A Brief Medical View Of Covid-19 Case Counting

I’ll be brief, as I’m hoping - in vain perhaps - that most people with a brain above room temperature would already know and understand the following.

What passes for news reporting in the United States has been and is - I believe for purely political reasons - focused exclusively on the number of new cases reported.

Allow me to VERY briefly say this about that: Communicable diseases transmit through exposure. As more and more people climb out of their government/self-imposed bunkers they will, by scientific definition, expose themselves to infection. Are you with me so far?? Good!!

We now have therapeutics - at least a few - that have been shown through usage to be of significant benefit in mitigating the effects of the virus on the body. So far, so good?? I sure as hell hope so. How about you Democrats, are you getting this?

The point is, as more people are exposed by way of beginning to crawl out of their bunkers and resume their lives the more reported cases we should expect - unless you are a Democrat, in which case none of this will make sense.

The real key statistic is NOT the number of new cases, but the death rate among those contracting covid-19.

As we have learned more about the virus, the death rate has been and is falling significantly in the US - among all age groups and among those with seriously compromised immune systems. Scientifically, that is a function of having a better understanding of the disease leading to our ability to significantly improve our regimen of treatment protocols.

Survival rates - again, for those of you on the Left, the survival rate refers to the rate of survival among those who have tested positive for covid-19. Among the younger members of our society in good health we currently have a survival rate approaching 99.8% For those of you who did not pay attention during your exposure to 3rd grade math, that translates to roughly 2 deaths per 1000. Even among the aged and infirmed the current survival rate is in the 95.5% range - or 4.5 deaths per 1000.

And for this, according to Joe Biden and the entirety of the Left, we are to shut down our economy (read: destroy our economy and our future) if Fauci says so?

Are some of you nuts, or what?

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Where are you getting your numbers? Also, double check your math on the elderly:

That’s 45.5/1000, or just under 1/20

Oh the irony…

Mike, if you’re going to take the time to write a patronizing insult about people’s ability to do “3rd grade math”, you should probably be more careful not to fail in your attempt in actually doing 3rd-grade math.

95.5% of 1000 is 45, not 4.5.

Thanks for the lolz.

I like to imagine, due to a simple math error, we just caused him to realize the pandemic is much worse than he thought

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Yikes, I am guilty of faulty math - my bad. 99.8% does translate to roughly 2 per 1000. 95.5% does indeed work out to roughly 45/1000.

Point is this - the VAST MAJORITY of Americans can, with obvious relative safety, return to their normal, pre-covid routine. As for the aged/compromised - you use precautions. You damn sure don’t close down the economy.

I don’t believe that Fauci is the final word, nor did ByeDon say that he would leave it up to Fauci.

I agree that millions of cases sound worse than 100’s of thousands of deaths, but perhaps if we frame the number of deaths by reminding people the number of COVID-related deaths is higher than our losses in WWII.

So yeah, I agree, we should focus on the number of people that have died.

There are 2 statistics we can look at for this.

The CFR or case fatality rate (or more colloquially the “death rate”), which is simply the number of deaths divided into the number of reported cases.

Something like this

Which, as of today is 3.56%

Now since we know that not all cases are reported, we know that the actual fatality rate is smaller BECAUSE we know the actual number of cases is much higher.

However, this is a double-edged sword for Republicans and especially Trump who want to downplay the number of cases not increase it!!! But this is the only way that the case fatality rates decrease unless you try to claim that the number of cases is wrong, which is indeed what we’ve seen, but I’ll get back to this.

So in order to report something closer to the real fatality rate, you have to admit there have been more cases.

This is known as the Excess Mortality Rate or EMR. Something that is often confused with the CFR or Case Fatality Rate. People and the media often swap these around (which btw is what I expect you’re doing Mike). If you take the reported cases (CFR) and divide it into numbers derived as part of the EMR, you will indeed get numbers similar to what you are reporting.

Now what’s really, really ironic is that the number of deaths is a reasonably reliable statistic. Doctors can’t and don’t get an opinion about a person dying or not. They are either dead or they are not. Sure they have input on the cause of death, but death is a death and you can’t make them up, you’ll get caught.

So if we look at death rates (not causes) just deaths, we see the number of deaths when measured against past years (that are remarkably consistent over the last 5 years) is higher.

So here is a chart that measures deaths per day.

You’ll see the number is much higher than the average of 2014-2018.

What accounts for the dip in deaths in March is worth discussing (but a separate issue). If I had to guess, people were more aware of symptoms and were probably more likely to seek help, but that’s just a guess.

Looked at another way, we can see this year has spiked.

Now, the number of deaths that have occurred, are right there and the only rational explanation is COVID related (meaning that COVID caused the underlying problem that caused a person to die).

Thus, we know one factor and if we know 2 we can do the math.

