There is a difference between deaths from covid and deaths with covid. Consider a man who, with the best possible medical care, is rapidly going downhill with congestive heart failure. The day before he dies he tests positive for covid. It is misleading to classify this as a death caused by covid. It is a death with covid.
Then there are deaths caused by covid that aren't from covid. Someone who can't get a bed in the hospital because they're full of covid patients. Someone with an otherwise treatable condition who can't get their meds because the Mango Murderer has said the meds they depend on can treat covid. People who won't get treatment because so many doctors have died from covid there aren't enough to treat people who don't appear critical. I was pondering what I'd do if one of my kidney stones decided to cut loose right now. They're both large enough to block the exit, and I'd likely eventually die from some kind of internal damage or septicemia if I couldn't get it removed. But if the hospitals are overburdened with people drowning in their own white blood cells, I'd be low priority.
I recently (3 weeks ago) passed three large ones after a course of 2oz fresh lemon juice and 2oz olive oil 3x daily for three days. They were soft and squishy by the time they made their way out.
Not recommending it but just saying, they were causing problems and I managed to clear them without surgery.
I hope you continue well. We need you. We're here for a good time not a long time.
....Weeks ago I saw a graph which showed the relationship between covid deaths in Italy and pre-existing serious medical conditions. Five serious conditions were listed. Two of them were heart disease and lung disease. I don't remember the other three. Less than five percent of those who died had none of these conditions. ....
Obesity, hypertension and diabetes.
Unfortunately, not only are they serious, they're ubiquitous.
I have all three of those listed by @Soror Magna , and don't at all feel on the verge of keeling over. So if I were to contract covid-19 and then die while still infected, that seems to me very much a death from covid-19, not just with covid-19, because I wouldn't have died right now without the covid-19. (I'm in my late 50s.)
I really hope that doesn’t mean domestic cats can get it.
From that article:
There have been a handful of reports outside the U.S. of pet dogs or cats becoming infected after close contact with contagious people, including a Hong Kong dog that tested positive for a low level of the pathogen in February and early March. Hong Kong agriculture authorities concluded that pet dogs and cats couldn’t pass the virus to human beings but could test positive if exposed by their owners.
It's pretty clear now that there are downward trends for Spain and Italy though new case daily totals and death daily totals remain pretty high. Looks like it's going to be a slow downhill trend. The UK? Close to the summit I guess. The USA? Further to go and I suspect there may be several sequential state apexes following New York.
It would break my dogs heart if I suddenly wouldn't let her sleep with me, nap under my shirt while I'm at the computer, periodically slurp my face, etc. Like the old Windsong perfume ad, I am the very air she breathes. We'll just have to risk it.
There is a difference between deaths from covid and deaths with covid. Consider a man who, with the best possible medical care, is rapidly going downhill with congestive heart failure. The day before he dies he tests positive for covid. It is misleading to classify this as a death caused by covid. It is a death with covid.
This reminds me of the snarky and overly-semantic parsing during the '80s and '90s about how no one had actually died of AIDS. It just weakened their immune system to the point where something else killed them. This seems like a similar level of distinction without a difference.
Weeks ago I saw a graph which showed the relationship between covid deaths in Italy and pre-existing serious medical conditions. Five serious conditions were listed. Two of them were heart disease and lung disease. I don't remember the other three.
If only there were some way to link to information, possibly through some world wide network of information, we wouldn't have to rely on "some graph @Moo saw weeks ago when there were half as many infections and one-third as many deaths". (Going from the data from Italy two weeks ago. If you go back further the numbers are even lower.)
Another possibility is that those with relevant pre-existing conditions die quickly of COVID-19 while healthier people take longer. It's really difficult (and irresponsible) to draw those kind of conclusions from an ongoing outbreak. For example, on March 22 (two "weeks ago") Italy had 5,476 deaths attributed to COVID-19, 7,024 people who had recovered from COVID-19, and 46,638 people who were known to be actively infected with COVID-19. If I was looking at those numbers I wouldn't draw the conclusions @Moo reached, I'd note that the vast majority of cases (nearly 4/5ths) hadn't had an outcome yet and while we had some idea who was most at risk that didn't necessarily translate into low risk of mortality for those still infected.
