Cases vs Deaths
 

We are seeing the US case count shoot up. It’s been a steady climb over the past 3 weeks. Yet we are seeing the death rate steadily decline.

Is COVID becoming less virulent as the Italians assert? Even if it’s younger people testing positive, you’d think the death rate would increase slower...but steadily decrease? If it’s mass testing, we could explain the case increase, but wouldn’t the death rate stabilize rather than continue to decline? So, what’s happening here?

Purposely not posted in PARF. Let’s keep it that way.

Dead is recorded always.
Sick is only recorded when tested or dead.

Test more and sick:dead ratio will drop, no?

Plus certain states may have overexposed vulnerable groups early on. That may also skew things.

There was a spike in deaths yesterday, but that may be NJ added 1800 "probable" deaths yesterday supposedly after reviewing death certificates.

I wouldn't count on it being less virulent. Deaths lag at least a week or 3, and I suspect we are seeing more younger cases,as they are the ones frequenting bars and restaurants in the states that are opening. Nursing/assisted living has figured out how to keep (older more likely to die**)patients safe, and us old farts are (mostly) smart enough to wear masks, wash hands, and stay out of crowds.

** we have been interviewing and looking actively at local assisted living for our mother (90yo). They are still locked down, do not allow socializing among residents, no visitors, and actively testing and screening their staff.

I think the data is showing more young people are getting CV. Young people have a lower death rate by CV. But they will ultimately infect people with a higher death rate by CV.

And lags don't help with objective, absolute correlation. You don't get tested, confirm positive and die all in a day or two.

With more testing you're finding more cases but the morbidity rate % is the same as it always was.
The reason it appears to be going down is because it's being skewed by the higher number of discovered cases.

Cases and hospitalizations as a result of new cases is important IMO. If hospitalizations go up due to increasing new cases, it's a safe bet that deaths will go up as well.

I wish there was more reporting on how these people were getting infected.

Take 10 different people in a half-hour segment.

Take us through their routines that led to their infections.

Then do it again with 10 more people.

Documentary style - no editorials - just the facts.

Mostly that is not known Bazza.

The more are exposed, the closer herd immunity is

Very little news of progress on the treatment front. HCQ and Redemsivir stories have dissolved for the most part. So, is treatment protocol improving to minimize severity? Why so little reporting on treatment developments?

Even when you account for a lag, this helps to illustrate when is happening across the country (NY excluded).

http://forums.pelicanparts.com/uploa...1593262329.png

Correct, the uptick was just a mass adjustment from NJ, we have seen that a few times so far in the data. The CDC data that shows all deaths regardless of cause is another good way to look at it, they track above expectations, the only problem it is really slow to update, last I checked the data was 20 days old.

They came in contact with an infected person. Not trying to be a smartass here. I've read several reports on the spread. Some of the big concerns like getting the virus from surfaces seem to be a minimal risk. Direct contact seems to be the primary transmission path.

I'll see if I can find the articles I read on transmission recently.

I wish there was more open reporting here. Genuinely new infections (not repeat positive tests which are being double counted), number of test conducted, new hospitalizations, and deaths in which Covid is the cause of death. But you'll really struggle to find that data, especially in the same place. It's unfortunate because we continue to test more, so you would expect to have more new positive cases in asymptomatic people. But if the hospitalization rate and death rate aren't rising dramatically then it's far less concerning.

Like I've said all along, the inconsistency and lack of data provided to the public on this issue is disgusting, and brings into question the validity of everything being reported. Why aren't we ever given the entire story?

Guess what I was looking for is....more about this person who got infected. The precautionary steps they themselves took, if any, and what their activities were previous to getting infected.

Did they go out every day to stores and public areas?
Did they stay home except for the occasional food run?
Were they mask wearers?
What were their interactions with other humans?
What kind of symptoms did they experience?
Were their hospitalized?
If so, for how long - and what treatment(s) did they receive?
How old are they?
What is their demographic?
What about travel? Did they go anywhere recently?
Do they have any comments to us....the folks....they would like to pass on?

Get these people in front of a microphone or on video. I realize many will refuse any publicity and want their privacy. But not all will.

Do some digging and get us some details.

These media people are pretty damn lazy if you ask me. They wouldn't know human interest/public safety stories if they bit them in their arse. :rolleyes:

There is no reporting standard for states. Cases and deaths we have s pretty good idea. Hospitalization and ICU is where we fall far short. Some states report cumulative hospitalizations while some report only current and some report both. Same for ICU.

Election year.

