Confusing information

It comes as the latest NHS data from UK hospitals showed a more than doubling of deaths in just four days, with 381 new deaths reported on Tuesday, bringing the toll to 1,789. They included 28 patients with no underlying health conditions, one of whom was a 19-year old man.

What’s the relevant number to be considering here?

Depends upon the definition of underlying really. But there’s at least an argument that the relevant one for public policy services is the 28, not the 381/

38 thoughts on “Confusing information”

  1. They mean no *known* underlying health conditions. Plenty of people are walking around with mild or moderate issues, but they’ve been fobbed off too many times by their GP to bother. Nobody is going to spend time diagnosing them after death either.

  2. We won’t know for a while. The Chinese figures of 15% for over 80s and 8%ish for the over 70s is not dissimilar to the percentage chance of someone over the age of 85 dying in the UK (1 in 6) and for someone between 75 and 84 (1 in 15). Thus some of those who are old might have died anyway.

    I’m not convinced that the right number is the 28 – many of these will have had underlying health conditions that had not been diagnosed. We’ll know more by June on this.

  3. Both are useful in different ways.
    The number dying of Covid and nothing else is the best available guide to how deadly the disease is.
    The number dying with it is the best available guide as to its increase.
    Neither is very good, they’re just the best we’ve got.

  4. And it’s died *with* not died *of*. I read somewhere that the Italian coronavirus deaths included someone who died in a road accident, but had coronavirus.

  5. The statistics are not just noisy they are incomplete and dirty, which kind of invalidates all this statistical wankery and modelling. But last week, deaths were doubling every 3 days. It could be slowing down or, on the other hand, it might not. In Spain, the police started finding unreported dead people in houses. Could that happen here?

  6. They have started counting Italian –or semi-Italian–style. Casualty numbers are bound to increase.

    I would not be surprised if Blojo and his gang now know they have blundered badly and want to do everything to make matters seem as bad as poss. Trying to justify the crazy lockdown.

    Nor is the 28 that worrying even if no underlying conditions.

    Every year flu/colds/pnuemo carries off tens of thousands of old/infirm in the UK and also several hundred young able bodied people. We have all seen and paid little heed to newspaper pieces in years gone by–cyclist 30 dies of flu, ditto bodybuilder 22–both at the peak of health/fitness–but assorted URTI’s did for them without any help from a “deadly pandemic”.

  7. Bloke in North Dorset

    Out of interest, what do people think is a reasonable life expectancy to be protected or not counted in the statistics? Lots of people with underlying issues. I have a very minor heart defect that a consultant told me to forget about plus my BP has always been on the high side, even when in the Army and young and fit. At 63 and fairly fit there’s no reason why I shouldn’t live the 20+ years that the actuarial tables predict. If I get it and die is it with or from the virus?

    What about other underlying factors, say someone who’s been given 5 years, or 2 years? My cousin had been given 2 months, was he not worth protecting?

  8. @Pat

    The problem is that we don’t know how many “extra” people are dying until we have a decent size sample. Mr Ecks’ point is quite correct even those with no health issues sometimes die of flu etc because they were unlucky. By looking at excess mortality we get rid of the effect of counting those who die with covid as opposed to from covid.

    The Italians are undoubtedly seeing extra deaths in Lombardy and Emilia Romagna as a result of crowded ICUs – Covid is probably killing lots of uninfected as they lack access to healthcare as well.

    @Diogenes

    The stats are noisy but in aggregate they are probably a reasonable basis for making a few guesses – I am willing to say that at the 99.99% level the Italians are seeing excess deaths concentrated in the north and among the old. I am not certain that this will lead to excess deaths in the UK yet, probability is over 50% that it will, but would it be worse than a standard flu season? Maybe not.

  9. BiND

    The message was sent to those with underlying health conditions – so everyone who was vulnerable is meant to be sheltering no matter how long their remaining life expectancy. This makes sense from the viewpoint of keeping people safe. Your cousin would thus be in the category of the protected.

    From a mortality viewpoint, we’ll work out what the death rate should have looked like this year (based on age etc) and then see how many more deaths there were. (could also do this by region or by age category). In this case, your cousin’s death would have been statistically likely and would not be counted.

    The point at which the rubber hits the road is when ICUs are overwhelmed (Catalonia in Spain and Lombardy in Italy) which is where the life expectancy is used to decide whether to treat or not and whether to use an ICU bed / ventilator or not. Your cousin with 2 months would score poorly on this measure.

  10. You’re talking about the concept of quality adjusted life year there, qaly. Which we could usefully price at what the NHS does, £30k per. Actions which cost more than that per qaly are an inefficient use of resources.