For reference, here is an animated graph that shows the top 15 causes of death in the U.S. over time from March 1 through yesterday (April 4). On March 1 COVID-19 was at the bottom of the list. On April 4 it was #3 after heart disease and cancer and right above "accidents".
We have our first case in our rural county. Someone who worked out of the area infected by co-worker. It really was not a case of if but when. Hope this makes people a little more careful.
List of countries with at least 5,000 known COVID-19 cases.
United States - 336,830 (309,235 / 17,977 / 9,618)
Spain - 131,646 (80,925 / 38,080 / 12,641)
Italy - 128,948 (91,246 / 21,815 / 15,887)
Germany - 100,123 (69,839 / 28,700 / 1,584)
France - 92,839 (68,578 / 16,183 / 8,078)
China - 81,708 (1,299 / 77,078 / 3,331) 4.1%
Iran - 58,226 (34,887 / 19,736 / 3,603)
United Kingdom - 47,806 (42,737 / 135 / 4,934)
Turkey - 27,069 (25,453 / 1,042 / 574)
Switzerland - 21,100 (13,970 / 6,415 / 715)
Belgium - 19,691 (14,493 / 3,751 / 1,447)
Netherlands - 17,851 (15,835 / 250 / 1,766)
Canada - 15,512 (12,290 / 2,942 / 280)
Austria - 12,051 (8,849 / 2,998 / 204)
Brazil - 11,281 (10,667 / 127 / 487)
Portugal - 11,278 (10,908 / 75 / 295)
South Korea - 10,284 (3,500 / 6,598 / 186)
Israel - 8,430 (7,904 / 477 / 49)
Sweden - 6,830 (6,224 / 205 / 401)
Norway - 5,759 (5,656 / 32 / 71)
Australia - 5,750 (3,398 / 2,315 / 37)
Russia - 5,389 (4,989 / 355 / 45)
The listings are in the format:
X. Country - [# of known cases] ([active] / [recovered] / [dead]) [%fatality rate]
Fatality rates are only listed for countries where the number of resolved cases (recovered + dead) exceeds the number of known active cases by a ratio of at least 2:1. Italics indicate authoritarian countries whose official statistics are suspect. Other country's statistics are suspect if their testing regimes are substandard.
If American states were treated as individual countries thirteen of them would be on that list. New York would be ranked between Italy and Germany.
Since the last compilation Russia has joined the list, an addition many consider to be post-mature.
AIUI epidemiologically you need to look at excess deaths over a year in a population to get a figure for the impact of a disease. (On that basis, in the U.K. at least, the swine flu outbreak of a decade ago barely made a blip in the death rate. Coronavirus disease will be different.)
Things are tightening down further in California, and here in San Francisco. Much of our bus system is scheduled to close down today (Monday). As of yesterday, they were still trying to figure out the details. Someone high up in the agency said it will be awful today, and "the worst service we've provided since 1906". (The Great Quake and resulting fire.)
AIUI epidemiologically you need to look at excess deaths over a year in a population to get a figure for the impact of a disease. (On that basis, in the U.K. at least, the swine flu outbreak of a decade ago barely made a blip in the death rate. Coronavirus disease will be different.)
This is correct. I wrote about it about 10 pages back... obviously this is a massive thread now.
The point being that there are three categories here:
1) Vulnerable people who would have died from something else if it wasn't Covid-19.
2) People who died from Covid-19 who otherwise had a normal life expectancy.
3) People who died from something else who would have survived if the healthcare system (or society at large) was not under so much pressure.
We're over 4000 deaths in the UK with people who tested positive for Covid-19 but contextually, this time of year there's around 11,000 deaths per week in a 'normal' year.
A large chunk of the Covid-19 deaths will be in box 1. Probably the majority. But dying alone is the fresh tragedy. Box 2 is really tragic and that's where a lot of the frontline staff who have died are. Box 3 is important: I am sure that there will be a spike is cardiac and stroke deaths as well.
