worth acting on. Every published "case" should include the PCR cycle threshold to enable statistical analysis.

birken 6y ago
They've talked about this issue a lot on TWIV [1], and apparently many of the most commonly used PCR machines do the maximum number of cycles on every sample and then test to see if the sample is positive or negative. So they couldn't report a cycle count even if they wanted to, the machine doesn't allow it. I don't know what percentage of PCR machines in the wild this applies to, but based on how they talk about it on the podcast, it seems like a lot of them. Maybe the global cycle count for the machine could be adjusted, similar to what you are talking about, but that is different than reporting the cycle count of every positive test. 1: https://www.microbe.tv/twiv/ https://www.microbe.tv/twiv/

spirobel 6y ago

tldr: because the corona thing is just not as dangerous as your government and media would like you to believe. But you shouldnt commit wrong think! Its because we "now better protect the elderly". This is a true fact and questioning it is illegal. This is the new normal now. You will not get your rights back.

XMPPwocky 6y ago
> This is a true fact and questioning it is illegal. Doesn't seem like you're using a throwaway for this. Why aren't you concerned for your safety?
- spirobel 6y ago
  Because I cant be bothered to create one. And I think people that use throwaway on hn are ridiculous.
etripe 6y ago
In my experience, no one who's seen what this virus can do to their own age cohort talks like that. I have a (early thirties, no co-morbidity, no pre-existing conditions) brother who was hit particularly hard by covid, from which he's still recovering. Also, I don't know where you are, but what rights have you lost, exactly? My country locked down pretty hard and pretty early, and the only "rights" I've lost are going to crowded spaces and walking around without a mask in populated areas.
- spirobel 6y ago
  the rights I have lost is that the economy got ruined and my generation has to pay for this bullshit and for the rest of europe because our politicians just love to give away money to strangers. Also the corona rules are used to selectively disallow unwanted protests. There is no scientific proof that the lockdown or the mask did anything. look at sweden:practically no new deaths and almost no new cases. But I guess most people are fine with it. So I better get in line ... or else :-) My parents both had corona and they are fine by the way. Just a mild flu. Actually more like a cold.

ImaCake 6y ago

Hey there is a lot of health misinformation in this thread. Please seek advice from professionals, not potentially biased people on a software start up forum. There is a reason medical professionals are trained not to give advice about your symptoms outside the practice.

mikeyouse 6y ago
It’s incredible isn’t it?
credit_guy 6y ago
Professionals like Dr Gupta who said for so long at the beginning of the crisis to not wear a mask? https://www.cnn.com/audio/podcasts/corona-virus?episodeguid=3cf1777709183bdf1ad692c7a6e3e51d.mp3 https://www.cnn.com/audio/podcasts/corona-virus?episodeguid=...
- ImaCake 6y ago
  Turns out science opinion changes with new evidence. When this all started the evidence did not suggest masks would help. Turns out they do, so now the science advice has changed. So your argument is because science is working as intend we should thus not trust it? This is a common anti-science/anti-medicine fallacy.
  - credit_guy 6y ago
    Incorrect. Dr Gupta and others had known all along that masks are useful. They were contradicting themselves when they were telling us "don't use masks, they are useless, we need them for the healthcare personnel". Why did they need them for the healthcare workers if they were useless? They simply decided to lie to us.

pieceofcakedude 6y ago

Because we're relying on a test which can barely be trusted. It's a research tool and should never be used in a diagnostic capacity. Don't listen to me about it though, that quote is from the PCR test's inventor Kary Mullis. It's bizarre that this isn't mentioned more. There's a rumor that it has a high false positive rate as well. There was a New York Times article that summarized this a few days ago. Again, perplexing why this isn't mentioned and studied more.

