Well said, thank you

Do all the guys lamenting the closing of the rodeo still think it was a bad idea?

angus55 said:

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k2aggie07 said:

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OP is infectious disease physician.

---

Which to me is a like a fancy mechanic. A high paid guesser.

---

But we can guess using big words!

With every 10k cases reported the corresponding mortality rate is dropping. Where are the deaths?

They will be happening in the next week, or 2, or 10...they are coming just look at the damn graphs.

oldarmy1 said:

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With every 10k cases reported the corresponding mortality rate is dropping. Where are the deaths?

---

They are coming. Just wait. Keep waiting. They're coming. Be patient. It's inevitable. Just wait 10 more days.

Haha you guys

Quote:

---

The range for death to hospitalization for COVID19, using CDC's same numbers linked above, was 5-17% of hospitalizations end in fatality. Not sure why that's more or less relevant than overall CFR.

---

Thanks for the China funny data callout. Made me laugh.

I don't believe we can compare CFRs on COVID-19 and the flu since the CDC uses its estimate of flu cases for that. What if we have 10-100x more infections of COVID-19 than we actually know? That radically changes the CFR for C19. We're only testing those the CDC allows us to test in hospitals right now so we still don't know what we don't know.

It seems that we might be getting positive tests from the most critical, right? If you're the CDC and you are rationing tests, please tell me who gets the test right now...this instant.

Patient A: Dear, CDC. I have a patient who is 82 years old, has several comorbidities, and recently went to China?
Patient B: Dear, CDC. I have a patient who is 25 years old, in good health, and has no respiratory issues? No international travel history?
Patient C: Dear CDC. I have an NBA player here.

If you guessed A and C, you would be correct. Now, let's toss out patient C since there are too few of these to significantly affect the overall sample size. By selecting Patient A for testing, you allow for better care for the highest risk patient, which is the right decision. At the same you will skew the data to show a larger number of deaths per confirmed case since you're testing is skewed toward the highest risk patients.

Make sense?

Philip J Fry said:

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They will once they start flattening out. We don't know yet when that will happen.

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But we do know how many will die. Just be patient.

k2aggie07 said:

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But no one is going to be convinced by someone else saying there are no firebreaks. People have to come to terms with that fact. What stops it?

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Individual responsibility.

oldarmy1 said:

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With every 10k cases reported the corresponding mortality rate is dropping. Where are the deaths?

---

Numerator is lagging an exponential denominator by 3-5 days.

Do you really think the people who do this for a living haven't considered undetected cases?

Every paper being published right now is making a distinction between symptomatic case fatality (sCFR) and infected fatality (IFR). They're using a bunch of different metrics to try to back into the number of undetected cases. Read this, it really is fascinating. These folks aren't dumb. They're not missing glaringly obvious errors in their methods. They know they have ascertainment bias. They know there are cases they're missing.

And if we can't compare CFR of COVID19 to seasonal flu, can we drop the seasonal flu comparison altogether then?????

Troutslime said:

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k2aggie07 said:

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But no one is going to be convinced by someone else saying there are no firebreaks. People have to come to terms with that fact. What stops it?

---

Individual responsibility.

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You seen the average individual?

Bo Darville said:

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Troutslime said:

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k2aggie07 said:

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But no one is going to be convinced by someone else saying there are no firebreaks. People have to come to terms with that fact. What stops it?

---

Individual responsibility.

---

You seen the average individual?

---

Been looking at you for 3 days.

benchmark said:

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oldarmy1 said:

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With every 10k cases reported the corresponding mortality rate is dropping. Where are the deaths?

---

Numerator is lagging the denominator by 3-5 days.

---

Can't be emphasized enough. A virus isn't a car crash... you don't get diagnosed and your outcome is binary and defined in that instant. Deaths is most certainly lagged by this much if not more than that. Huge deal given the growth rate of this thing.

Italy's rates have gotten awful as they've run out of medical infrastructure and they are running exponentially too... I think there's a fair shot the 3-4% number would be low worldwide if we didn't try to limit the cases right now.

benchmark said:

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oldarmy1 said:

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With every 10k cases reported the corresponding mortality rate is dropping. Where are the deaths?

