Official Covid-19 Discussion Thread

[dohboy_24]

The raw number infected actually isn't all that useful for making such decisions if the testing strategy and/or capacity is changing over time. They want a sense of how quickly the disease is spreading, or the number of people each infected person is currently spreading this to on average i.e. an estimate of the current reproduction number. If you based your estimate of that just on the number of daily new positive cases while testing is changing radically, then it will screw up your estimate.

No, you're wrong.

If you were measuring the heights of 10 million people, it would be perfectly okay to switch from measuring in cm to measuring in inches and it would be perfectly okay to switch from using a measuring tape to using 30cm long rulers.

Why can't we do the same when measuring who has covid-19 and who doesn't?

[dohboy_24]

Knowing who is actually infected (as much as you can possibly know, anyway) is like step 1 in being able to reopen. The raw number of infected people is actually very useful. "There are a lot more people infected than we thought" is a big deal, no matter how many people you tested yesterday vs. today.

Do you know what number is more useful than the raw number? Perhaps a number that could be used to compare raw numbers with different denominators?

[jaymeister15]

It’s also not just that the number of tests being done has increased so dramatically, the guidelines on who is being tested are so different now than even a few weeks ago, it’s completely unreasonable to suggest that the true number of new cases hasnt been going down significantly

During the peak, not only were asympomatic people not being tested, people with symptoms that weren’t serious enough to need treatment were being told just to stay home and isolate vs coming in to be tested in many cases. It’s actually a bit amazing that the number of positive cases has stayed pretty flat as the province opens up and considering the sheer number of tests being done now that they are recommending anyone that has any reason to think they’ve been exposed to the virus, even if asympomatic, gets tested.

[jaymeister15]

All caveats regarding models duly noted...

https://covid19.healthdata.org/sweden

IHME projects that Sweden is 22 days away from peak resource use and 23 days from peak daily deaths. They are projecting a 3,700 bed shortfall.

They are projecting 17,000+ deaths in Sweden.

That would be fair to call a catastrophe. If Sweden's healthcare system is overrun and they have around 13k deaths by June 1st, I would agree their decision was bad and I was completely wrong.

On the other side, what would Sweden have to look like on June 1st for you to acknowledge that they might have it right?

Under 8,000 would be a big win. Over 13,000 would be a big loss. In between those two numbers it could get a little muddy.

But even then...it depends what lens you want to use. California, with 4X Sweden's population, has reported 500 fewer deaths, despite being one of the earliest locations of community spread. If California was on Sweden's trend, there would already be 10,000 dead and the IHME would be projecting 60,000 dead by August.

So do we look at the 5-10,000 lives that Sweden could have saved with a stricter lockdown or the 60,000 more that California could have lost with a looser one?

It’s now June 2nd. The projection you were using to predict doom for Sweden that suggested 13k deaths and an overrun hospital system by June 1st was completely off. Even the 8k number you said would be considered a big win was way too high.

Total number of deaths as of today is 4,468, with the vast majority being over the age of 70 and the overall majority being in long term care homes. I’m sure their government would agree that long term care homes were handled poorly, just like they were here.

133 people under the age of 60 have passed away with only 12 people under 50, almost all with underlying conditions. The hospital system has stayed below capacity.

Would it now be safe to say you might have been wrong about the consequences their decision to stay open would have?

[Fairview4Life]

The raw number infected actually isn't all that useful for making such decisions if the testing strategy and/or capacity is changing over time. They want a sense of how quickly the disease is spreading, or the number of people each infected person is currently spreading this to on average i.e. an estimate of the current reproduction number. If you based your estimate of that just on the number of daily new positive cases while testing is changing radically, then it will screw up your estimate.

No, you're wrong.

If you were measuring the heights of 10 million people, it would be perfectly okay to switch from measuring in cm to measuring in inches and it would be perfectly okay to switch from using a measuring tape to using 30cm long rulers.

Why can't we do the same when measuring who has covid-19 and who doesn't?

How they are testing people has not changed. Who they are testing and how many people they are able to test everyday might have changed, but the fact that they are infected with COVID-19 doesn’t change whether or not they were tested. We just know they have it when we didn’t know that yesterday. Maybe you should have thought your analogy through a little more?

[Fairview4Life]

That would be fair to call a catastrophe. If Sweden's healthcare system is overrun and they have around 13k deaths by June 1st, I would agree their decision was bad and I was completely wrong.

On the other side, what would Sweden have to look like on June 1st for you to acknowledge that they might have it right?

Under 8,000 would be a big win. Over 13,000 would be a big loss. In between those two numbers it could get a little muddy.