JulianWasTaken 6y ago
This is false. See e.g. https://www.reuters.com/article/uk-factcheck-pcr-idUSKBN24420X https://www.reuters.com/article/uk-factcheck-pcr-idUSKBN2442....
- listenallyall 6y ago
  This "fact check" only serves to confirm pieceofcakedude's statement. Not about who said it (who cares?), but about the test not being trustworthy. Reuters states, in the last paragraph, "PCR tests ... show that SARS-CoV-2 viral genetic material is present in the patient" -- not that the PCR test confirms any minimum quantity, enough to cause any adverse effects. This is what the NYTimes reported on, that the amplification necessary to detect the virus was very often so great, implying what existed in the person was so tiny as to be inert. Reuters agrees: "It is important to note that detecting viral material by PCR does not indicate that the virus is fully intact and infectious" Pregnancy tests should return a binary result. Pretty much every other test requires a quantity for context. Imagine a blood-alcohol test that can say yes, alcohol is present, but is unable to distinguish between ingesting a teaspoon of cough syrup vs. drinking a six-pack.
- pieceofcakedude 6y ago
  Fact checks from zero credibility organizations like Reuters don't hold any weight with me and shouldn't with anyone else. That's not even Mullis' original quote. I'm actually not sure what the fact check proves. Okay fine, let's say Reuters is correct and Mullis never said whatever quote some randoms on Facebook are trying to say he said. Here's a research paper pointing out everything wrong with the PCR test: http://theinfectiousmyth.com/book/CoronavirusPanic.pdf http://theinfectiousmyth.com/book/CoronavirusPanic.pdf Let me know what you think.

mas3god 6y ago

Its much easier to measure deaths than cases

laurencerowe 6y ago

This article could really do with a discussion of how the positive test rate is increasing over the past month, see: https://www.ft.com/content/e26349e5-29d4-4797-96ea-a09aac8cd652 https://www.ft.com/content/e26349e5-29d4-4797-96ea-a09aac8cd...

ageitgey 6y ago

> Cases peaked at 5,451 on April 5, reached a low of 101 on June 10 and very recently have appeared to be rapidly rising again. The most recent rise in cases, to more than 2,600 a day, is particularly unsettling. One thing the article briefly mentioned but didn't really dig into (IMO) is that the peak of 5,451 cases on April 5th is basically a meaningless number and that it is important to try to figure out what the real number should have been. On April 5th, the UK was only doing 16,000 tests a day and had a nearly 40% positive rate for tests. Only very sick people were being tested. That implies that the 5,451 cases detected that day is a vast undercount of the actual number of new cases at that point. It is bad data science to keep reporting that peak case number in comparison with the current case numbers as if it means anything. So how many new cases were there on April 5th? No one knows for sure, but various estimates based on community surveys guess that it was more like 100,000/cases per day. That would be a very different graph than what gets attached to every news story. Compare that with now, where the UK is doing ~200k tests a day (over 10x!). We also have much better community survey data now and can estimate that there are about 3,200/cases a day right now. The daily testing is picking up the majority of those expected cases. So if you actually compare numbers that are comparable (~100k cases/~1000 deaths with ~3k cases/~10 deaths), you get a much better idea of what is actually going on. Demographics are definitely working in our favor now, which keeps death rates lower. But it's not like we have "solved COVID treatment" and can cure everyone now because we know to use steroids. It's mostly that there just aren't nearly as many people getting it right now as there were at the peak. Even if tomorrow we detected 5,451 cases again, there's no reason to expect that the death rate should approach the peak because we are getting much closer at detecting all the sick people than before.

thu2111 6y ago
3,200 cases/day is a little more than the daily positive UK RT-PCR tests. But by the government's own admission and recent commentary about cycle counts, it's entirely plausible and in fact likely that 100% of these are false positives. It's the only explanation you need to determine why there are no deaths, although there may well be other correct explanations too. The problem is that the test's sensitivity has been amped up to such a huge level that labs are reporting positive for people who have virtually no virus in their blood, or actually no viable virus at all, and certainly are not infectious let alone at risk. Fortunately the British government in the last few weeks finally understood that RT-PCR tests do in fact have false positives, contrary to what was being regularly claimed back in April. They changed their guidance on September 6th. There's an analysis of this by a scientist here: https://lockdownsceptics.org/when-is-covid-19-not-covid-19/ https://lockdownsceptics.org/when-is-covid-19-not-covid-19/ A useful quote is this one: The number of cycles is not actually specified in the publication. Instead each laboratory must determine their own. A beautiful French study demonstrated the relationship between the number of cycles and the chance that a sample will be from an infectious case. Above 30 cycles and the chances of a test being from an infectious case are only 50/50. Above 34 cycles they are all positive. Another laboratory may find a different cut off. Indeed, a Canadian study found no cases requiring more than 24 cycles were infectious. To put it in perspective, COVID testing labs have routinely been reporting positive at 40 cycles.