    Call it 36k for ease of calculation. More than £6k to treat cousin is inefficient.

    That does rather run into a problem of course, that palliative care for 2 months is going to cost more than £6k anyway but the basic logic is sound whatever price we attach or complications we introduce.

    To get a little more personal, my father’s death 18 months ago. His pacemaker gave out about 3 months before the prostate cancer entirely ate him. Sure, there’s an element of self-reassurance in this, but the general familial agreement is that he benefited from that, not suffered a loss.

  11. Ken, I guess the stats do suggest where attention is needed to beef up ICU capacity, eg Paris and the Eastern regions in France, London and Birmingham in the UK etc. But the ranges of deaths in the detailed models from IC and various bloggers is so vast that I don’t really see their usefulness for policy. However, they do suggest that we either lock down till the end of April or risk a protracted epidemic going through to September. If even partial lockdown lasts till September, I don’t think we will have a functioning society

  12. The statistics are meaningless unless and until the total number infected is known, and per age group.

    On the other hand the Diamond Princess cruise ship gives actual data in near perfect lab conditions.

    Out of about 3 500 passengers and crew across all age ranges, all tested, all symptoms and deaths know, 83% did not have the virus, nearly 50% with the virus were asymptomatic, the rest mostly mild, death 7, over 80.

    What we have seen after two to three months of this virus suggests the cruise ship model is close to what is happening in general populations.

    The virus is supposed to be fast spreading and dangerous, yet most reports of those tested are of mild symptoms, a small number serious and relatively few deaths across the age ranges and then nearly all with famous ‘underlying conditions’ and in older people.

    The virus either is fast spreading but mostly harmless, or it is dangerous and spreads slowly: it cannot be both. There may also be an acquired immunity to the Wu Flu, gained over the years from other virus of this type, and the proportion of the population immune may be large and sufficient to contain the virus.

    Two features stand out: the large number of positive tested people who have mild symptoms; those with none.

    The focus has been on speed of contagion rather than severity. That is a gross error of judgement – alas expected from a political class who flock to rallies to worship, praise and be harangued by a mad teen, and whose lack of competence in any situation is evident.

  13. The Diamond Princess data seems to be missing something imv. Of the 83% who tested negative at the time of the test, had any of them already had the virus and beaten it off?

  14. The death rate from the Diamond Princess has gone up a bit – more people have died who were in hospital. But it’s still not massive. The issue is numbers – of infected people and beds/ventilators. Those guys were right at the start and got access to the best medical care. Many survived but some of those certainly would not survive now in northern Italy.

    Too many people are going to get it and need ITU care that just isn’t there. That’s what’s going to kill them. Not to mention, people who would have needed ITU care anyway. Try being diagnosed with a curable cancer now. Or needing a heart op.

    I would still like someone (sensible) to explain what they think so many competing politicians and scientists and mathematicians stand to gain by fucking us all up if it really isn’t necessary?

  15. @Dave – my concern is that ‘at least up to now’ isn’t the point with an exponential growth pandemic with most people washing their hands more and not driving/having workplace accidents etc

  16. ‘What’s the relevant number to be considering here?’

    How many died from flu. Betcha it’s bigger.

    These statistics are published for the purpose of frightening the citizenry, not to inform them.

    ‘more than doubling of deaths in just four days’

    Trashy sensationalism. Journalism depends on the ignorance of their readers. Chiefly, what shits journalists are.

  17. @Gamecock

    These statistics are published for the purpose of frightening the citizenry, not to inform them.

    For the love of God, what the fuck is in it for ‘them’? In your country, the stock market was booming, billionaires were growing on trees, it was basically sweet. They invent a viral panic that is actually demonstrably killing people just to frighten them? Who? Trump did that? Why?? He was cruising to re-election. I assume you think it’s his enemies – like the NY mayor who was begging people to get out in bars a fortnight ago – but seriously? The bodies are there. You can’t invent this. And did they also invent it in every other country in the world?

    The seriousness is arguable; that it is actually serious is inarguable.

  18. The death rate from the Diamond Princess has gone up a bit – more people have died who were in hospital. But it’s still not massive. The issue is numbers – of infected people and beds/ventilators. Those guys were right at the start and got access to the best medical care. Many survived but some of those certainly would not survive now in northern Italy.

    All true, but the important facts from Diamond Princess are 83% not infected; and most of the 17% infected having zero to mild symptoms. On a cruise ship, probably the biggest non-laboratory disease incubators going.

  19. These statistics are published for the purpose of frightening the citizenry, not to inform them.

    For the love of God, what the fuck is in it for ‘them’?

