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Coronavirus: a senseless panic or a real challenge?

Coronavirus: a senseless panic or a real challenge?

Here are two texts, both of which cast a cold eye on the current panic over this virus. Why are we so upset by this particular outbreak? The evidence exists for for it being more dangerous - infectious, mortal - than any other strain of influenza is limited. So why the panic? Why are we conscientiously wrecking our economies in dubious attempts to limit its spread? If we do isolate people, they will remain vulnerable to infection at some future date. The "peak spreading" virtues of isolation, intended to to spare calls on emergency services, seem pretty vacuous when compared to the scal eo conventional 'flu outbreaks. The virtues of these care systems rest on their ability to reduce Covid mortality substatially. There is no evidence that they can do this, given the generally weak nature of most mortally ill patients.

Here is an excellent, professional article that assesses the threat in an epidemiological context

The United States Centers for Disease Control [...] publishes weekly estimates of flu cases. The latest figures show that since September, flu has infected 38 million Americans, hospitalised 390,000 and killed 23,000. This does not cause public alarm because flu is familiar. [...] Early evidence from Iceland, a country with a very strong organisation for wide testing within the population, suggests that as many as 50 per cent of infections are almost completely asymptomatic. Most of the rest are relatively minor. In fact, Iceland’s figures, 648 cases and two attributed deaths, give a death rate of 0.3 per cent.

Why the mad panic?

Why the mad panic?

Our primary take on Covid is that we are in the middle of an wave of organised hysteria, organised by the many agencies which have been salivating for an epidemic to which to respond. Pandemic has been top of the preparedness list for at least two decades and the basic policy lesson is that if you wind a spring, the clock will eventually chime.

What have we got? A minor variant of influenza. It is no more nor less communicable or dangerous as conventional flu, which kills 8000 people in the UK every year. And hundreds of thousands in China. Chinese Covid-related mortality is, currently, just over 3500, UK passing 100, mostly of people who were in imminent danger of death from other causes.

The scary stories come from population models which have never approached reality. The orthodoxy notion is that epidemics proceed to "herd immunity" levels, which drop out of the models at 80%. No disease save perhaps the Black Death has ever effected 80% of the population in bald fact, but combining that number with a 1% mortality rate should have led to 9+ million deaths in China. As indicated above, it has not. The infections have stopped, in part because air pollution has fallen sharply in China, lungs are less irritated and the thing appears to have fizzled out. Imperial College, which released a mathematical scare story predicting half a million deaths in the UK, should be publicly ridiculed.

But the hysteria prevails,. We are busily wrecking our economy for the sake of a few potential victims and a silly story about the health service being overwhelmed, something that is to be avoided at any price whatsoever and which is predicted by the same silly models that started the nonsense in the first place. But why are Italians seemingly so vulnerable to SARS-COV-2? We don't know, but hypochondria is a national pastime in Italy, and there are no reliable testing kits available. You need to test eight time to get a reliable positive based on failure rates and Bayesian statistics. Milan is, though, famously polluted.

When we build a road or a bridge, we assess the probably mortality associated with various options and apply an official number for the value of a life spared. That amount is currently a bit over a million pounds, which be coincidence the average cost of a fatal road traffic accident. Britain is splurging something around a trillion pounds - almost half our GNP - on the Covid outbreak. At the above costing, that implies that these measures would have to save a million lives: one person in seventy in the country will live who would otherwise have died. This is, for the reasons already advanced, a dubious proposition. As Covid deaths are chiefly restricted to the elderly, the 15% of the UK population who are over 70 years of age - 10 million people - would have to be (literally) decimated if these numbers are meaningful. Unkind voices would no doubt say that they have to die of something, and that it would be economically advantageous to the state if it had to stop paying pensions and affording medical care. Whilst nobody would applaud these voices, it remains the case that half of the health budget is spent on the over 70s.

Added subsequently:

Incoming query:Your critique of the Imperial v Oxford modeling approaches would be particularly valued.

I have no access to either model, but I do know the approach which is taken. The key differences lie in the assumptions. Oxford assumes that most COV 2 is asymptomatic, that it has been loose in the global population for a considerable time (months to years) and that infection is therefore widespread. Its lethality is consequently necessarily limited and its spread is self-limiting.

Ferguson at Imperial takes different starting parameters: that it arrived in January, that it is highly infectious and this it will spread through the population until it hits 80% infection rates. It also assumes a 1% lethality, which delivers the large projected numbers. (Hundreds of thousands.) We won't know which of these is the most true until random population samples are taken and analysed for antibodies.

Compare and contrast this from the CDC:

(You need to scroll down through the fluff to get to the meat.)

This estimates the average deaths from commonplace influenza in the US. The CDC estimates that influenza has resulted in between 9 million – 45 million illnesses, between 140,000 – 810,000 hospitalizations and between 12,000 – 61,000 deaths annually since 2010. The table gives the annual numbers and the forward estimates. These numbers make COV-2 to date look like nothing, or at worst as routine, yet we have this progressive economic suicide in train. So why? Hysteria? Cover for an alien invasion, as conspiracy nuts suggest? Either way, an utter failure at the top, hypnosis of the leadership by the modeling witch doctors.