They don't really know yet. Maybe the most vulnerable are doing a better job of avoiding it, maybe treatments are getting more effective now that they understand the disease better, maybe the virus is weakening. It is possibly a little of all three.

My wife's hospital in LACO has a record 48 serious Covid patients right now and 1/2 are under 35 years. Definitely a different demographic than 2 months ago.

No. It was Fauci, Birx , and CDC dropping the ball and not setting up reporting standards for states to report to.

It's not politics imo. My background is computer science (modeling), and quantitative analysis, and I spent a career doing this stuff, though not in this arena. Collecting and standardizing the input data is the hard part .... then designing the meaningful variables for the models, then the modeling and statistical analysis....

GIGO - garbage in, garbage out

Some things are universal.

The experts have been winging it with scant and bogus input from the git-go, but that's all they've had to go on.... jmho.

I wish that were true but I didn't wake up on the other side of the sunset.

That and the Medicare bonus for CV-19.

Not political at all and, yes, I "fact checked" it.

How do we account for the excessive expected deaths? From Jan through March the number of deaths was as expected. April and May they increased dramatically. The only classification was that they were pushing up daisies.

You have to look at morbidity rates, who died and in which age groups, and where there accompanying causes of death: Meaning, was CV-19 really the cause of death?

That is the issue. There was and is a financial incentive to cite CV-19 as the cause of death when in fact it may not have been.

Look at the numbers in Minnesota: 79% of of suspected CV-19 deaths are at LTC and elder care facilities. The average age in over 80.

Testing is up so it is natural that more positive cases result. Remember the models thought the real number of cases was 16 times the know positive cases because CV-19 often has no symptoms in those affected. It is very informative that as the sports leagues begin to ramp up and test evryne, there are positive cases in asymptomatic people that were not aware they had CV-19.

As I wrote earlier, a good friend of mine has a son flying off the TR - he tested positive and was shocked.

Also, I wear all the gear, wipe everything down, social distance, etc. I simply want clean unabridged numbers. That is what I do.

I still help at the LTC facility my wife's mother is in (zero positive cases, btw, they did great work early) so I need to understand the risks...harder to do with junk numbers.

No politics.

Those excess deaths are not classified by any cause. Just excessive deaths. Any reason to push up daisies. In April and May we had about 30% more than expected. Jan through March we had the expected number. Where did the increase come from?

Show me real numbers, how they were classified, etc. and I'll be happy to oblige. I'd gum up this thread with politics in order to give you my frank assessment.

My suggestion is that a task force be assembled to review in detail every death certificate that lists CV-19 as either a primary cause of death or a contributing factor.

120,000 is a really low number to review. Should take about two weeks.

I think it's simply "out there", far more widespread than any of our authorities either realize or would like to admit. I think it's realistic to assume most of us will eventually be infected with it. Yes, the measures we are now taking may be slowing it a bit, but with what remains extremely spotty testing, I don't think we will ever fully understand even that aspect of it. Sometimes I think we're just wearing a condom to the baby shower...

I am always skeptical of cause of deaths, after seeing how a few family members were classified. I have an 'in-law' that was an alcoholic, chain smoker, on pure oxygen for the last 2 years of her life. Lungs gone. Cause of death? Heart failure.

However, in this case, morbidity can be reasonably estimated/checked against prior year data for the same period of time. NJ jumped by more than 10,000 in April, which is consistent with covid data.

https://nj.gov/health/chs/documents/2015-2020%20Deaths%20by%20Month%20and%20County%20of%20R esidence.pdf

I have not seen data on "years of life lost" by covid, like often published for alcohol, obesity, and alcohol. I would find that data interesting.

My favorite professor that hooked me into financial and economic modelling had a very simply mantra: When faced with ambiguities, it is ok to say you don't know.

One more time.

These are only classified as dead people. No reason why. Only that they are dead. Here is the CDC data. I did it in one minute.


https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm

You can see the national number. As expected for the first 8 weeks. Less than a 1000 covid deaths within those first 8 weeks. Then the number of deaths started to climb. Peaked at 40% more than expected the week of 4/11 and slowly started to decline as distancing measures took place.

There is also state data. That state data includes the same first 8 weeks where there was basically no increase. The last 5 or so weeks data is incomplete.

If we look at Arizona we see they have 110% more than expected which includes the first 8 weeks where there were very few additional expected deaths. Also, those last 5 weeks or so are incomplete. Pull out those first 8 weeks where we were at the norm, add in the additional unreported deaths that will come in over the next few weeks and Arizona is at 20 to 25% higher than expected over a 2 month time frame.

The states that bore the brunt of the initial surge show exceptionally high number of deaths.