The yellow line on the chart above is the line between expected and excess deaths. Interestingly you’ll note that the recorded number of deaths is usually slightly lower. But even using anything above the yellow line, we have a problem. The number of deaths does not jive with your numbers.

Thus, either people are dying of something unrelated to COVID in HUGE numbers, something NO ONE else is reporting, or your wrong.

9.2 of all deaths this year are related to COVID. Of which about 10% of those are people 65 and under.

image

Now, if you do the math, that’s just shy of 20,000 people under the age of 65 who have died from COVID related causes.

And I’m willing to bet, you’ll see another 10-20 thousand deaths by people under 65 before it’s over unless we have better leadership at the top.

There are two factors to getting out of this mess. One is a vaccine, but that will probably be no more than 65 to 70 percent effective. The key is herd immunity. That’s what ended the 1918 “Spanish Flu” (It did start in Kansas BTW) and that is what is going to reduce this to livable levels.

Shutting everything down only made sense in the early part of the pandemic so that the hospitals would not get slammed. After that, we had to open the economy because the effects on the economy and the metal state of the people were going to be worse during the shutdown than the disease itself.

Without boring people with a bunch of charts, there are two things we have learned about this disease. First, it’s contagious has hell. The thing spreads very easily, and it will continue to do so until herd immunity and a vaccine are achieved.

Second, it posed a series danger to older citizens who are vulnerable anyway. Among those under 70 the recovery rate is on the order of 99%. There is the issue permanent tissue damage, which is a concern. That is a big issue, but it’s not a reason for another shutdown. Unfortunately, mortality and morbidity are facts of life. Something is going to kill you someday, and there is chance that something might disable you before then.

The final issue is what part do China play in this pandemic? Only a fool, or a disgusting communist, would try to deny that it came from China. The next two questions are, did China spread the virus deliberately? If so, that is one more reason to do whatever we can to live without them. Worst of all, did China create this intentionally and spread it on purpose. If that’s true, it would be hard to call for a war, but certainly a cold war would be very much on the table.

The current leader of China is the 21 century’s version of Adolf Hitler. You can take assessment to the bank because it’s true. The only question is, is he as crazy as Hitler was? Does he have any level of restraint?

The CDC nationwide numbers as of this morning - 10/7/2020 were as follows - confirmed covid-19 cases were 7,621,323 and confirmed deaths were at 214,647 - an overall 2.8% death rate counting all age groups and regardless of age or pre-existing infirmity…

HOWEVER - and this would be wise for the truly ignorant on this site to keep in mind - given that a relatively small fraction of Americans have actually been tested, there are without any doubt millions of Americans who have contracted the virus, were asymptomatic, who have not been tested and, therefore, are not included in the case count.

Have nice day ignoring the obvious while rooting for Joe, Hunter and China,

It’s interesting to see the difference in cases by Dem and Republican areas.

I think the state data is misleading, but the county by county data is much more telling.

Keep in mind that there are generally more people in Democratic areas (as they tend to live in more populous cities).

We see the Trump influence in full effect.

This is ALL horse-hockey! First off, we have NO IDEA how many people Covid-19 has killed because we see political motives in reporting them. Some guy falls off of a ladder and dies? Covid death! A guy comes into the ER with 3 bullet holes in his chest? Covid death! A 92-year-old lady dies in a nursing home from pneumonia? Covid death! Why did this happen? Because we foolishly PAID a premium to hospitals, nursing homes or other health care providers for any patient treated for Covid-19! That guy who died from a fall? Medicare/medicaid would reimburse the ER who treated him about $1,500, but IF his death could be attributed to Covid-19, the ER gets “reimbursed” $13,000 and if they can show they put him on a ventilator, $35,000! Is it ANY wonder why so many deaths were attributed to Covid-19?

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So in your opinion (or in the opinion of whoever built your “chart”), the death-rate in America would be going DOWN if not for Covid-19? That’s pure BS and I think even YOU know it.

It’s not seasonally adjusted. Less people die in the spring/summer than the winter. If the chart kept going through winter, it would have risen again.

Here’s average deaths by month from the CDC
https://www.cdc.gov/mmwr/volumes/68/wr/figures/mm6826a5-F.GIF

As Gene said…Look at the months on the chart you are talking about and look at this one, which covers multiple years.

I spoke to Herman Cain the other day. He told me mdmike is completely full of crap.

Prove me wrong.

And if a frog had wings, it wouldn’t bump its butt every time it jumped?

Not my fault you don’t know how to interpret basic graphs

I always enjoy your posts, Dr.Mike! Being a science and math major, I understand perfectly what you are saying. If I hadn’t become a teacher (classically trained) I would have liked to have become a virologist. I have been saying the same ever since this whole COVID-19 pandemic started. I still believe that this was a “last ditch effort” for Pelosi to eliminate Trump. LOL!