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More Fevered Calculations: Working the Coronavirus Numbers
In all the hype and happy talk around the latest coronavirus to cross over to humans, keep an eye on this number in America: 498,000. That is the number of people this novel coronavirus will have to infect to cause as many deaths as the annual, seasonal flu. I tried to make sense of the numbers around notorious coronavirus, a.k.a. COVID-19, in a post about a week ago now.
I now note that the presidential proclamation, suspending travel from certain countries, referred to COVID-19 as “SARS-CoV-2.” The CDC page explains the reason for the changing names. This prompted another look at the numbers, with this math-challenged scribbler doing a bit of stubby pencil, back-of-the-envelope figuring. Check my math as I work through the numbers; hopefully it is better than Ma and Pa Kettle’s.
SARS last time had an 9-10% mortality rate. It was nothing like influenza, including the worse known version in 1918-19, because the number of people who actually contracted SARS was so much lower than the number of people who get the flu globally every year. Think about it: if the flu regularly kills 1 in 1000 infected, and SARS killed 1 in 10, then you can see that SARS would have to infect 1/100 the number of flu victims to reach the same death count.
It is still very early days, perhaps 90 days into this latest coronavirus outbreak, but the deaths divided by total resolved (recovered or dead) percentage (likely the best measurement of lethality) is down to 6%, according to the Worldometer coronavirus dashboard. So, the question will be how many cases are detected that recover versus die over the next few months or year. If 1 in 1000 die of flu, then I think that means this new coronavirus variant would have to infect 1.66 percent as many people as the flu to kill the same number this year.
[It is fair to note that the numbers out of China and Iran may be unreliable. We should probably track deaths divided by total resolved cases excluding these two large sources. However, the early numbers from each reporting country vary wildly, suggesting a single number, capturing all data from all sources outside China and Iran, may itself be misleading in these first 90 days.]
While 1.66 percent sounds small, the sheer number of flu cases is always huge. How huge? That is hard to say, because it is only an estimate and varies widely year to year, according to the CDC:
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.
That is just in the United States. Eyeballing the numbers, it looks like the median number is around 30 million falling ill with the flu annually. So, 0.1% mortality means around 30,000 deaths expected from the flu in such a year. If my fevered figuring is right, and if SARS-CoV-2 (COVID-19) only has to infect 1.66% of that flu number (30 million) to extract the same death toll, then this novel coronavirus will have to infect 498,000 people in the United States to cause as many deaths as the annual, seasonal flu. Sure enough, if you multiple 498,000 cases by 6% mortality rate, you get roughly 30,000 deaths.
This is why we should all be interested in limiting the spread of this latest bad bug. Let’s all cough and sneeze into our elbow, not our hands, wash our hands while singing the alphabet song, and work on getting good sleep, food and a bit of exercise for good health. Oh, and check the CDC COVID-19 page from time to time. I leave you with three videos for the weekend: Ma and Pa Kettle, the alphabet song, and Fever.
First up, math gone horribly wrong:
Second up is the original (and only legit) alphabet song, brought back to my attention in a tweet by a woman to the effect of “Washing my hands when a little girl started singing the alphabet song. Couldn’t stop until she finished!”
Finally, let’s all strive to avoid giving each other the wrong sort of fever:
[Thanks for the feedback, leading to a correction on SARS, a clarification on the mortality metric, and a brief note on data quality.]
Published in Group Writing
Yes. I expressed the metric incorrectly. I updated accordingly. I caution on just taking all cases outside China and Iran at the moment. The reports are wildly different, from no fatalities to overwhelming fatalities. This cannot be representative of whatever the truth may be.
Yes. Fixed it. However, My argument was as between flu and this new coronavirus. I got that math right. Do you believe it likely that 30,000 Americans will die of SARS-CoV-2 this year?
Exactly so.