Also in box 3 is some children. In my hospital as of 8:30 am yesterday we had 0 children with Covid-19 in the hospital. However, we are working much harder to do all the normal emergency work in this context. There was a death in the last couple of weeks of a child with Staphlococcus sepsis. Investigation is ongoing but the thinking among the paediatricians involved is that the late presentation (because of Covid-19) is why this child died when we expect most to recover from Staph sepsis.
We will only know in retrospect.
AFZ
P.S. The key message is, if your child is unwell, don't hesitate to seek help. We are set up for doing our usual service. Everything is just a bit more complex but it's much much more likely that your child has something else.
Probably worth adding that the current global daily death total attributed to COVID-19 is about 3% of the average global daily death total. Whether that means that the epidemic is killing about 3% more than would normally have died anyway may require a good deal of analysis.
But I'm with KarlB in believing that the additional strain on our health services and the consequential effects of that is of most concern. And I hope the light will have dawned that this is the consequence in the UK of significant underinvestment in both normal and contingency provisions.
Many American communities are putting out stuffed bears or other animals in their front windows or outside their front doors. That way, when families take their young children out for walks (allowed with some conditions). We only have one family in the neighborhood that has young kids. We will be putting a couple of stuffed animals out for them to see. The program is called: We Are Going On A Bear Hunt. Named after the children's book.
Our litter tray disinfectant informs me that it is effective against coronaviruses, so cats do get some.
Mr Dragon took Dragonlet2 to A&E yesterday as he was concerned about a cut inside her lip from a few days ago and 111 went 'it's a head injury, we'll just tell you to go there.' They met her at the door, took a look, said that's ok, they can look a bit odd, bye. The quickest A&E trip ever!
Feline coronavirus is quite common I think, and most cats don't get very sick. It's separate from the present species, not sure if it is a species or subspecies.
Re dogs and cats. They simply need to practice social isolation with whomever they own. Don't go to free run dog parks.
Our isolation is going easier I think than most. Third blizzard in 10 days, but it's quite warm at -7°C, up from -22 a few days ago. I've been hoping for another 6 weeks on winter, which does happen sometimes. As soon as it gets to +10°C people start wearing shorts, socks and sandals, bunnyhugs, toques and hanging around outside drinking beer and barbequing
Feline coronavirus is quite common I think, and most cats don't get very sick. It's separate from the present species, not sure if it is a species or subspecies.
I just dug out my (20 year old) molecular virology textbook to make sure I've got this exactly right. In addition to Family, Genus and species (like the rest of biology), there is something called The Baltimore Classification for viruses. Everything else on this planet has a double-stranded DNA genome of some form. The arrangements are different in bacteria (a single, circular double-stranded 'chromosome') and vertebrates (a number of paired chromosomes made up of lengths of double-stranded DNA with special ends called Telomeres) but all double-stranded DNA.
Viruses can be double-stranded DNA, single-stranded DNA, double-stranded RNA and single-stranded RNA. There are in-fact 7 classes. (Wiki article).
So Covid-19:
Baltimore class: IV (+vs sense ssRNA)
Family: Coronaviridae
Genus: Coronavirus
Species: Covid-19
Which is why talking about 'coronavirus' is a little misleading. There are a lot of species around. Covid-19 is a new species (in as much as it's newly discovered, whether it is genuinely novel is a different question). The other coronaviruses that infect other animals are not really relevant. The evidence we have thus far is that Covid-19 does not cause disease in other animals nor can animals pass it to humans. The evidence is new and changing all the time but I think this one is solid as if there was a risk of animal->human spread, I think we'd know by now, given how rapidly it has travelled around the world and how much is being written in the medical literature constantly at the moment.
Things are tightening down further in California, and here in San Francisco. Much of our bus system is scheduled to close down today (Monday). As of yesterday, they were still trying to figure out the details. Someone high up in the agency said it will be awful today, and "the worst service we've provided since 1906". (The Great Quake and resulting fire.)