    To make the citizenry comply with the lockdown.

  20. What is in it for the Press Interested?

    The same leftist scum who are demented about Trump and Boris? At the moment they are spreading a new phase of Project Fear and loving how it has worked.

    They are pushing the line that mot enough has been done. But once they see that coro is a damp squib and the economy is fucked that line (and throughout the left) will turn on a dime and “Trump/Boris hysteria ruined YOU” will be the creed and the prev one memory-holed.

    Blojo –and to a lesser extent Trump have done the same as you– overeacted–and not known enough economics to see the danger

  21. @PJF – I get that they want people to comply with the lockdown, that’s not the question – the question is why do they want what (according to Ecks and others) is an entirely unnecessary lockdown which is certainly going to fuck the economy? There must be someone on here who can answer this without sounding utterly insane?

  22. Ecks – your definition of ‘overreacted’ appears to be ‘does not entirely agree with Ecks’ spittle-dribbling conspiracy theories’. I have enough food in for a week or so, as normal, because the supply chain is fine. If it goes tits up I have ground source heating, a cesspit, a spring a quarter of a mile away, open fires, a shotgun, a rifle, and plenty of booze. There’s food in the woods if needed. I’m chilled. You’re the one who’s overreacting – you sound like your head has completely gone, which by your standards is fucking impressive.

  23. I see it links to the Telegraph, which in turn links it to supposed official stats.
    Anyone see the Guardian (yes, I know) story about the 21 year old girl who was reported to have died of the lurgy and had “no underlying…blah blah”?
    The Beeb had it up as such, but has now taken it down. Anyone interested should look at the Spiked article and form their own opinions on our beloved media.
    https://www.spiked-online.com/2020/03/27/chloe-middleton-the-coronavirus-death-that-wasnt/

  24. …the question is why do they want what (according to Ecks and others) is an entirely unnecessary lockdown which is certainly going to fuck the economy?

    It’s not a question of wanting it; they clearly feel it is a necessary burden. The question then becomes one of “are they correct?”. And that isn’t addressed by whether or not SARS-CoV-2 / COVID-19 is a serious issue (it clearly is), it’s answered by whether it’s serious enough to warrant the damage being caused by the lock down.

    Even today’s terrible figures (deaths and new infections) will have to be typical for a sustained period to make this a bad year for respiratory disease deaths. We had one of those in 2018 and we didn’t damage the whole country to deal with it.

  25. Interested–You are rambling chum.

    I never questioned and don’t see the relevance of your personal preparations. Good for you but zero to do with discussion.

    The media –just told why they want economic fuck up. The fucking Dems said that last yr–economic disaster to stop Trump. And like many middle class leftists they assume their lifestyle will endure from everlasting to everlasting. So they don’t see it affecting them.

    Italy–told you why–they blundered into it and are trying to brass it out as crisis of the age therefore not our fault. Ditto the rest.

    UK–Blojo was fair set after December –but he has advisors who are 1-useless and destructive –Imperial College–with a proven track record-plus 2-advisors-the SCS –who are malicious and hate his govt–recent events show that. Like the leftist media they also believe (probably correctly in their case ) that econ downturn won’t affect them.He had a tough decision–and was encouraged to make the heavy-handed one and is going to brass it out and fuck the economy rather than admit he was wrong. Eton or not it is highly likely he is full of pseudo-Keynes crap and thinks funny money will save his bacon–but it WON’T. Or the World’s either come to that.

    Would you like me to quote you a couple of million bad/ruinous political decisions from history or can you do it yourself or do you believe political pork can do no wrong? And just because common sense shows something is a bad idea that must mean they won’t do it.

    Trump has had a lot of local gobboons causing him problems and has done similar to Bloj as far as keeping LD to end of April. I still think he might see sense and move quicker to stop it tho. If he does local/state Dem idiots will get much more blame for the mess–as they deserve.

  26. “Try being diagnosed with a curable cancer now. Or needing a heart op”

    Or even something as “routine” as a hip replacement. I’m in that boat, and don’t exactly look forward to the future with much glee. Even if this situation eventually calms down by the summer, there will 1) be a massive backlog of NHS operations, and 2) even if I delve into my savings to go private, I’m not keen on getting it done ASAP when there will probably still be some virus lurking, as I’ve been informed previously that the biggest risk of such procedures is subsequent infection. This is also more likely during the winter months, when CV may well put in another appearance…

  27. @PJF

    It’s not a question of wanting it; they clearly feel it is a necessary burden. The question then becomes one of “are they correct?”. And that isn’t addressed by whether or not SARS-CoV-2 / COVID-19 is a serious issue (it clearly is), it’s answered by whether it’s serious enough to warrant the damage being caused by the lock down.

