For number-crunchers...Coronavirus Michigan raw stats
Michigan population: 10,045,029
Current documented cases as of 4/2/2020 - 9334 (.09292% of population)
Documented deaths due to Coronavirus as of 4/2/2020 - 337 (.00335% of population)
https://www.michigan.gov/coronavirus/0,9753,7-406-98163-520743--,00.html
Model Estimate of total Coronavirus related deaths by August 4 - 3169 (.03154% of population)
https://covid19.healthdata.org/projections
*interesting stat model updated daily
Comparison
2018 Michigan auto accidents - 312,798 (3.11% of population)
2018 Michigan auto accident fatalities - 905 (.009% of population)
https://www.michigan.gov/documents/msp/2018_Year-End_for_Web_653222_7.pdf
*MSP doesn't list 2019 data
What your analysis does not present is that COVID-19 produces a mortality rate of approximately 3% based off your numbers above.
Applying that against auto accidents of 312k, that would mean deaths of 9k+ based off the same sample size, which is 10x greater than auto mortality rate.
3% mortality rate also assumes that you are able to get treatment.
Yep 3% mortality rate which seems to mirror what some other regions have experienced...Italy being the outlier.
Spain, France, Iran, the UK and the Netherlands are all above that. The evidence suggests that the longer you are on your curve, the greater the mortality rate due to the lag of deaths behind cases.
Except we have no idea how many people are actually infected and how many cases there are, so speculating on the mortality rate is pointless.
No one anywhere has tested and confirmed even a fraction of infections though. The most recent and likely best estimate of fatality rate is by the Lancet which has tried to estimate the true number of infections (still a wild guess) and revised down the fatality rate to about 0.66%. I suspect this will decline further as we roll out antibody testing and find out just how many people were infected with little to no symptoms. When all is said and done the total numbers aren't going to be crazy.
But make no mistake, this is at least several times as deadly as the flu and it requires lengthy hospitalizations and it's all hitting in a short period of time since no one is immune (rather than spread over a several month season) so the impact on our healthcare system is going to be unimaginable for the next month. Our doctors and nurses working on this are true heroes. Please stay home to allow them a fighting chance.
This is true; but it’s factually incorrect to say that Italy is the only country with a mortality rate above 3%, using the deaths/total cases metric.
People are really pushing this “Italy is a country of old, frail people” argument when the truth is probably more that they’re just further along the curve than other countries. A lot of European countries are looking like Italy right now and we’re showing signs of it too.
Average age of death in Italy is 78 years old: https://www.epicentro.iss.it/coronavirus/bollettino/Report-COVID-2019_24_marzo_eng.pdf
In Spain, 80: https://www.lavanguardia.com/vida/20200316/474173692939/fallecidos-coronavirus-covid-19-mayores-ancianos-80-anos.html
They are old.....the young are getting sick but surviving. The old are dying.
my two cents.
not to get into all the details, and take it for what it's worth, but i did my own calculation of NY mortality rate based on cuomo's daily press conferences. i have been watching them every day. i had to make some assumptions based on estimates of several factors. that said, i came up with an overall mortality rate of 0.8% for infected people.
today was the first day cuomo indicated that hospitalizations were LESS than recoveries (hospital releases). that is a great sign. that means less beds are being used today then yesterday. hopefully, that holds and/or improves the next few days.
i will also predict that NY will fare worse than the rest of the US. perhaps NOLA and/or a few other hot spot cities could be worse. but i think the overall US mortality rate will be lower than that 0.8%.
the key in the coming months is to keep testing people, determine who has had it and likely immune, then allow segments of the population get back to work. also, a cure/treatment would be critical in the coming months to mitigate a Fall relapse. then a vaccine by this time next year.
be smart for the next few weeks. each day gives us more data. who knows, maybe will will catch a miracle cure soon and can get back to normal.
This has been discussed before but bears repeating. This 3% figure is based upon the number of positive tests-it obviously doesn’t include people with minor symptoms who are never tested and who recover nor does it include any false negative tests.
We need to be smart and keep our distances but we also need to understand the stats that are being tossed around.
Undocumented people who contract the Coronavirus & aren't part of the sampling would skew the mortality rate down. It begs the question how many people die of complications related to the Coronavirus but aren't linked?
