Tom Kirkman

Charts of COVID-19 Fatality Rate by Age and Sex

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On 4/6/2020 at 10:40 PM, grizzly bear said:

 

On 4/6/2020 at 11:05 PM, 0R0 said:

Terrific. 

Rational people get good results, political poseurs and bureaucratic power grabbers don't.

Lurking here for a while, but just had to sign up and say hello to comment on this! It's close to home since I moved to Norway some years ago and have been following the situation in Scandinavia closely.

First things first, the authors clearly have their narrative and are looking for evidence to support it. No problem with that - it's clearly an opinion piece and they're welcome to their opinion, even if I don't personally agree with it (and nor do most of the world's government and health experts, including many in Sweden). But damn, when I got to the part they compared Sweden's situation with Norway as if it supported their position I nearly fell off my chair laughing!

You could tell they were struggling to stay on narrative as soon as they brought up Norway - the only cherry available to pick was 'but Norway has more people in ICUs'. Even that is highly dubious - current Worldometer data shows 78 in 'serious/critical' condition in Norway compared with 640 in Sweden, so if that factoid is even true at all it must be a technicality from different criteria for what constitutes being in an ICU. But every other number and trend paints the picture that the social distancing measures in Norway (and the rest of Scandinavia except Sweden) are in fact having a dramatic effect in spread and fatalities.

Here in Norway it is considered 'under control'. I'm personally a bit hesitant to agree with that for the country as a whole because in the capital, whilst they have killed the exponential growth, they still have a pretty linear increase of new cases per day, albeit showing signs of declining in the last few days. But here in Stavanger and most of the rest of the country I'd agree - it's almost been stamped out. I can count the number of new cases for the last week on one hand. Numbers in hospital are declining, and no I don't just mean the rate of new hospitalisations is decreasing, I mean the actual number of people in hospital is declining as recoveries (and of course deaths) has overtaken new admissions. It's about 20% down over a week ago for the country, skewed by Oslo numbers, but here there are just under half the people in hospital compared to a peak about two weeks ago.

Sweden on the other hand is really not looking so good. After that article posted Sweden posted a dramatic spike in deaths of 77 in a single day, followed the next day by an eye-watering further increase of 114 deaths. This is more than Norway's sum total in a single day, bringing them to almost 600 dead - about 7 times the number in Norway, or almost double the rest of Scandinavia combined! Norway also had it's highest death count yesterday, but it's 12 - an order of magnitude less than Sweden. Not looking too clever.

Sweden's numbers per capita are frankly terrible for a low population density 1st world nation with 50%+ households single occupancy. They sure ain't no shining example for how to do this right at all! Internally the PM is under massive pressure to take it all more seriously. Over 2000 doctors signed a petition begging the government into action noting 'they are leading us to catastrophe'. Whilst kindergardens are still open, around half the parents have taken it upon themselves to keep their kids home. And that was all before the last two days' horrible numbers.

Meanwhile Norway is beginning to open up the country on April 20th starting with opening kindergardens and relaxing some restrictions on businesses. Denmark doing the same. If Sweden's numbers keep going they way they are, then as the rest of Scandinavia opens up, Sweden will be forced to u-turn and shut down due to public revolt! We shall see.

So no, just no! Anyone comparing the situation in Sweden to Norway (or the rest of Scandinavia) and coming to the conclusion that 'it will become clear that social distancing like that in Norway accomplishes very little in terms of reducing disease and fatalities' is plain bonkers. It is already very clear the opposite is true, and Scandinavia is as good an example as you can get since here we can compare the two responses in a region where the notion 'all other things being equal' is pretty valid.

 

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On 4/7/2020 at 10:46 AM, Rob Plant said:

Our prime minister who is 55 and a bit overweight but runs and cycles regularly is now in intensive care, so I guess his immune system may not be as robust as most.

