US CV-19 Deaths

Charles

Been struggling to get my head CV-19 deaths given onslaught of daily stats reported.

From Our World In Data site for US (ref thru 2017):

Avg daily deaths (all causes): 7,565
Avg yearly deaths: 2,761,225
US Population: 325.1M

So, 0.85% die yearly in US from all causes.

Today, US CV-19 deaths are 144,283, or 5.2% of normal and 0.04% of population ... so far.

It does seem that somehow we went from flattening-the-curve to stomping-out-the-virus.

Anyway, these numbers help me provide some context, especially after the horrible images from NYC and Italy this past March/April.

Thought I'd share.

msf

You may be mixing apples and oranges. A reduced mortality rate (thanks in part to increased knowledge about treatment) is not the same as a reduced infection rate. Especially since we're finding out that the long term effects on those who survive (which was the vast majority even back in April) can be life altering.

The purpose of "flattening the curve" is twofold:
1) To buy time until there is an effective vaccine or at least a cure.
2) To spread out cases requiring treatment (independent of mortality rates) so as not to overextend the healthcare system.

Overextending the healthcare system, aside from the PTSD widely reported lessens the quality of care, thus amplifying the impact of the virus per person.

You mention the horrible images of NYC a few months ago. Consider the horrible situation in south Texas now, where they are beginning to do triage (sending people home to die), their systems are so overloaded.

The US has more hot spots now than in April, albeit smaller ones (hard to find a larger metro area than NY). They are pushing or are over capacity. Reducing (flattening) the average case level would help if there were a national plan to mobilize resources to where they were most needed.

Stomping out the virus? We're not even flattening the curve. 0->1M took 99 days; 1M->2M took 43 days; 2M->3M took 28 days; 3M->4M took 15 days. (I wrote this from memory before checking; I can even recite person, woman, man, camera, TV.)

Here are some pages and graphics from the interesting cite you provided:
Is the world making progress against the pandemic? We built the chart to answer this question
https://ourworldindata.org/epi-curve-covid-19

Daily new confirmed cases of COVID-19 (animated graphic)
https://ourworldindata.org/grapher/daily-new-confirmed-cases-of-covid-19-tests-per-case

Tests conducted per new confirmed case of COVID-19 (animated graphic)

Countries that do very few tests per confirmed case are unlikely to be testing widely enough to find all cases. The WHO has suggested around 10 – 30 tests per confirmed case as a general benchmark of adequate testing.1

The countries that do more than 30 tests per case are shown in shades of blue. Those that find a case for every 30 tests or fewer are shown in shades of orange and red.

https://ourworldindata.org/grapher/tests-per-confirmed-case-daily-smoothed

catch22

(I wrote this from memory before checking; I can even recite person, woman, man, camera, TV.)

Hi @msf
Never a doubt in the minds of those here who pay attention. Your skills and dedication to proper documentation is superior.
Thank you again.
Respectfully,
Catch

Charles

Thanks msf. At this point, I did only want to focus on death rate. I find it easier reconcile, sadly perhaps, like P/S or EBITDA. c

msf

Hi @Charles,

I appreciate the focus. Death is more severe and less ambiguous. Though even here, there are often questions about the actual cause(s) of death and contributing factors.

I think we both try to look behind numbers to see what is going on. That can include recognizing when non-GAAP acounting figures like EBITDA enlighten and when they distort. Likewise, in reading mortality rates, it is helpful to see the whole picture even if just to add context to the numbers.

Trump had a good idea(!) in analogizing fighting the coronavirus with waging a war. At least in some respects.

Historically, military death rates have dropped precipitously due to medical advances. "[T]he US military developed, fielded, or dramatically expanded more than 27 major innovations in little more than a decade over the course of the wars in Iraq and Afghanistan. As a result, the death rate from battlefield wounds decreased by half, to the lowest level in the history of warfare." Of course this trend extends much further into the past than just the 21st century.
https://www.healthaffairs.org/do/10.1377/hblog20180628.431867/full/

While this is generally a good thing, there's another side to it. Greater survival rates means greater numbers of disabled veterans. If one doesn't reduce the number of people sent to fight wars, one doesn't reduce the number of injuries regardless of the mortality rate.

Based on the Current Population Survey of 60,000 households in 2018, BLS said that "41 percent of Gulf War-era II [post-9/11] veterans had a service-connected disability, compared with 25 percent of all veterans."
...
Advances in battlefield medicine and rapid evacuations to treatment centers have resulted in more veterans surviving wounds that would have killed them in previous wars, said Armstrong, a graduate of the U.S. Military Academy at West Point who served tours in Iraq and Afghanistan with the Army's 10th Mountain Division.

In addition, there's a heightened awareness in the military and at the VA of the aftereffects of traumatic brain injury (TBI), along with more screenings for mental health issues resulting from post-traumatic stress, Armstrong said.

"If you look at the VA data on that, certainly post-9/11 generation veterans have been experiencing higher rates of service-connected disabilities than previous generations -- that's a fact," he said.