Some deaths will not be attributed to the virus when they should have been but far more infections that resolve without a positive test will occur such that the net result is that a fatality rate of 3% is way, way too high.
i can tell you right now that they think up to 50% of infected people show no symptoms at all. so they likely aren't even being tested. so that fact alone reduces that 3% to 1.5%.
I just read an article today suggesting an absurdly high false-negative testing rate:
also, wrt the mortality rate discussion, I like to think in terms of number infected (just my preference as a predictive metric), not number that test positive. There was a recent article that in my opinion did a rational job at trying to estimate the inherent death per infection rate given the issues around testing availability and sampling bias:
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30243-7/fulltext
What's the difference between an infected person and a person that tests positive?
The Lancet study you cited was interesting but seemed to be a summary pointing to age is a major factor in morbidity unless I didn't dive deep enough there.
Those that test positive are only a subset, possibly a very small subset of those infected. Not even close to everyone that's infected is being tested, let alone testing positive.
*smacks forehead*
lies, damn lies, and statistics.
Of course, stats can only be based on the samples available. Given that the early guidance for people experiencing symptoms consistent with COVID-19 was to stay home and self-quarantine unless the symptoms worsened to something closer to life-threatening, I am sure there are a very significant number who aren't counted among the number of cases. Not to mention those with minor symptoms or who are asymptomatic. So yes, the numbers very likely aren't nearly as grim as 3+% mortality rate, but it does, at least, appear to be significantly higher than the common strains of the flu.
At some point, there will be a vaccine and we will have built up antibodies and this virus will not incite panic, but here we are for now, dealing with a heretofore unknown virus with heretofore unknown effects.
The other side of it is that of these 9334 cases, 8992 are still active. If we calculate deaths/cases, we’re assuming that all 8992 active cases will result in recovery, which isn’t realistic.
People keep making this argument (that expanded testing should bring down the mortality rate) but this doesn’t actually seem to be happening anywhere. Even in Germany, mortality is creeping up.
It's creeping up in Germany because there is a lag between positive test and death and they're testing a lower percentage of actual cases now because it's grown beyond the point where they can reliably contact trace every positive test which they were doing in the beginning.
The argument for expanded testing, which will have to be done before we can ease restrictions is to keep infections down, which will necessarily decrease the number of fatalities. Mortality rates are kind of useless unless you're talking population mortality rate because we are measuring the number of cases imperfectly and inconsistently.
The idea behind expanded testing is that you test aggressively, find out who has it, regardless of symptoms, isolate those people so they can't infect others and then contact trace to test everyone they may have come in contact with regardless of symptoms. This is what Germany and Korea and Taiwan and Japan have done to keep fatalities way down overall.
See what happened with swine flu
“One example is the H1N1 pandemic of 2009, known as swine flu. Early case fatality rate estimates were inflated by a factor of more than 10. Even 10 weeks into the epidemic, estimates varied widely between countries, coming in between 0.1% and 5.1%. When medics later had a chance to go through case documents and evaluate cases, the actual H1N1 case death rate was far lower, at 0.02%.”
https://www.bbc.com/future/article/20200401-coronavirus-why-death-and-mortality-rates-differ
The article is a good read that talks about many of the issues. Just to be clear, I am not suggesting that the number is anywhere near as low as 0.02. Just making the point that once all the data is in, numbers have gone down in the past. 500 people died in New York State in one day from Covid-19. I am pretty sure that is not typical for the flu.
I understand this argument - but a lot is going to come down to the capacity of hospital systems to cope, which was not a serious issue during the swine flu. Every time we see mortality statistics for the U.S., someone rushes out to say “This is the worst case scenario!” but we can’t be certain of that. It is very likely that the raw mortality rate (deaths divided by confirmed cases) will continue to increase in the coming weeks. It will finally drop when we produce our final statistical model in the end, but that final percentage might not be that different from what we see now.
A lot of people had immunity to the swine flu. There was a massive effort back in the 70s to vaccinate people. So the swine flu could have had a bigger impact on older people like COVID-19 is it would’ve been the older people that had some immunity to H1N1. It’s not the same exact H1N1 in those two different decades but there’s going to be some immunity.
last i checked automobile accidents aren't contagious.
they can be on a icy highway in SE michigan in the winter.
I don't get what you are trying to prove. This is a contagious virus. 1/3 to 1/2 of the population will eventually get it. Something like 20% require hospitalization/ ventilators. If you don't get a ventilator you will die. So...