It looks to me like Boris might not have the most healthy diet.  Plus, he's overconfident.
He just assumed he was tough and would survive.

https://www.youtube.com/watch?v=XGcrlbTPhCY

 

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1 hour ago, Uvuvwevwevwe Onyetenyevwe Ugwemuhwem Osas said:

It looks to me like Boris might not have the most healthy diet.  Plus, he's overconfident.
He just assumed he was tough and would survive.

https://www.youtube.com/watch?v=XGcrlbTPhCY

 

Hey dont write the fat English guy off just yet😂

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9 hours ago, LiamP said:

But every other number and trend paints the picture that the social distancing measures in Norway (and the rest of Scandinavia except Sweden) are in fact having a dramatic effect in spread and fatalities.

 

9 hours ago, LiamP said:

Sweden on the other hand is really not looking so good. After that article posted Sweden posted a dramatic spike in deaths of 77 in a single day, followed the next day by an eye-watering further increase of 114 deaths. This is more than Norway's sum total in a single day, bringing them to almost 600 dead - about 7 times the number in Norway, or almost double the rest of Scandinavia combined! Norway also had it's highest death count yesterday, but it's 12 - an order of magnitude less than Sweden. Not looking too clever.

I don't think the goal in Sweden is to minimize deaths. It is the realization that minimizing deaths NOW does not minimize deaths over time. The goal that I support is steady spread of the disease at a rate that the hospital system can withstand. Not because the economy is more important than the death of octogenarians, but because without a quick development of herd immunity, the disease will be back and the same high risk group will be exposed once again, so you are just playing around with their date of exposure and then death. 

The goal of China and the rest of the quarantiners to kill off the virus entirely is quite frankly idiotic. China now has only Hubei and Guangdong halfway immune and Wuhan as largely immune. The rest of the country is open to re-ignition of the pandemic. They can't take flights from abroad, and their outgoing flyers are at risk. 

That is exactly the opposite of the proper policy goal. The proper rational goal is to obtain immunity among the young and their parent's generation, who are low risk and once immune can serve as a buffer against the spread of the next outbreak. The only caveat is that you want the spread to be slow enough that the hospitals are not overwhelmed and so that the elderly have a reasonable chance of survival as their care givers have a lesser chance of carrying the disease. 

Norway can be satisfied with having fewer deaths now but no economy, and instead having those deaths in the future. There is no vaccine, and there is unlikely to be one. SARS vaccines have been in the works for 15 years. They are more dangerous than SARS is, an absolute flop. None are in use. Though there is new unconventional synthetic vaccine technology, there is no vaccine from that source that has passed regulatory testing.  So I am hopeful, but not suggesting planning on integrating that into a policy plan any time soon. The "wait for a vaccine" crowd may be still sitting at home in 5 years. 

So Sweden is showing more deaths now but will face less of a problem in the future. Norway is having fewer deaths at an extremely high cost, the same cost as most of the world is paying in order to achieve a second outbreak. It buys us time, but at an extremely high cost.  A hard quaranitine does not result in a solution to the Pandemic. It just halts it temporarily. That at an extremely high cost. All the state governors and global parliaments that took that route should be dissolved, fired, resigned and replaced. They are a trillion pound foolish and penny wise. 

The best thing we can do is give away millions of cellphone compatible thermometers so that we can collect regional fever measurements as Kinsa does. That allows identification of regional hotspots just a couple of days from their start. So they can be quarantined regionally. 

The estimated benefit of 91% drop in transmission rates with simply a mask and gloves and glasses/goggles to prevent touching your face is enough to keep R0 below 1 so that the disease self extinguishes. Note that the correlation of geographical population density with cases per million (infection density) is extremely strong. That suggests the main culprit in spreading the disease is public transport. So I would say don't allow access to public transport without mask and gloves (or hand sanitizer). If you can, hand  them out at the stations, or by bus drivers. That and distance learning for high school and university students will do well to stop the propagation. 

Measures to assist the high risk section of society to allow self quarantine will help. 

Total quarantine is a waste of resources for the meager result of delaying deaths that ARE going to happen anyway. Once a treatment is available, and it seems that at least HCQ/Z is one that is beneficial at least to early stage patients, which is sufficient to allow lower intensity lockdowns as infection for the high risk population results in substantially lower mortality.