Armstrong said advances in the ability to diagnose PTSD are "another of the many drivers, I would say, of the uptick in disability rates."

https://www.military.com/daily-news/2019/03/25/post-9-11-vets-have-far-higher-disability-ratings-prior-generations-report.html

In broad brushstrokes, the current situation parallels this. As doctors and scientists have learned more about Covid-19, they have been able to substantially reduce the mortality rate while also discovering greater long term effects than previously suspected.

Charles

I absolutely agree.

A fallout of the current crisis is to be much more aware of these statistics on life expectancy, cause of death, by country, by age.

A remember being stunned to learn that more folks actually died after 9/11 from fear of flying due to car accidents the year following the attack than in the attack itself.

Ditto that more people die from selfies, like at Grand Canyon, than shark attacks. (Though Jaws at 45 is still terrifying.)

On my drive down to see my daughter in Palm Springs this week, CalTrans was displaying car accident deaths this past year in California. It was about 3500. Hard to think of a more senseless way to go.

Stay well!

zenbrew

Case fatality rate & mortality rate are often juxtaposed but aren't actually the same.

Finally, a metric we are seeing less often, but still merits attention, is the overall mortality rate. This refers to the portion of the population that dies as a result of the pandemic. This number is typically very different from the case fatality rate because not everyone is exposed to the disease. Imagine a country with just 100 people in it. If 20 of those people got infected, and 1 of them died, the case fatality rate — the proportion of those infected who died — would be 5%. However, the mortality rate is only 1%. That is, 1% of the total population passed away.

Case fatality rate vs. mortality rate

Even one of the sites I use a lot United States COVID-19 Statistics seems to mix up case fatality & mortality rates.

This site is good for giving estimations for multiple data points going forward for 7, 14, & 30 days pending whatever is the current data at the time (both for the country as a whole & by state).

Roughly 50 million tests have been done in the U.S. to date which is only about 15% of the population being tested & I would say probably much less % than that as many people have been tested multiple times. Meaning a great majority of our population is still susceptible to being infected. On the other hand, there are probably quite a few people that have been infected & just were never tested. So unless, we do antibody testing more extensively, we won't know. And that will only be dependent on reliable antibody testing to begin with.

Death rates should be going down if we consider that better treatment for more severe cases is being implemented & the population age of those now being infected the most are younger but the trend is going slightly up. That to me is concerning.

Numbers comparisons can be tricky. They typically detract from addressing whatever is being looked at. But they can give perspective. The number of U.S. Covid-19 (direct) deaths would be equivalent to approximately 400 filled to capacity Boeing 747 crashes in 6 months. That would be sure to get someones attention.

But these numbers also don't reflect the negative impact on our overall healthcare system & overall outcomes due to equipment shortages, hospital ICU capacity issues, postponements of elective procedures, people just not going to the doctor, etc. that an overwhelming virus like Covid-19 can cause.

@Charles

A remember being stunned to learn that more folks actually died after 9/11 from fear of flying due to car accidents the year following the attack than in the attack itself.

Curiosity got the better of me:

Excess Automobile Deaths as a Result of 9/11

@msf

The purpose of "flattening the curve" is twofold:
1) To buy time until there is an effective vaccine or at least a cure.
2) To spread out cases requiring treatment (independent of mortality rates) so as not to overextend the healthcare system.

To that I would add 3) To buy time, to set up & implement an effective system to deal with the virus going forward such as a cohesive & consistent plan of action, adequate testing, contact tracing, etc.

6 months into this & we are still in the first wave & our ability to deal with a pandemic is still ineffectual & dismal.

I agree long-term morbidity could be a real concern. We just don't know yet. There is much research ongoing. The following tracks research by treatments as well as outcome parameters.

Global Coronavirus COVID-19 Clinical Trial Tracker

I agree the analogy of dealing with the virus to waging a war is a good one. But I think Trump actually made a mistake in doing so. If we make an analogy of a war being waged on our own soil, we see a commander-in-chief who never showed up to lead & let the "enemy" take over our country.

Charles

Cool.

Rbrt

Charles said:

Been struggling to get my head CV-19 deaths given onslaught of daily stats reported.

From Our World In Data site for US (ref thru 2017)
Avg daily deaths (all causes): 7,565
Avg yearly deaths: 2,761,225
US Population: 325.1M
So, 0.85% die yearly in US from all causes.
...snip
Thought I'd share.

A lot of info on this thread to digest, for right now I just want to add that COVID death rates are currently 1000/day a 13% increase over the existing average. That’s significant.

Mark

@Charles - might be worth a peek:

An interactive visualization of the exponential spread of COVID-19

Adding: The home page for 91-Divoc

Sven

Thank you all. There is considerable information to digest and ponder. Yet, school starts in mid-August. Majority of university has gone on-line teaching until a better way to ensure health safety for students and teachers. Only a handful private universities open for in classroom teaching.

royal4

If schools open we'll be counting the deaths of teachers and staff just like we're counting deaths of front line medical workers now...... VERY stupid idea IMHO.

Old_Joe

Yes.

sma3

https://jamanetwork.com/journals/jama/fullarticle/2769034

Strong correlation between early school closings and decreased cases and deaths.

But WH has already said "science doesn't matter" in the decision