Uh oh. From Drudge citing Axios:
“A CPAC 2020 attendee tested positive for the novel coronavirus in New Jersey on Saturday, the American Conservative Union confirmed, indicating that the attendee’s exposure to the virus took place prior to the conference.”
https://www.axios.com/cpac-attendee-coronavirus-ac732478-bf2d-403e-981f-81c9f8ef2dfd.html
No one came into contact with Trump or Pence, but this could be very, very scary.
I would seriously rethink going to any rallies for any Presidential Candidate at this point.
I like the new column at the Worldometers site.
It gives cases per 1 million population for each nation.
While the U.S. has the ninth largest number of cases among all nations (at 437), 5th in number of deaths (19) it’s still 1.3 cases/million, which puts it 41st on the list.
Some perspective at least if anyone is playing the odds.
Worldometers lists 15 recovered but the Johns Hopkins site seems stuck on 8 for the last week.
Does this study suggest that the flu shot might create an interference in our ability to fight coronavirus, especially a strain new to the entire population?
https://www.sciencedirect.com/science/article/pii/S0264410X19313647
Thursday PA had zero cases. Today we have 4 confirmed cases.
What scares me is that this may have started in October in China, and the deaths there may be from reinfections, not first infections. And that there are at least 2 strains now.
According to what I read today, the “L” strain came first in Wuhan, and was more aggressive. And then through human hosts mutated into a less aggressive “S” strain.
I’m not sure if that means that it’s the “S” strain that’s now spreading around the globe . . . or what.
Don’t hear what I wasn’t saying. My question was only about the math error. Thanks for the correction.
The OP uses terms inconsistently. The terms should be precisely defined before diving into the analysis.
(Also, while 19 deaths is crazy high in relation to cases/million, 16 of those deaths were all at that one nursing home facility in Seattle. Very tragic, but very contained.)
And now the number of total U.S. cases at the Johns Hopkins site just dropped by 13 cases. So . . . I don’t know where those figures come from.
It may be worth noting that while we are over 100,000 cases worldwide, we are also over 60,000 recovered. That’s good news.
It looks like they adjusted the numbers based on where those infected were first identified, at least as far as the Princess Diamond cruise ship goes. For awhile the Johns Hopkins site showed them where they were hospitalized in the US. According to their website, the CDC was showing these patients as on the ship where they were infected, the Johns Hopkins site switched for consistency.
I saw on twitter where Democrats / Liberals that discovered they were infected with coronavirus were being encouraged to attend Trump and other Conservative events to kill off Trump and his supporters. I believe this process was even supported by some Democrat elected officials.
Please help clarify. I make no claim of expertise. I can read and generally comprehend statistical and scientific claims. My point here is to make sense of various metrics and claims between the seasonal flu, which will likely kill 30,000 Americans again this year and this new variant on coronavirus.
No, I don’t. But so what if they do? We have 2.8 million deaths a year in the US. 30,000 is 1% of 2.8 million. 30,000 Americans dying of Chinese corona virus would hardly be more than a rounding error in a nation of 350,000,000 people.
https://www.cdc.gov/nchs/fastats/deaths.htm
Chinese corona virus, to date, is just another viral respiratory infection. It will run into and through the population and then be forgotten. Commonsense management, as advocated by my state’s board of registration in medicine, is called for. A shutting down of civil society is not.
The current panic is being driven by the left and abetted by the media in order to bring Trump down and in order to generally further disorder and the rupture of American culture and values. This should surprise no Ricochetti. That’s what the media and the left do.
And don’t call me a heartless whatever, because I’m not. My first wife died of a respiratory infection, one that was not novel to the community.
The fascinating part of this is that the bullying by the media and by the Democrats (same thing) may cause the Trump administration to go overboard on combating this thing, and they will come out of it looking like people who properly managed a crisis.
Looking at Rodin’s chart, I think the number that is more meaningful than the total deaths is the total deaths plus the “serious, critical.”