Mildly amused by this story around the closing of the Church of the Holy Sepulchre.
Oh indeed. Every tile on the floor there is someone or other's responsibilty and God (?!?) help you if you step on it.
A slight exaggeration but only slight. If you want to see Christian factionalism at its ugliest, the holy places in Israel and Palestine are the place to go.
Which is why talking about 'coronavirus' is a little misleading. There are a lot of species around.
It's like, you know the giant spider downtown that sits on the buildings and sometimes eats cars? I think technically it's a mutant T. annexa wolf spider, but everyone just calls it "The Spider" and we all know what they mean.
Things are tightening down further in California, and here in San Francisco. Much of our bus system is scheduled to close down today (Monday). As of yesterday, they were still trying to figure out the details. Someone high up in the agency said it will be awful today, and "the worst service we've provided since 1906". (The Great Quake and resulting fire.)
How will carless people buy groceries?
Or, nurses or other health workers who don't have cars and need to get to work? Or, the staff at the grocery stores .... public transit is an essential service that should be maintained at the highest possible level (some reduction in frequency is inevitable as staff are off sick). I don't see the justification for closing it, that's also true of places like London which went to a Sunday service with the result that those who needed to use the Tube or buses got crammed into a much reduced number of services.
Which is why talking about 'coronavirus' is a little misleading. There are a lot of species around.
It's like, you know the giant spider downtown that sits on the buildings and sometimes eats cars? I think technically it's a mutant T. annexa wolf spider, but everyone just calls it "The Spider" and we all know what they mean.
That is brilliant. I agree that most of the time it doesn't matter in the slightest.
But every now and then you see stuff on social media or regular media talking about a totally different Coronavirus and it leads to confusion...
As an example, from a different context: E. coli 0157 is a VERY nasty infection that you really don't want. Conversely k-strain E. coli is part of the normal flora of the human intestine and you really DO want it.
Precision matters because the coronaviruses found it cats are different...
Things are tightening down further in California, and here in San Francisco. Much of our bus system is scheduled to close down today (Monday). As of yesterday, they were still trying to figure out the details. Someone high up in the agency said it will be awful today, and "the worst service we've provided since 1906". (The Great Quake and resulting fire.)
How will carless people buy groceries?
Or, nurses or other health workers who don't have cars and need to get to work? Or, the staff at the grocery stores .... public transit is an essential service that should be maintained at the highest possible level (some reduction in frequency is inevitable as staff are off sick). I don't see the justification for closing it, that's also true of places like London which went to a Sunday service with the result that those who needed to use the Tube or buses got crammed into a much reduced number of services.
Ok, I just checked. We've got 89 routes (including city buses, cable cars, various light rail, etc.). By Wednesday, we're supposed to be down to *17*. (They'd already shut down some routes, and reduced service on others.)
More than 40 percent of Muni operators are expected to be out this week in self-quarantine, so the SFMTA is planning to run just its most-used lines that provide service within one mile of all San Franciscans.
I think they're trying to protect their drivers, but still get people to essential services. If, in some cases, they're prepared to walk a mile. I'm glad I made it to the grocery store last week, by bus.
{Tangential but pleasant diversion.}
I know lots of people are fascinated by cable cars, so... Cable Car Museum.
These both have pics, but could use more. On the museum site, pay attention to the right-hand nav bar. Various things are semi tucked away. But there's a pic of the patent drawing for the original mechanism. The history site has pics tucked in at the bottom of the page.
More than 40 percent of Muni operators are expected to be out this week in self-quarantine, so the SFMTA is planning to run just its most-used lines that provide service within one mile of all San Franciscans.
I think they're trying to protect their drivers, but still get people to essential services.
Or a lot of their drivers may have potential exposures and they're trying to protect the public.
Comments
I recently (3 weeks ago) passed three large ones after a course of 2oz fresh lemon juice and 2oz olive oil 3x daily for three days. They were soft and squishy by the time they made their way out.
Not recommending it but just saying, they were causing problems and I managed to clear them without surgery.