But even then...it depends what lens you want to use. California, with 4X Sweden's population, has reported 500 fewer deaths, despite being one of the earliest locations of community spread. If California was on Sweden's trend, there would already be 10,000 dead and the IHME would be projecting 60,000 dead by August.

So do we look at the 5-10,000 lives that Sweden could have saved with a stricter lockdown or the 60,000 more that California could have lost with a looser one?

It’s now June 2nd. The projection you were using to predict doom for Sweden that suggested 13k deaths and an overrun hospital system by June 1st was completely off. Even the 8k number you said would be considered a big win was way too high.

Total number of deaths as of today is 4,468, with the vast majority being over the age of 70 and the overall majority being in long term care homes. I’m sure their government would agree that long term care homes were handled poorly, just like they were here.

133 people under the age of 60 have passed away with only 12 people under 50, almost all with underlying conditions. The hospital system has stayed below capacity.

Would it now be safe to say you might have been wrong about the consequences their decision to stay open would have?

Their economy is not better than their peers and more people per capita are dead. So he might have been wrong About their absolute numbers, but Sweden’s decision to have a lighter set of restrictions hasn’t exactly worked out. I should say “yet” because they are supposedly banking on having a smaller second wave, even though their immunity estimates aren’t great either at the moment.

[Vaclac]

Under 8,000 would be a big win. Over 13,000 would be a big loss. In between those two numbers it could get a little muddy.

But even then...it depends what lens you want to use. California, with 4X Sweden's population, has reported 500 fewer deaths, despite being one of the earliest locations of community spread. If California was on Sweden's trend, there would already be 10,000 dead and the IHME would be projecting 60,000 dead by August.

So do we look at the 5-10,000 lives that Sweden could have saved with a stricter lockdown or the 60,000 more that California could have lost with a looser one?

It’s now June 2nd. The projection you were using to predict doom for Sweden that suggested 13k deaths and an overrun hospital system by June 1st was completely off. Even the 8k number you said would be considered a big win was way too high.

Total number of deaths as of today is 4,468, with the vast majority being over the age of 70 and the overall majority being in long term care homes. I’m sure their government would agree that long term care homes were handled poorly, just like they were here.

133 people under the age of 60 have passed away with only 12 people under 50, almost all with underlying conditions. The hospital system has stayed below capacity.

Would it now be safe to say you might have been wrong about the consequences their decision to stay open would have?

Their economy is not better than their peers and more people per capita are dead. So he might have been wrong About their absolute numbers, but Sweden’s decision to have a lighter set of restrictions hasn’t exactly worked out. I should say “yet” because they are supposedly banking on having a smaller second wave, even though their immunity estimates aren’t great either at the moment.

Where are you getting this idea that the Swedish economy is not doing better than its peers? The most recent numbers are Q1 and so only capture the beginning of the lockdown but show Swedish GDP to have grown 0.1% in Q1. In contrast, Germany's GDP shrank 2.2%. Denmark shrank 2.1%. Norway shrank 1.5%. UK shrank 2.0%. France shrank 5.3%. Spain shrank 5.2%. Italy shrank 5.3%

[Fairview4Life]

It’s now June 2nd. The projection you were using to predict doom for Sweden that suggested 13k deaths and an overrun hospital system by June 1st was completely off. Even the 8k number you said would be considered a big win was way too high.

Total number of deaths as of today is 4,468, with the vast majority being over the age of 70 and the overall majority being in long term care homes. I’m sure their government would agree that long term care homes were handled poorly, just like they were here.

133 people under the age of 60 have passed away with only 12 people under 50, almost all with underlying conditions. The hospital system has stayed below capacity.

Would it now be safe to say you might have been wrong about the consequences their decision to stay open would have?

Their economy is not better than their peers and more people per capita are dead. So he might have been wrong About their absolute numbers, but Sweden’s decision to have a lighter set of restrictions hasn’t exactly worked out. I should say “yet” because they are supposedly banking on having a smaller second wave, even though their immunity estimates aren’t great either at the moment.

Where are you getting this idea that the Swedish economy is not doing better than its peers? The most recent numbers are Q1 and so only capture the beginning of the lockdown but show Swedish GDP to have grown 0.1% in Q1. In contrast, Germany's GDP shrank 2.2%. Denmark shrank 2.1%. Norway shrank 1.5%. UK shrank 2.0%. France shrank 5.3%. Spain shrank 5.2%. Italy shrank 5.3%

Basing it on what the Swedes themselves are predicting for the rest of the year. They currently have the worst per capita death rate in the world and are themselves predicting they will not outpace their neighbours economically since they are so heavily trade dependent. Maybe their infection and death rates will improve and they won’t see as big of a second wave like they are hoping, but I don’t see any reason not to trust their own internal predictions yet. Swedes went skiing in the alps and brought back the virus at the tail end of Q1. They are facing the same unemployment problems as everyone else, like 40% of small businesses are in danger of going bankrupt, etc etc etc.. This isn’t what success looks like. Still “yet” is their goal, so prayers up for them I guess.