Without accurate and widespread truly random testing data, and standardization...

It's GIGO ... period.

.....then of course politics :D

But it's a fustercluck from the start ... still is imo.

The CDC total death count is accurate. They are counting death certs as they are sent in. Why did the number of deaths spike during a 2 month time frame?

Also, covid is not listed as the primary cause of death on a cert. It is only listed as a contributing cause of death that leads to death by the primary cause.

Someone could have a heart condition that is being treated by meds or a pace maker. Tbey could live for years. They get covid and die due to heart failure. Covid would be listed as a contributing factor that led to the primary cause of death. Heart failure (or whatever the technical term). CDC has detailed guidelines to follow that are based on the request from The Council of State and Territorial Epidemiologists

Probably one of the few accurate stats in this whole fiasco.

Edited: yer back! .... what'd ya do, go on a long vacation ;)?

Medicare furor over the "bonus" for CV-19 has definitely been made political.
To me it makes sense to pay hospitals more to maintain isolation units for infectious diseases. Someone (Sen. Jensen?) mentioned that getting paid more increased the incentive to break the law. Duh. It was then turned into a political football by those with an axe to grind.
But the laws against insurance fraud and Medicare fraud have not been repealed. You lie about a diagnosis and it's still a crime.

You lie about a diagnosis and it is still a crime.

is/is or is/was ?

Seriously, the 'rules' for what can be counted as covid include flu-like symptoms.

LACO is the new hotspot in the US. I guess they haven't been told to wear their bandanas and ski-masks. :cool:

I got sick of all the name calling and took time off and went camping and fishing.

No.

You must test positive. If no test is available you must be in contact with a known case for a sigificant amount of time and have specific number of symptoms. Or, show specific number of symptoms after travel to a high case area.

Guidelines are specific. In all cases it is not listed as primary cause of death only a contributing factor leading ro death.

Where did the excessive deaths come from?

An article in the Tampa Bay Times, written by Politifact.com staff. Bold, with the exception of headlines, is mine. The Hatestream Media and it's consumers will be the very unraveling of the American Experiment.


PolitiFact: On hospitals and the possible financial incentive of COVID-19 patients

PolitiFact: On hospitals and the possible financial incentive of COVID-19 patients

Medicare is paying a 20 percent add-on to its regular hospital payments for the treatment of COVID-19 victims. That’s a result of a federal stimulus law.

By Tom Kertscher, PolitiFact Staff Writer
Published Apr. 22

An article shared on Facebook questions whether the count of COVID-19 patients is inflated, saying hospitals have a financial incentive to claim that a patient has the virus.

"Hospitals get paid more to list patients as COVID-19 — 3 times as much if put on ventilator," the story’s headline states.

The article was posted on WorldNetDaily, a conservative news website. It was produced by The Spectator, which describes itself as a conservative publication. The Spectator reported on comments made by Dr. Scott Jensen, a Minnesota physician and Republican state senator, in an interview with Fox News host Laura Ingraham.

The article was flagged as part of Facebook’s efforts to combat false news and misinformation on its News Feed.

Jensen said on Fox News that doctors are being encouraged to cite COVID-19 as a cause of death on death certificates and he suggested that money is a motivation.

Medicare has determined that a hospital gets paid $13,000 if a COVID-19 patient on Medicare is admitted and $39,000 if the patient goes on a ventilator, he claimed.

Jensen did not respond to our request for information.

The federal government has decided to pay hospitals more for treating COVID-19 patients. But it isn’t a windfall in the way the headline suggests. And there is no indication that hospitals are over-identifying patients as having COVID-19. If anything, evidence suggests the illness is being underdiagnosed.

How Medicare pays hospitals

Medicare pays for inpatient hospital stays using a diagnosis-related group (DRG) payment system. The hospital assigns a code to a patient at the time of discharge, based mainly on the patient’s main diagnosis and treatment given.

Medicare then pays the hospital a prescribed amount of money — regardless of what it actually cost the hospital to provide the care. The amount can vary in different parts of the country to account for labor costs and other factors.


The amounts

The dollar amounts Jensen cited are roughly what we found in an analysis published April 7 by the Kaiser Family Foundation, a leading source of health information. (Kaiser Health News, which partners with PolitiFact on health fact-checking, is an editorially independent program of the foundation.)

There isn’t a Medicare diagnostic code specifically for COVID-19. Using payment rates for similar respiratory conditions, Kaiser estimated the average Medicare payment at $13,297 for a less severe hospitalization and $40,218 for hospitalization in which a patient is treated with a ventilator for at least 96 hours.