    Even today’s terrible figures (deaths and new infections) will have to be typical for a sustained period to make this a bad year for respiratory disease deaths. We had one of those in 2018 and we didn’t damage the whole country to deal with it.

    Yes, that’s a sane response. It seems sane to me to say this is a problem, we don’t yet know how big a problem it is, and that there are debates to be had in good faith about what to do about it in response. The truth is we may never know to a precise factor, and we can’t wait to have the perfect picture before acting even if we one day will know.

    My issue isn’t with people saying that or trying to start such a debate – it’s with people who are obsessively suggesting that it’s all part of an evil masterplan by ‘them’, but who can’t explain what ‘they’ are gaining out of it.

    As it happens, I will gain – I am on top of the newss and I sold a lot of stock when this started and will buy it back way cheaper. You could make a case that some financiers somewhere are gaining – but I can’t believe the whole thing is planned as some are hinting or even outright stating, it’s just a sensible response to what is unfolding from people with more than a room temperature IQ.

    @Ecks – you write endless screeds of lunatic bilge, see above, so it’s a bit rich of you to accuse others of ‘rambling’. I didn’t read any further than that, sorry – it will be nonsense about ‘Blojo’ and ‘NuLiebour’ etc and I can’t be arsed. The virus won’t get you, but your blood pressure will.

  28. Well logic isn’t your strong point and you clearly don’t want to read anything that isn’t what you already know it is without having read it so all the best and stay safe.

  29. OK, it’s the Mail reporting anecdote, but this is still interesting:

    “Selfless heroes flocking to staff the emergency 4,000-bed unit in east London have been told to ‘be prepared to see death’, with a mortality rate of 50 to 80 per cent among those on ventilators.”

    https://www.dailymail.co.uk/news/article-8175379/Volunteers-NHS-Nightingale-hospital-warned-80-cent-patients-ventilators-DIE.html

    The new coronavirus hospital is due to take the healthier prospects while the worst cases go to the regular hospitals. And they’re warning of a 50% to 80% mortality rate for the healthier cases. Presumably the mortality rate is worse still for the others. Obviously, if true, that’s really, really bad.

    But doesn’t it bring into question the motivation for the lockdown strategy? The idea is to pace the infections to enable as many vulnerable types as possible to get a ventilator. But if most of those on a ventilator die anyway, what’s the point?

    With lockdown – most serious cases die – economy / country fucked.

    Without lockdown – most+ serious cases die – economy / country functioning.

    ?

  30. “And like many middle class leftists they assume their lifestyle will endure from everlasting to everlasting. So they don’t see it affecting them.”

    Correct. That the poor are devastated is an afterthought. “Oh, we’ll get the federal government to give them $1,200. That’ll make it right.”

  31. Those on a vent etc will be in a bad way. Does that mean all 4000 beds are going to be filled with such–or is it more projected deaths stuff?

    I think the latter. It is also the kind of lurid daily mail take on matters

    The time to shout is when deaths are really happening. Claims of what will happen are two a penny.

    PJF is right though –if mass deaths either way–then fewer with a working economy than a collapsed one.

    Still see no sign or reason to believe, DM hearsay doesn’t cut it.

    .

  32. “80% / 95%”

    In which case, as PJF said, what’s the point? ND Reader made the point earlier that it’s the difference in mortality between having the appropriate care and not that might be a reasonable issue that is driving the political process.

    80% or 95% is neither here nor there in that context. If there was absolutely zero ICU capacity, that’s only between 5% and 25% extra deaths compared to having as much ICU as you need (based on 95% or 80% mortality with ICU?). 100% not worth shutting the world economy down for.

  33. “100% not worth shutting the world economy down for.”

    Rest of medical profession shutting down, too. I heard today that 40% of American hospital beds are empty. People are so skeert that non-CV stuff is being put off.

    American hospitals are laying people off.

  34. @dearieme

    wow. Interesting paper. Sample period is between December 31st and January 31st, so before the Wuhan hospitals were overwhelmed. Sample size is not great – n = 191, but enough to be indicative. The ventilator numbers are indeed very bad, as indeed are the nasal cannula ones.

    It’s also possible that with a larger sample size, ventilator use might prove to be more effective amongst the young (under 60) with fewer complications who end up in intensive care. With an n = 191, we don’t have many under 60s that fall that ill (the death rate is low and the symptomatic cases are low – so it’s difficult to say – we’d know more with an n=1,000 plus).

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