[dohboy_24]

How they are testing people has not changed. Who they are testing and how many people they are able to test everyday might have changed, but the fact that they are infected with COVID-19 doesn’t change whether or not they were tested. We just know they have it when we didn’t know that yesterday.

Yesterday we tested 10,000 people and 500 of them were infected. Yesterday, 5% of the people tested were found to be infected.

A bunch of people heard something on the TV about getting tested (it was meant for the protesters who aren't social distancing) so we tested 20,000 people today, but still 500 of them were infected. Today, 2.5% of the people tested were found to be infected.

As long as the media and government reports there are 500 new infections each day, it doesn't matter if the percentage of people tested whom are found to be infected changes?

If one day the CDC report, Health Ontario report, or whichever other report of covid-19 stats says there are 500 new infections and 60 days later it says there are 500 again, it doesn't matter if the first 500 infections came after 1,000 tests and the next 500 came after 10,000 tests?

We should judge the severity of this virus the same if 50% of the tests are positive on day one the same as when 5% of the tests are positive on day 60?

[Fairview4Life]

If we don’t test anyone, those people are still infected. We just don’t know about it. So we open everything up because hey, no new infections! And then they spread the virus. Because they are infected. Because testing people doesn’t change whether or not they are infected. Knowing how many people are actually infected and who they are is extremely important.

If we test only symptomatic people in hospitals, that info wouldn’t help us make a good decision on opening things up. Testing everyone in the province daily would, but is not realistic. The media reporting that there were 500 new confirmed cases yesterday isn’t stoking fear. It’s telling people how many cases were found yesterday. What you want to do with that Info matters, but it doesn’t change the fact that those people are infected with COVID.

[dohboy_24]

If we don’t test anyone, those people are still infected. We just don’t know about it. So we open everything up because hey, no new infections! And then they spread the virus. Because they are infected. Because testing people doesn’t change whether or not they are infected. Knowing how many people are actually infected and who they are is extremely important.

If we test only symptomatic people in hospitals, that info wouldn’t help us make a good decision on opening things up. Testing everyone in the province daily would, but is not realistic. The media reporting that there were 500 new confirmed cases yesterday isn’t stoking fear. It’s telling people how many cases were found yesterday. What you want to do with that Info matters, but it doesn’t change the fact that those people are infected with COVID.

Correct. Reporting 500 new confirmed cases in and of itself is not really "stoking fear" as you say, but it's not 100% transparent reporting either, since things like whether the people tested were in a hospital or long term care facility or if they were all part of the general population and the number of tests administered can surely have an affect on the data and it's interpretation.

If the media were to report on the results of a study that measured the weight of 10,000 people, would it matter if the sample of people used for the study were all McDonald's customers or if they were all Lululemon customers?

In the case of McDonald's customers, the average weight might be closer to 250 lbs, but for Lululemon customers it might be closer to 150 lbs. As long as they reported there were 10,000 people who had their weight measured and the average weight was either 250 or 150 lbs depending on which companies customers were used, is that accurate, fair, and ethical journalism?

Considering the recommended Flesch-Kincaid Grade Level for most website text is 6th grade, most of the audience being influenced by such media won't do much with the information more than understand there were 500 new confirmed cases.

Just the same as they won't think whether it was 10,000 McDonald's customers or 10,000 Lululemon customers who weighed an average of 250 or 150 lbs respectively, they won't likely think to themselves "I wonder if they tested twice as many people today to get to 500 new confirmed cases as they did yesterday to reach the same number?" when the media reports 500 new cases.

Should they have it explained to them by the media and government on day one and day 60 the same as I have above, but with all of their fancy graphics and good-looking actors to help, would they think the same of each broadcast?

Would they think the virus as severe and risky on day one as day 60 or would they see that it's taking 10x as many tests to reach the same number of new confirmed cases as it did 60 days ago as a sign the virus isn't spreading as much as it was 60 days prior? Especially if it was followed by a number of consecutive days with similar results and the pattern continued for a number of days...

If not, how else are we to measure whether the virus is starting to be contained or if things are truly getting worse?