I hope you continue well. We need you. We're here for a good time not a long time.
AFF
This reminds me of the snarky and overly-semantic parsing during the '80s and '90s about how no one had actually died of AIDS. It just weakened their immune system to the point where something else killed them. This seems like a similar level of distinction without a difference.
If only there were some way to link to information, possibly through some world wide network of information, we wouldn't have to rely on "some graph @Moo saw weeks ago when there were half as many infections and one-third as many deaths". (Going from the data from Italy two weeks ago. If you go back further the numbers are even lower.)
Another possibility is that those with relevant pre-existing conditions die quickly of COVID-19 while healthier people take longer. It's really difficult (and irresponsible) to draw those kind of conclusions from an ongoing outbreak. For example, on March 22 (two "weeks ago") Italy had 5,476 deaths attributed to COVID-19, 7,024 people who had recovered from COVID-19, and 46,638 people who were known to be actively infected with COVID-19. If I was looking at those numbers I wouldn't draw the conclusions @Moo reached, I'd note that the vast majority of cases (nearly 4/5ths) hadn't had an outcome yet and while we had some idea who was most at risk that didn't necessarily translate into low risk of mortality for those still infected.
For reference, here is an animated graph that shows the top 15 causes of death in the U.S. over time from March 1 through yesterday (April 4). On March 1 COVID-19 was at the bottom of the list. On April 4 it was #3 after heart disease and cancer and right above "accidents".
The listings are in the format:
X. Country - [# of known cases] ([active] / [recovered] / [dead]) [%fatality rate]
Fatality rates are only listed for countries where the number of resolved cases (recovered + dead) exceeds the number of known active cases by a ratio of at least 2:1. Italics indicate authoritarian countries whose official statistics are suspect. Other country's statistics are suspect if their testing regimes are substandard.
If American states were treated as individual countries thirteen of them would be on that list. New York would be ranked between Italy and Germany.
Since the last compilation Russia has joined the list, an addition many consider to be post-mature.
Assume it does. And dogs. And birds. The 3rd more likely than the 2nd?
This is correct. I wrote about it about 10 pages back... obviously this is a massive thread now.
The point being that there are three categories here:
1) Vulnerable people who would have died from something else if it wasn't Covid-19.
2) People who died from Covid-19 who otherwise had a normal life expectancy.
3) People who died from something else who would have survived if the healthcare system (or society at large) was not under so much pressure.
We're over 4000 deaths in the UK with people who tested positive for Covid-19 but contextually, this time of year there's around 11,000 deaths per week in a 'normal' year.
A large chunk of the Covid-19 deaths will be in box 1. Probably the majority. But dying alone is the fresh tragedy. Box 2 is really tragic and that's where a lot of the frontline staff who have died are. Box 3 is important: I am sure that there will be a spike is cardiac and stroke deaths as well.
Also in box 3 is some children. In my hospital as of 8:30 am yesterday we had 0 children with Covid-19 in the hospital. However, we are working much harder to do all the normal emergency work in this context. There was a death in the last couple of weeks of a child with Staphlococcus sepsis. Investigation is ongoing but the thinking among the paediatricians involved is that the late presentation (because of Covid-19) is why this child died when we expect most to recover from Staph sepsis.
We will only know in retrospect.
AFZ
P.S. The key message is, if your child is unwell, don't hesitate to seek help. We are set up for doing our usual service. Everything is just a bit more complex but it's much much more likely that your child has something else.
Statement from the Royal College of Paediatrics and Child Health: https://www.rcpch.ac.uk/resources/delayed-presentation-during-covid-19-position
But I'm with KarlB in believing that the additional strain on our health services and the consequential effects of that is of most concern. And I hope the light will have dawned that this is the consequence in the UK of significant underinvestment in both normal and contingency provisions.
I'm with DT. A return to "politics as usual" seems less likely to me.
The trouble is that politics could swing even more strongly to the Right, rather than to the Left.
Time will tell - meanwhile, no doubt Starmer is sharpening his weapons, ready for the fray...