We will see soon enough if the HCQ/Z is sufficient. So far, NYC hospitals have 3000-3500 treated, NY State hospitals have 5000. Only 1000 are done with a 10 day course. So the impact on deaths should still not be substantial as that is not enough in a population of 14k in hospital, and 160k positive cases. Of course, outpatient treatment with HCQ/Z (or D= doxycycline, for the heart impaired). Is gaining steam, though at the end of march only 23% of positive cases were reporting treatment with HCQ/Z or D. At that point, 70% of European patients were reporting being treated with HCQ or related drugs.

 

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7 minutes ago, 0R0 said:

 

I don't think the goal in Sweden is to minimize deaths. It is the realization that minimizing deaths NOW does not minimize deaths over time. The goal that I support is steady spread of the disease at a rate that the hospital system can withstand. Not because the economy is more important than the death of octogenarians, but because without a quick development of herd immunity, the disease will be back and the same high risk group will be exposed once again, so you are just playing around with their date of exposure and then death. 

The goal of China and the rest of the quarantiners to kill off the virus entirely is quite frankly idiotic. China now has only Hubei and Guangdong halfway immune and Wuhan as largely immune. The rest of the country is open to re-ignition of the pandemic. They can't take flights from abroad, and their outgoing flyers are at risk. 

That is exactly the opposite of the proper policy goal. The proper rational goal is to obtain immunity among the young and their parent's generation, who are low risk and once immune can serve as a buffer against the spread of the next outbreak. The only caveat is that you want the spread to be slow enough that the hospitals are not overwhelmed and so that the elderly have a reasonable chance of survival as their care givers have a lesser chance of carrying the disease. 

Norway can be satisfied with having fewer deaths now but no economy, and instead having those deaths in the future. There is no vaccine, and there is unlikely to be one. SARS vaccines have been in the works for 15 years. They are more dangerous than SARS is, an absolute flop. None are in use. Though there is new unconventional synthetic vaccine technology, there is no vaccine from that source that has passed regulatory testing.  So I am hopeful, but not suggesting planning on integrating that into a policy plan any time soon. The "wait for a vaccine" crowd may be still sitting at home in 5 years. 

So Sweden is showing more deaths now but will face less of a problem in the future. Norway is having fewer deaths at an extremely high cost, the same cost as most of the world is paying in order to achieve a second outbreak. It buys us time, but at an extremely high cost.  A hard quaranitine does not result in a solution to the Pandemic. It just halts it temporarily. That at an extremely high cost. All the state governors and global parliaments that took that route should be dissolved, fired, resigned and replaced. They are a trillion pound foolish and penny wise. 

The best thing we can do is give away millions of cellphone compatible thermometers so that we can collect regional fever measurements as Kinsa does. That allows identification of regional hotspots just a couple of days from their start. So they can be quarantined regionally. 

The estimated benefit of 91% drop in transmission rates with simply a mask and gloves and glasses/goggles to prevent touching your face is enough to keep R0 below 1 so that the disease self extinguishes. Note that the correlation of geographical population density with cases per million (infection density) is extremely strong. That suggests the main culprit in spreading the disease is public transport. So I would say don't allow access to public transport without mask and gloves (or hand sanitizer). If you can, hand  them out at the stations, or by bus drivers. That and distance learning for high school and university students will do well to stop the propagation. 

Measures to assist the high risk section of society to allow self quarantine will help. 

Total quarantine is a waste of resources for the meager result of delaying deaths that ARE going to happen anyway. Once a treatment is available, and it seems that at least HCQ/Z is one that is beneficial at least to early stage patients, which is sufficient to allow lower intensity lockdowns as infection for the high risk population results in substantially lower mortality.

We will see soon enough if the HCQ/Z is sufficient. So far, NYC hospitals have 3000-3500 treated, NY State hospitals have 5000. Only 1000 are done with a 10 day course. So the impact on deaths should still not be substantial as that is not enough in a population of 14k in hospital, and 160k positive cases. Of course, outpatient treatment with HCQ/Z (or D= doxycycline, for the heart impaired). Is gaining steam, though at the end of march only 23% of positive cases were reporting treatment with HCQ/Z or D. At that point, 70% of European patients were reporting being treated with HCQ or related drugs.

 

 

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GREAT work here Sir.  THANKS!!

The French study on HCQ/Z is very positive, will try to retrieve it. 