“A COVID patient on a ventilator will need more services and more complicated services, not just the ventilator,” said Joseph Antos, a scholar in health care at the American Enterprise Institute. “It is reasonable that a patient who is on a ventilator would cost three times one who isn’t that sick.”

Medicare will pay hospitals a 20 percent “add-on” to the regular payment for COVID-19 patients. That’s a result of the CARES Act, the largest of the three federal stimulus laws enacted in response to the coronavirus, which was signed into law March 27.

“This is no scandal,” Antos said. “The 20 percent was added by Congress because hospitals have lost revenue from routine care and elective surgeries that they can’t provide during this crisis, and because the cost of providing even routine services to COVID patients has jumped.”

Julie Aultman, a member of the editorial board of the American Medical Association’s AMA Journal of Ethics, told PolitiFact it is “very unlikely that physicians or hospitals will falsify data or be motivated by money to do so.”

“There are strict policies for reporting and, quite frankly, health care workers are only focusing on helping their patients and doing as much as they can with little resources,” said Aultman, who is director of the medical ethics and humanities program at Northeast Ohio Medical University. “Ohio is reporting confirmed and suspected cases and so this is how our providers are responding to their patients — they are being very transparent about confirmed versus suspected.”


Indications of COVID-19 undercounts

As for the suggestion that there is an overcount of COVID-19 cases, "the data has suggested that, in fact, there’s a significant undercount of deaths due to COVID," Jennifer Kates, the Kaiser Family Foundation’s director of global health & HIV policy, told PolitiFact.

Here are some of those indications:

Strict federal definition: Until April 14, the U.S. Centers for Disease Control and Prevention counted as COVID-19 deaths only those in which the coronavirus was confirmed in a laboratory test — even as testing was not widely available; now, CDC counts probable cases and deaths. The day the change was announced, New York City’s COVID-19 death tally soared by more than 3,700 when it included in its total the deaths of people who were suspected of having COVID-19 but were never tested.

Surge in total deaths: The Economist reported on “excess mortality,” which is the gap between the total number of people who died from any cause during a given period, and the historical average for the same place and time of year. In New York City, for the four-week period ending March 28, there was an excess of about 1,400 deaths, compared with 1,100 official COVID-19 fatalities.


Our ruling

A post shared on Facebook claims hospitals have a financial incentive to claim patients had COVID-19, saying payment is three times higher if a patient goes on a ventilator. An article the post links to includes comments from a doctor who suggests the number of coronavirus cases is being padded.

It is standard for Medicare to pay roughly three times more for a patient with a respiratory condition who goes on a ventilator than for one who does not. That has nothing to do with the coronavirus.

As part of a federal stimulus bill, Medicare is paying hospitals 20 percent more than standard rates for COVID-19 patients.

Indications are that due to a lack of testing and other factors, the number of coronavirus cases has been undercounted, not padded.

For a statement that is partially accurate, our rating is Half True.

Finished mowing, hot outside.

No name calling from me, btw.

Here is my take. The CDC and WHO had a job to do and they did not do well.

We as a nation failed to protect the most vulnerable of our population...the numbers there are at least semi-clear and are startling.

Next steps, the way to find a path forward for this and the next round of virus'.

Do the research on all CV-19 related deaths. With politics aside, it could be organized and funded, performed, in a month. That is the essential building block.

All new positive cases need to be immediately re-tested with the same testing protocol, free of charge, to establish the false positive rates for that particular test. The false positive rate is important.

Establish a consistent checklist for testing for CV-19, including, not hard, the person being tested needs to consent to releasing access to their medical information, including past CV-19 tests that may have been negative, to form a better data base.

The checklist should also include a questionnaire, just like every doctors visit ever, a symptoms yes or no list: Age, weight, BP, headache, cough, other issues like diabetes, drug use, prescription drugs, etc.

Establish a CV-19 Testing database based on actual tests and retests, follow-on information to include transition to symptomatic: follow the arc of CV-19.

Lastly, estimates of flu deaths spike at 62,000 a year in the US. I'd like to know, and we can't, how many other ills and deaths can be attributed to locking down the country, nearly destroying our economy for an additional 60 - 80k deaths.

Everybody has a number.

Looking backward: https://www.verywellhealth.com/deaths-from-flu-2633829

Lastly plus one: the post above is opinion, not fact.

The rules/guidelines have changed back to more reasonable reporting, from what I've heard. But, for months the relaxed reporting rules really pissed off a lot of people involved.

^^^ Paul
In other words we need leadership. Wish you were in that role now - I would feel better about the future.