---

Numerator is lagging the denominator by 3-5 days.

---

Numerator? Denominator? Are those complex or simple math words?

Can some smart guys explain them words to me?

benchmark said:

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oldarmy1 said:

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With every 10k cases reported the corresponding mortality rate is dropping. Where are the deaths?

---

Numerator is lagging the denominator by 3-5 days.

---

This is true. As testing ramps up, the CFR should initially drop. I've been watching the USA CFR fall from about 1.8% to 1.25% recently. Perhaps it starts rising again or perhaps the drug cocktail is prescribed enough off label that we stamp this virus out altogether.

The guy who started this thread said best available data points to 0.5-1% final infection fatality ratio. The really basic numbers we're using now (deaths / known cases or deaths / closed cases) are known to be extremely unreliable, especially early on.

The more you test, especially when we get antibody tests, the more you'll see. But deaths are growing exponentially. Both here and everywhere else... and that makes sense. No matter what the actual percentage of deaths to cases is, if cases grow exponentially, deaths will too. (And I mean real cases, not known).

Well, the hospital data is sketchy at best, but based on what's been reported:

Of the 600 cases that were serious, 70% of them ended in death.

We have 2000 documented hospitalized cases now. Once the hospitals run out of ventilators, that 1% death rate is going to start increasing.

dBoy99 said:

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benchmark said:

---

oldarmy1 said:

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With every 10k cases reported the corresponding mortality rate is dropping. Where are the deaths?

---

Numerator is lagging the denominator by 3-5 days.

---

Numerator? Denominator? Are those complex or simple math words?

Can some smart guys explain them words to me?

---

At those point there's a decent chance it may actually have to be explained.

FriendlyAg said:

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Rattler12 said:

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Sid Farkas said:

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Social Distanced said:

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He doesn't seem angry to me.

---

Yeah. Not angry. But really really wrong

When this is over we will all likely know and love someone who either dies or is permanently damaged by the virus, even with extreme measures in place

However it could be even worse if we just relax and go back to normal life now.

I happen to believe government involvement will almost completely recede when the virus does. its easy to get frustrated when the people who disagree seem to have no appreciation for the complexity of the situation and simply go full throttle on the "evil gubmit" meme (it just sounds so dumb in this situation)

...I said it here before: anyone who ignores the government orders and their families should be denied a hospital bed and ventilator and be held criminally and civilly liable for anyone they make sick (directly or indirectly)

---

I already have 15, 20 maybe 30 people or more that I have known and loved and that have died from something. Life has gone on. Deaths are just as much a part of living as births are. Bad things happen to good people. This will pass and life will go on. I choose not to live in fear and panic mode. Does that make me really really wrong?

---

No one is disagreeing. The measures that are being taken are there to reduce death. Are you against reducing death?

---

Are you Ok with taking us back 200 years on an economic basis? I'm in if you're in.

aggie2812-2 said:

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How many positives vs tested?

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Obviously testing is a rate limiting state, but we're starting to get a feel for the real disease burden and soon extrapolating based on positive test numbers, rates and distribution like we can with flu will become possible.

That's not what I meant, and it's nonsense besides. If that's what we're hoping on we're screwed anyway. We can't individual-responsibility our way into widely using flu vaccines or washing our hands without mass hysteria driving our OODA loop.

What stops an epidemic? How does it stop?

Infection_Ag11 said:

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Already 14k new US cases since yesterday and by the end of the day we'll have more or less doubled in 24 hours (24k to 45-48k estimate).

Worldwide we'll surpass 500k by tomorrow morning and hit a million sometime early Wednesday. We're still at least a week away from curbing the exconential growth internationally if our current measures work and it's essentially a mathematical and medical certainty we'll hit 10 million cases world wide by the start of next week.

A lot of people are about to get a very disturbing math lesson.

---

More cases are showing up because we are better at testing.

No matter how good you are at testing you can't find cases that aren't there.

Troutslime said:

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Gordo14 said:

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Troutslime said:

---

Quote:

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We do not know if the projections (death) are materializing or not. We also dont know if the measure are working or not. Its March 22.