Call me a cockeyed optimist but what I hope for is a reduction in the politics of greed. We're better together.
Oh indeed. Every tile on the floor there is someone or other's responsibilty and God (?!?) help you if you step on it.
Mr Dragon took Dragonlet2 to A&E yesterday as he was concerned about a cut inside her lip from a few days ago and 111 went 'it's a head injury, we'll just tell you to go there.' They met her at the door, took a look, said that's ok, they can look a bit odd, bye. The quickest A&E trip ever!
Re dogs and cats. They simply need to practice social isolation with whomever they own. Don't go to free run dog parks.
Our isolation is going easier I think than most. Third blizzard in 10 days, but it's quite warm at -7°C, up from -22 a few days ago. I've been hoping for another 6 weeks on winter, which does happen sometimes. As soon as it gets to +10°C people start wearing shorts, socks and sandals, bunnyhugs, toques and hanging around outside drinking beer and barbequing
(bunnyhugs are called hoodies elsewhere)
I just dug out my (20 year old) molecular virology textbook to make sure I've got this exactly right. In addition to Family, Genus and species (like the rest of biology), there is something called The Baltimore Classification for viruses. Everything else on this planet has a double-stranded DNA genome of some form. The arrangements are different in bacteria (a single, circular double-stranded 'chromosome') and vertebrates (a number of paired chromosomes made up of lengths of double-stranded DNA with special ends called Telomeres) but all double-stranded DNA.
Viruses can be double-stranded DNA, single-stranded DNA, double-stranded RNA and single-stranded RNA. There are in-fact 7 classes. (Wiki article).
So Covid-19:
Baltimore class: IV (+vs sense ssRNA)
Family: Coronaviridae
Genus: Coronavirus
Species: Covid-19
Which is why talking about 'coronavirus' is a little misleading. There are a lot of species around. Covid-19 is a new species (in as much as it's newly discovered, whether it is genuinely novel is a different question). The other coronaviruses that infect other animals are not really relevant. The evidence we have thus far is that Covid-19 does not cause disease in other animals nor can animals pass it to humans. The evidence is new and changing all the time but I think this one is solid as if there was a risk of animal->human spread, I think we'd know by now, given how rapidly it has travelled around the world and how much is being written in the medical literature constantly at the moment.
AFZ
How will carless people buy groceries?
A slight exaggeration but only slight. If you want to see Christian factionalism at its ugliest, the holy places in Israel and Palestine are the place to go.
But I appreciate the irony of the situation re the keys...
It's like, you know the giant spider downtown that sits on the buildings and sometimes eats cars? I think technically it's a mutant T. annexa wolf spider, but everyone just calls it "The Spider" and we all know what they mean.
Indeed. I apologize that that wasn't, if not obvious, then inferrable. (Except clearly it was inferrable, at least to some.)
That is brilliant. I agree that most of the time it doesn't matter in the slightest.
But every now and then you see stuff on social media or regular media talking about a totally different Coronavirus and it leads to confusion...
As an example, from a different context: E. coli 0157 is a VERY nasty infection that you really don't want. Conversely k-strain E. coli is part of the normal flora of the human intestine and you really DO want it.
Precision matters because the coronaviruses found it cats are different...
AFZ
Ok, I just checked. We've got 89 routes (including city buses, cable cars, various light rail, etc.). By Wednesday, we're supposed to be down to *17*. (They'd already shut down some routes, and reduced service on others.)
From SF Gate, a branch of the SF Chronicle:
I think they're trying to protect their drivers, but still get people to essential services. If, in some cases, they're prepared to walk a mile.
{Tangential but pleasant diversion.}
I know lots of people are fascinated by cable cars, so...
Cable Car Museum.
Cable Car History (SFMTA).
These both have pics, but could use more. On the museum site, pay attention to the right-hand nav bar. Various things are semi tucked away. But there's a pic of the patent drawing for the original mechanism. The history site has pics tucked in at the bottom of the page.
(What to pray eh?!)
Or a lot of their drivers may have potential exposures and they're trying to protect the public.