FYI: The Flesch-Kincaid Grade Level for the above text is 14.5 so I obviously need to brush up on "dumbing things down" with a score almost 2.5 times as high as I should hope to aim for, but hopefully that's not an issue...

[Fairview4Life]

I have good news. The people making policy decisions aren’t actually relying on public sentiment.

But if you find 500 new infected people on day 60, even if that’s only really because you’re testing more people, that is still 500 more infected people, and that is a problem for opening up restaurants movie theatres.

[dohboy_24]

If the government says, "We're not going to open up restaurants, movie theaters or ease other restrictions until the number of new cases of infection per day is less than 500 per day for 10 days straight", we shouldn't be concerned if the number of people tested on day 1 that produced 100 positives is 20x fewer than the number needed to produce 100 positive tests on day 10?

Why aren't the number of tests administered and the percentage of people tested who test positive viable numbers for the media and government to use when reporting on the situation, considering which actions to take and measuring the effectiveness of the actions previously taken?

[Vaclac]

I have good news. The people making policy decisions aren’t actually relying on public sentiment.

But if you find 500 new infected people on day 60, even if that’s only really because you’re testing more people, that is still 500 more infected people, and that is a problem for opening up restaurants movie theatres.

Of course they are. Please tell me the actual scientific basis on which ontario is basing its decisions. As I said earlier, if they are actually basing decisions on anything, then it is the trend in the data and hoping trends have been going down for a period of time before opening next stage. And if they are doing that as they say, then they are not, as you apparently think, waiting until no one is infected, but rather waiting until the trend is downward and hoping that each stage of reopening is not enough to kick the reproduction rate back over one.
But it's obvious they are very much driven by public sentiment. When people were scared out of their pants they restricted more and more, without restrictions needing to have any basis in science, but rather the need to satisfy public desire for restriction - ie ticketing families for walking through a park via the emptier field, rather than staying on the more crowded path.
Now that people are less scared and want to actually do things they are opening. The virus hasn't changed, nor has its overall prevalence on Ontario all that much, but public sentiment certainly has.

[Fairview4Life]

The number of people in Ontario isn’t wildly changing. Knowing how many of them have the virus is important. The government should be testing as many people as they possibly can. The fact they are testing more people everyday is good. The fact they are still finding hundreds of infected people everyday is bad. None of that has changed.

[Vaclac]

The number of people in Ontario isn’t wildly changing. Knowing how many of them have the virus is important. The government should be testing as many people as they possibly can. The fact they are testing more people everyday is good. The fact they are still finding hundreds of infected people everyday is bad. None of that has changed.

And yet they are reopening. If they are basing that decision on science rather than public sentiment, then they obviously disagree with you about how the science informs how they should approach reopening decisions.

[M3tro]

Fairview better be first in line for that vaccine.

[Fairview4Life]

The number of people in Ontario isn’t wildly changing. Knowing how many of them have the virus is important. The government should be testing as many people as they possibly can. The fact they are testing more people everyday is good. The fact they are still finding hundreds of infected people everyday is bad. None of that has changed.

And yet they are reopening. If they are basing that decision on science rather than public sentiment, then they obviously disagree with you about how the science informs how they should approach reopening decisions.

If they think the vast majority of infections are confined to long term care facilities, or isolated to specific communities and they have the hospital capacity to handle flare ups, then yeah. I’m not sure where I have argued that the number of new infections needs to be 0?

[Fairview4Life]

Fairview better be first in line for that vaccine.

Do you think this is an insult?

[Vaclac]

The number of people in Ontario isn’t wildly changing. Knowing how many of them have the virus is important. The government should be testing as many people as they possibly can. The fact they are testing more people everyday is good. The fact they are still finding hundreds of infected people everyday is bad. None of that has changed.

And yet they are reopening. If they are basing that decision on science rather than public sentiment, then they obviously disagree with you about how the science informs how they should approach reopening decisions.

If they think the vast majority of infections are confined to long term care facilities, or isolated to specific communities and they have the hospital capacity to handle flare ups, then yeah. I’m not sure where I have argued that the number of new infections needs to be 0?

You have argued that the raw number of test-confirmed cases is what should drive decisions, rather than trends in infections. So if there are 500 confirmed cases, that is too many, regardless of whether the actual rate of infection in the community is decreasing and the apparent increase in cases is a result only of increased testing. I'm not sure what scientific basis there could be for a specific threshold of raw new confirmed cases without regard for testing capacity being relevant unless you think we can't tolerate having any infected people. Even projecting future healthcare capacity needs (which we are far below right now) depends on how many people are actually infected right now, not how many we happen to confirm are infected via tests.