10M * .33 * 20% = 660,000 people who need ventilators.
There are currently 1,700 in the state of Michigan.
If people weren't staying at home ~250,000 to 1,000,000 people in Michigan would die.
If there are only 3169 deaths by Aug 4th we should all be very thankful.
1/3 to 1/2 of Michigan population is a 33% to 50% infection rate...where did you see this?
March 13th NY Times said 160 million and 214 million people in the U.S. with the virus and 200k to 1.6M dead assuming the hospitals don't get overwhelmed.
People keep talking about going back to work in a few weeks or hitting the apex in a two weeks, but if there are only 10M people with the virus today world wide, and there is no immunity, without a total lock down for weeks I don't see how you can contain it. China totally locked down their shit (the advantages of being in an authoritarian state), but I think the U.S. is in big big trouble.
I agree with you that the OP was pointless and lacking in analysis. I also would contend that the people still making comparisons without data on COVID-19 to other fatalities are being dishonest.
However, not every person that is hospitalized for COVID-19 needs a ventilator. The hospitalization rate of 20% may or may not be high, but the number of ventilators needed is way less than what you projected here.
As for fatalities, we cannot ignore the additional fatalities that result from the rationing of healthcare that will be required if the healthcare system collapses. People complained about "death panels" in the past. I do not hear these people discussing the fact that doctors are asking for immunity for choosing who will get care and who will be denied care in the event of a lack of resources.
Yes it was lacking in analysis that's why it was called raw data for number crunchers.
You just happened to include in that raw data something that is being peddled by those trying to downplay the severity of this pandemic (namely, talking about auto accidents or some other straw man-inducing comparison).
Dumb people shouldn't double as statisticians.
Where are you seeing that 20% of the infected population will require hospitalization? It may be the case that with the current sampling bias on testing 20% of positive tests require hospitalization, but it seems unlikely that 1/3 to 1/2 of the entire population will fall into the current criteria of receiving a test.
20% hospitalization were initial doomsday projections. This has been revised down quite substantially.
This is based off of the UK paper that caused the initial panic. They say 7.7% based on the United States demographics. They've also said that 30% of people hospitalized will need the ICU. So 2.3 out of every 100 cases.
Iceland, the most complete data set we have on a population, has had 3.3% of cases hospitalized, with a little under 1% requiring ICU.
https://www.icelandreview.com/ask-ir/whats-the-status-of-covid-19-in-iceland/
This would be somewhere between 30,000 and 80,000 ventilators needed if we did nothing, but obviously we aren't doing nothing.
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Also worth noting that both the models being used for projections are off as far as I can tell (If I'm missing something please let me know and I will delete):
Using New York because Michigan does not track hospitalizations
https://covidactnow.org/state/NY
https://covid19.healthdata.org/projections
The first link has New York projected at 21,000+ hospitalizations with strict compliance of SIP on April 1st. Reality is they have had 18000 with poor compliance.
https://covidtracking.com/data/#state-NY
Also, when factoring in discharges, there are 13,383 hospitalized in New York, not sure if they are measuring the same thing.
https://nymag.com/intelligencer/article/new-york-coronavirus-cases-updates.html
Second link - which I believe is what the Trump Administration is basing their response on - says New York should be using 50,000 beds today.
As I said, if I'm missing something here, please let me know.
Good stuff thanks for sharing
This sort of makes me feel better, but I'm skeptical of using Iceland as a model because they have so few cases. In the links you shared NY has a ~3% mortality rate while Iceland only has a 3.3% hospitalization rate. Those numbers don't jive. According to this business insider article from 3 days ago the hospitalization rate was 20.5%. (scroll half way down. I had to add up the age groups and divide.)
Even if only 1/3rd of the hospitalized people need ventilators, that's a shit load of people. The napkin math on this stuff paints a very grim scenario. I mean 3% mortality rate times 240M people is 7.2M dead people. Italy was overwhelmed and has an 11% mortality rate. 26M people?! I'm being a little dramatic, and none of the models say that, but given the raw numbers, I don't see why that won't happen? If weren't not totally locked down, how is it doing to magically go away?
Your numbers are way, way, way high. 20% of cases are considered "severe" but only a fraction of those, about 1/4 or 5% of total cases require hospitalization. Only a fraction of those require ventilators. So it's a much, MUCH smaller number.