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10 hours ago, LiamP said:

 

So no, just no! Anyone comparing the situation in Sweden to Norway (or the rest of Scandinavia) and coming to the conclusion that 'it will become clear that social distancing like that in Norway accomplishes very little in terms of reducing disease and fatalities' is plain bonkers. It is already very clear the opposite is true, and Scandinavia is as good an example as you can get since here we can compare the two responses in a region where the notion 'all other things being equal' is pretty valid.

 

The difference will come as Norway opens up and either does or does not see flare ups and new hot spots of the pandemic. They may have shut down early enough to have stopped the infection rate to single % points. But I doubt it. 

We really need the antibody test availability to rise. The Chinese test kits sent to Europe earlier were really bad (worse than a coin flip as 37% gave no result 30% false positives and about the same in false negatives). Still not heard what is going on with the newer shipments. 

Neither I nor any others believe that the lockdowns don't stop the progression of infections. They obviously do. 

The question is, what is the point if your population is already 30-40 or 70% infected. On the other hand, If your population is <5% infected and new cases are coming in at a lower rate, like a single new daily cpm (case per million) why are you still on a hard lockdown? time to start getting folks to work where exposure is not likely when good distancing can be practiced. Or with PPE used. .

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On 4/6/2020 at 5:27 PM, Gerry Maddoux said:

The development--or not--of the fabled cytokine storm determines ventilator or not, life or death. This outpouring of cytokines--fever molecules that fight infection--is usually associated not with the very young or very old but the folks in the middle with great, well-developed immune systems, having been challenged by various offending microbes. 

This virus is so weird! It replicates in the nasopharynx and trachea without much fever, only a dry cough or sore throat. After endocytosis (engulfment) by the epithelial cells, it replicates per usual for a virus but remains in the cell, where large numbers of viruses form a "pouch." When thousands of those pouches reach critical mass, they mostly get "washed off" and floated downstream--into the lower respiratory tract (bronchi, bronchioles, alveoli)--at one time, producing a giant infectivity there by bursting out of their pouches. 

This sudden release of hundred of thousands of viruses all at one time in the most vulnerable part of the respiratory tree causes--in some people--this cytokine storm as the immune system goes parabolic trying to fight it. Therefore, the virus is tricking the human body to create a form of auto-immune reaction so severe that it destroys lung tissue at an extraordinary rate. This is why someone goes into the hospital looking pretty good, with a decent oxygen saturation but with early pulmonary infiltrates on chest X-Ray and then deteriorates rapidly, sometimes so fast they die on a gurney in the hallway. So far, the likelihood of such a storm is not predictable. 

Is this storm related to the ACE-2 receptors a person has in the lungs? Probably, as those receptors serve as the gateway for the virus. This is exceedingly more complicated than the influenza virus, which enter cells through sialic acid endocytosis and don't form such large cellular pouches. Which leads to another question not being discussed: Will the taking of ACE-Inhibitors for high blood pressure reduce the entry of mass numbers (superinfection)? This is a very pertinent question, as ACE-I's are one of the most commonly used drugs in the world. Or, contrariwise, does an ACE-I increase entry in some bizarre way. I hope there is enough data-sharing to answer this and many other questions. 

This is a very, very sophisticated virus! Its RNA strand is much longer than most coronaviruses, thereby encoding for some very intricate mechanisms, all construed to kill certain people. The RNA strand is so much longer that it creates all sorts of conspiracy theories in my mind. I have no idea whether or not they are valid.

Each time I have to go out I use a salt pipe with iodine in it. Inhale it into my lungs and through my nose. Do the same when I get back. Iodine fooks over viruses while being relative benign to our cells. Other precautions high dose Vit D< Zinc Citrate, FFP3 facemask and fingers crossed. 

 

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2 hours ago, 0R0 said:

We will see soon enough if the HCQ/Z is sufficient. So far, NYC hospitals have 3000-3500 treated, NY State hospitals have 5000. Only 1000 are done with a 10 day course. So the impact on deaths should still not be substantial as that is not enough in a population of 14k in hospital, and 160k positive cases. Of course, outpatient treatment with HCQ/Z (or D= doxycycline, for the heart impaired). Is gaining steam, though at the end of march only 23% of positive cases were reporting treatment with HCQ/Z or D. At that point, 70% of European patients were reporting being treated with HCQ or related drugs.