For Italy, for example, which is probably nearly comparable to the United States in terms of the accessibility and availability of modern state-of-the-art hospital care, as of yesterday, March 7, there have been 4,636 cases and 197 deaths. The number of presently active cases is 3,916, of which 462 are still considered serious, critical. The pressure on hospitals is being felt in those serious, critical cases. How those turn out will depend on the medical care and the equipment and facilities available. Would those have been deaths if those patients had received less or inferior care?
In other words, the death toll is low because we have taken this threat seriously and acted to mitigate its effects. Of the 3,000 people who have died in China:
Those WSJ numbers from China do not include nurses and other hospital staff.
The people who have been working on the front lines of this outbreak have assumed a great risk for themselves and their families.
I don’t know why this new virus different from the flu in this respect, but it is.
Doc – this idea of bringing down Trump? How does that correlate with Italy quarantining 1/4 of its population just now and the rapid spread across the far reaches of the world – none have anything to do with Trump.
Stay off of the cesspool called Twitter and don’t get into the mud with the haters – this is the Lenten season. I’m not judging anyone here, but stay in prayer and reflection and out of the trash heap. This feels like a judgement and will have long term effects, not just health-wise.
There is a switch between diagnosed cases and infected (which includes non-diagnosed). There is high uncertainty in the number of non-diagnosed persons, so it is important to be consistent.
Among the reasons I don’t think this is just the flu is the reaction of the Chinese government. It routinely favors economic growth over the safety of its citizens yet it took extreme measures with Covid-19 that have had the effect of tanking its economy, at least in the short term, something that never would have happened if this was just the flu.
US data so far is also basically useless due to the CDC’s masterful handling of the test kit rollout.
Numbers can be skewed by the fact that sicker people wind up in hospitals. People with mild cases may well never be diagnosed, and won’t wind up in the hospital.
I have removed the post and its link because despite my attempts at careful editing it was [CoC] censored. I suspect, and this edited version will be a test, that the linked blog was the offending material and not what was on the former post.
Aesop, an experienced ER nurse notes: ICU beds are at or near capacity NOW and have been for months. There is a severe shortage of N95 masks, let alone more rigorous PPE. Hospital staff will get sick.
23 doublings in, we hit 5 million cases. About 20% will need hospitalization; fewer than 10% will find an available bed for various reasons, including “We ain’t taking no more Kung Flu cases, our beds are reserved for trauma, strokes heart attacks, etc.”
Respiratory illness will be triaged to mass care sites in gyms, warehouses, etc., mostly with undertrained and inadequate staff.
And even if you work in a hospital wearing a Level A suit, if you take it off at the end of shift and go home without it, or go home wearing it and don’t have a good decon station in your front yard, you’re gonna get it from the general population.
Oh Zero Hedge. Always with the end of the world scenarios.
You have quite the range in your video selections. Those were great. Oh, and your math is fine.
The WHO and CDC have to choose between, ironically, precision and accuracy; that is, provide a precise mortality rate by dividing known deaths by known infections which have run their course, or provide a way more accurate (and way lower) mortality rate by using a best guess of total infections in the denominator. The fact that they have chosen the former has fed the hysteria.
Expect the hysteria to hit Level 11 over the next couple weeks as the hockey stick graphs appear which claim to show exponentially increasing cases of the virus in the U.S. but in reality only show our increasing capacity to detect cases which have been here for some time.
Reality: We’re in the midst of a ho-hum bell curve (no hockey sticks, anywhere) that will peter out as we get deeper into spring and will leave in its wake a death toll which won’t amount to a rounding error of typical yearly flu deaths.
Earth has gone mad. Can’t wait for Memorial Day when all this silliness will be behind us — and the panic-mongers won’t even have the decency to say sorry. Per usual.
I hope you’re right.
330,000,000 (estimated population of US) x 80% (potential spread of infection over an unspecified time period) = 264,000,000 (# of people with coronavirus) x 2% (worst case ? mortality rate) = 5,280,000 (potential deceased in some undefined time period). Are the assumptions noted unreasonable based on what you have read?