And let's go back to "cases" which are confirmed cases. We have no idea how many actual cases get confirmed. Lot of evidence mounting that we only confirm a very small fraction of cases. Most infections resolve without becoming severe so they're not being tested. So hospitalizations as a percent of infections instead of "cases" is probably a lot smaller than 20%.
Social distancing will saves thousands of lives in MI, maybe low tens of thousands but there are not hundreds of thousands of MI lives at risk.
Even the worst case national projections are 1mm-2mm fatalities. No possible way Michigan could be up to half that.
from what i've gathered in the cuomo press conferences, approx 20% of confirmed cases get hospitalized and much less than 50% of those hospitalized end up on ventilators. it's likely closer to 1/3.
what i would like to know is how many people survive after being placed on a ventilator; and further after a certain amount of days. ie. i think if someone is on a ventilator more than 20 days, the odds are not good.
Your point is well taken WQ, but you missed some significant factors.
- Most hospitalized COV-19 patients don't require a ventilator - only about 20%.
Models and experiences from hospitals vary, but from what I can find it appears roughly half those hospitalized require ICU, <half of those require ventilators - roughly 20% of hospitalized patients.
- Your model assumes a 20% hospitalization rate, but that's based on those presenting symptoms. It's likely a large number of infected people are asymptomatic, so hopefully even if a large percentage of the population is infected the number requiring hospitalization will be lower than your estimate.
- It also appears "splitters" can enable 2 or more patients to use a single ventilator. And of course not everyone will be hospitalized at the same time - ventilators are available again as patients recover/(sadly) die.
In summary - about 4% of patients who present symptoms are likely to require a ventilator, it appears ventilators can be adapted for use by multiple patients simultaneously, and hopefully MI will obtain more ventilators.
So, while the picture isn't pretty, it's not hopeless. Let's all hope resources aren't overwhelmed and everyone who needs care receives it. Anything that can be done to slow things down will help.
This is a post you should not be proud of.
Wow, this. . . this blows my mind. I'll have to re-think everything. I can't believe how wrong I was.
I swear, I had absolutely no idea that auto accidents were contagious.
We're still making these posts?
Say we have 20% growth. Which is about what we're averaging* the last few days. That says a doubling time of ~3.5 days.
So that's 160k by April 16. A million by April 27. And then your numbers are dumb.
*That assumes that our testing is complete and accurate. Which it is not.
Not my numbers...it's the IHME risk model being used by the government link at bottom of the post. Where are you getting your million by April 27th numbers from?
The model assumes social distancing policies are followed. If not, and you let it spread uncontrolled, we've got a 20% growth rate (or higher).
It's pretty simple math from there.
Infections = 9334 * 1.2 ^ x, where x is days since April 1.
x = 26 for April 27 gives us 1,068,513 infections.
Exponential growth is a hell of a drug.
Their math models take in account the measures being used in a given state and incorporating, to date, Coronavirus related statistics.
Your suggestion is a guess on what happens if we went about business as usual.
Sweden is doing exactly what you said here is their data:
Singapore is the only other country (so far as I know) that has not imposed serious movement restritctions on their population. It will be interesting to see what their spread rate will be in comparison to those countries that did impose serious restrictions.
My thought exactly...didn't know about Singapore.
Sweden's "doubling rate" (number of days it takes for total cases to double) is holding pretty steady over time at 7-7.5 days.
A steady doubling rate indicates that they still are showing exponential growth. But, with the time period being 7-7.5 days, the exponent isn't that large (it's around 1.1).
They may be able to manage that - though it will be touch and go.
Nearly every other European country is seeing their doubling rate increase on a day-to-day basis. They are generally all getting to that 7 day level themselves. Some countries are higher (Italy = 11.27), some are lower (UK = 5.09), but the doubling rate is increasing over time and the median is around 7-8.
So nearly every other European country is now outside of the "exponential growth" stage. Growth has become either linear, steady or even on a slow decline.
At the very least, Sweden WILL be an interesting control case when all the various academic studies are done about this after the fact. I do tend to think they are acting responsibly.
You get in trouble when your doubling rate is in the 1-4 range. That's quick exponential growth. It's where most of Europe was in mid-March. America's doubling rate was 4.77 as of yesterday: we were below 2 on March 19 and March 20, <3 up until March 26, and <4 up until March 30.