Do you know any trending data on treatment? Should be coming out through leaks, I would imagine.

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On 3/31/2020 at 11:59 AM, Geoff Guenther said:

 

I wouldn't place too much faith in the Telegraph/Barclay brothers and their promises of manufacturing coming to Britain. They've been promising a manufacturing boom because of Brexit for four years now, and all we've seen is an acceleration of companies leaving the country.

What I do see happening, though, is an accelerated shift to robotics for manufacturing. The fewer people required for the process, the less risk people pose to production. This may or may not be at the cost of globalisation but we'll certainly see.

We are certainly due for a realignment of the economy. The fact that few families in the West have the luxury of being able to live off a single - and many struggle even with two - mirrors the problems that the Soviets had 30-40 years ago. What we have right now was going to break, and having America take on another $20 trillion in debt may just break it.

I'm looking forward to discussions about how the future economy should be structured. I'm worried that Bernie bros will push too much government control, worried that Koch-style anarchist/libertarians will set up a corporatist state, and worried that the religious right will become the Taliban. But at the same time, I'm optimistic that we can develop a working model that benefits people much more than our current one.

And without all the cheap plastic toys that we all feel we need to buy for our kids with the second income.

After COVID the EU is likely to disintegrate. Eastern Europe don't want Mutti Merkels newly arrived 'Doctors, Engineers and Scientists'. Italy on the verge of bailing. Debt hole liable to implode, No coordinated response over COVID. If this happens there will be less incentive to move business to Europe. 

Even that Commie Varafoukis is now saying the UK right to leave Eu. His words were the EU is only capable of causing harm

Not manufacturing but a friend of mine works for one of the big Swiss banks in London. After Brexit they had a hissy fit and offshored loads of work to Europe (Eurozone). Well they are rapidly bring it back on the basis of - 'well we won't be making that mistake again' 

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Utah company weighs in on study showing obesity factors heavily in coronavirus risk

The largest U.S. study conducted on COVID-19, with 4,000 patients in New York participating, found that after age, obesity was a significant factor associated with hospitalization.

The United States Center for Disease Control and Prevention has listed those over 60 years or older, or those who have pre-existing health conditions as being at a high risk of severe illness from COVID-19. Individuals who are clinically obese, or with a body mass index of 40 or over, also have made the list.

In the study, led by Christopher Petrilli from the New York University Grossman School of Medicine and published earlier this month, a team of researchers assessed the factors associated with hospitalization of patients with COVID-19.

The team looked at different characters of each of the 4,103 patients to identify the biggest risk factors for individuals whose outcomes were more severe. Of the over 4,000 participants, 1,999 required hospitalization and 650 were placed on a ventilator, died or were discharged to hospice care, according to the study.

Although age remained the biggest risk factor for hospitalization or critical care, researchers also found that obesity, heart failure and chronic kidney disease were also linked to severe coronavirus cases.

MD Diet Clinic is a Utah-based company with locations in Salt Lake City and Orem. The company’s marketing and operations director, Winston Behle, said he was surprised by the study’s findings.

“We’ve always known obesity is bad for your health,” he said. “Obesity puts you at a higher risk for most diseases, but what I think was most surprising was to find out that obesity put you more at risk for COVID-19 hospitalizations than even those with respiratory or heart conditions or diabetes.”

Behle said prior to the study’s publication, healthcare experts believed prior health conditions, like the ones he listed, were the biggest factors outside of age.

Obesity is known to create chronic inflammation in the body, which can be exacerbated when contracting COVID-19, Behle said. This remains the researchers’ theory on why individuals who fall into the body mass index of over 40 experience greater risk.

Another theory, Behle said, is that those who suffer from obesity have lower oxygen levels than people at a healthy weight.

One of the biggest reasons for coronavirus-related hospitalizations has been decreased oxygen levels. When people are obese, there is more blood to circulate through the body and more areas of the body for it to be dispersed to, head nutritionist Ashley Forsythe said.

“Combining obesity with COVID-19 is really a double whammy when it comes to low oxygen,” Behle said.  ...

 

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