The Perfect Panic: Diamond Princess Mysteries

The Perfect Panic: Diamond Princess Mysteries

Guest Post by Willis Eschenbach

OK, here are my questions. We had a perfect petri-dish corona virus disease (COVID-19) experiment with the cruise ship “Diamond Princess”. That’s the cruise ship that ended up in quarantine for a number of weeks after a number of people tested positive for the corona virus. I got to wondering what the outcome of the experiment was.

So I dug around and found an analysis of the situation, with the catchy title of Estimating the infection and case fatality ratio for COVID-19 using age-adjusted data from the outbreak on the Diamond Princess cruise ship (PDF), so I could see what the outcomes were.

As you might imagine, before they knew it was a problem, the epidemic raged on the ship, with infected crew members cooking and cleaning for the guests, people all eating together, close living quarters, lots of social interaction, and a generally older population. Seems like a perfect situation for an overwhelming majority of the passengers to become infected.

And despite that, some 83% (82.7% – 83.9%) of the passengers never got the disease at all … why?

Let me start by looking at the age distribution of the Diamond Princess, along with the equivalent age distribution for the entire US.

Figure 1. Number of passengers by age group on the Diamond Princess (solid) and expected number of passengers given current US population percentages (hatched).

When as a young man I lived in a port town with cruise ships calling, we used to describe the passengers as “newlyweds and nearlydeads”. Hmmm … through some improbable series of misunderstandings and coincidences, I’m in the orange zone now … but I digress …

In any case, Figure 1 shows the preponderance of … mmm … I’ll call them “folks of a certain distinguished age” on the Diamond Princess. Folks you’d expect to be hit by diseases.

Next, here’s the breakdown of how many people didn’t get the virus, by age group:

Figure 2. Percentage of unaffected passengers on the Diamond Princess. “Whiskers” on the plot show the uncertainty of each percentage.

In addition to the low rate of disease incidence (83% didn’t get it), the curious part of Figure 2 for me is that there’s not a whole lot of difference between young and old passengers in terms of how many didn't get corona virus. For example, sixty to sixty-nine-year-old passengers stayed healthier than teenagers. And three-quarters of the oldest group, those over eighty, didn't get the virus. Go figure. Buncha virus resistant old geezers, I guess …

Next, slightly less than half the passengers (48.6% ± 2.0%) who got the disease showed NO symptoms. If this disease is so dangerous, how come half the people who got it showed no symptoms at all? Here’s the breakdown by age:

Figure 3. Percentage of Diamond Princess passengers who had corona virus. but were symptom-free. There was only one illness among the youngest group, and they were symptom-free. As in Figure 2, the “whiskers” on each bar of the graph show the uncertainty.

Again, a curious distribution. Young and old were more likely to be symptom-free, while people in their 20s, 30s, and 40s were more likely to show symptoms. Who knew?

There were a total of 7 deaths among those on board. All of them were in people over seventy. So even though the generally young were more likely to show symptoms if they had it, as it hits old people the hardest.

Finally, according to the study, the age-adjusted infection fatality rate was 1.2% (0.38%–2.7%). Note the wide uncertainty range, due to the small number of deaths.

For me, this is all good news. 83% of the people on the ship didn't’t get it, despite perfect conditions for transmission. If you get it, you have about a 50/50 chance of showing no symptoms at all. And the fatality rate is lower than the earlier estimates of 2% or above.

It is particularly valuable to know that about half the cases are asymptomatic. It lets us adjust a mortality rate calculated from observations, since half of the cases are symptom-free and likely unobserved. It also gives a better idea of how many cases there are in a given population.

To close out, I took a look at the current state of play of total corona virus. deaths in a few selected countries. Figure 4 shows that result.

Figure 4. Deaths from corona virus. in four countries. Note that the scale is logarithmic, so an exponential growth rate plots as a straight line. Blue scale on right shows the deaths as a percentage of the total population.

At this point at least, it doesn't appear that we are following the Italian trajectory. However … it’s still early days.

Finally, a plea for proportion. US corona virus. deaths are currently at 67, we’ll likely see ten times that number, 670 or so, might be a thousand or three … meanwhile, 3,100 people die in US traffic accidents … and that’s not 3,100 once in a decade, or 3,100 per year.

That’s 3,100 dead from auto accidents EACH AND EVERY MONTH … proportion …

As Always: When you comment please quote the exact words you are referring to, so we can all understand who and what you are discussing.

Terminology: Yes, I know that the virus is now called 2019-nCoV, that it stands for 2019 novel Corona Virus, and that the disease is called Covid-19, and that it stands for Corona Virus Disease 2019 … so sue me. I write to be understood.