Edit and I'm not sure what historical data you are referring too. There are plenty of historical pandemics that were far worse or far better than this.

---

Exponential is the new buzzword yet nobody has brought up proportional. If the flu kills X, and the Swine flu kills Y, and pneumonia kills Z, why haven't past government responses been proportional? (Please don't go into infection rate because it's not relevant to my point). CV shows up, it becomes a media firestorm and now here we are. WTF? If 1.5% death rate is the norm, what can we expect for .5%?

Besides, if they really believed what they were saying (politicians) there response is woefully inadequate.

If the argument moves to "overwhelming the system", why didn't we address it in 2009 during the Swine flu? Is it because there wasn't a problem? Probably. If the concern is that CV will overwhelm it, why not focus on helping hospitals out? The solutions being implemented don't match the crime so to speak. Also, I'm 55 and have yet to see an accurate government prediction, yet I'm supposed to believe this one. I'm not a skeptic, I'm a product. A product of failed government. Don't blame me.

---

Good thing plenty of people whp are experts in the field and don't work for the government are also equally concerned. And if you ignore that then you can always fall back on your gut instinct, which I'm sure is well informed.

What should their response be then? The government is using every tool it has besides forcing people to stay home - what is inadequate about that?

Swine Flu was a concern. Schools were shut down... however, hospitalization rates were lower, it was less contagiois, it was less likely to cause death, and humans had some natural immunity to it being exposed to the seasonal flu regularly. Our body was well equipped to have an immune response on day one. Also the incubation period was shorter. CV19 is worse in every category I just described than Swine Flu. Therefore, it requires a different response. The problem is hospitals only have so much physical equipment to deal with things like this. Sure they are asking for aid from the government, but part of the issue is hospital beds and ventilators for which there isn't a massive supply sitting on the open market ready to be bought. PPE is well short of where it needs to be. If a hospital has say 110% of the max capacity they've ever needed of ICU beds and ventilators, and something puts some 3% of the local population or more into a condition where they need equipment on top of the standard baseline demand for that equipment... Then you end up with many times the demand you have supply for. Again the problem is we need to slow the rate of people gettint sick down. There's only one way to do that when we have no real medical tools to slow or stop this thing - keep people away from each other. 80% of infections have been passed by people who had no symptoms, yet. The only way to stop transmission is to drop those infections.

---

What would you expect "experts" to say? They have no skin in the game.

Are they responsible for the results of their views? No. Hell, even the politicians aren't when you boil it down.

---

You have zero credibility. Your argument is "WAHHHHHHHHHH, life has changed! NOT FAIR!"

Rattler12 said:

---

FriendlyAg said:

---

Rattler12 said:

---

Sid Farkas said:

---

Social Distanced said:

---

He doesn't seem angry to me.

---

Yeah. Not angry. But really really wrong

When this is over we will all likely know and love someone who either dies or is permanently damaged by the virus, even with extreme measures in place

However it could be even worse if we just relax and go back to normal life now.

I happen to believe government involvement will almost completely recede when the virus does. its easy to get frustrated when the people who disagree seem to have no appreciation for the complexity of the situation and simply go full throttle on the "evil gubmit" meme (it just sounds so dumb in this situation)

...I said it here before: anyone who ignores the government orders and their families should be denied a hospital bed and ventilator and be held criminally and civilly liable for anyone they make sick (directly or indirectly)

---

I already have 15, 20 maybe 30 people or more that I have known and loved and that have died from something. Life has gone on. Deaths are just as much a part of living as births are. Bad things happen to good people. This will pass and life will go on. I choose not to live in fear and panic mode. Does that make me really really wrong?

---

No one is disagreeing. The measures that are being taken are there to reduce death. Are you against reducing death?

---

Are you Ok with taking us back 200 years on an economic basis? I'm in if you're in.

---

No, but I am also not going to choose saving money over saving a million people's lives. The market will rebound. Don't sell. Buy continuously and your cost average will go down.

FriendlyAg said:

---

Troutslime said:

---

Gordo14 said:

---

Troutslime said:

---

Quote:

---

We do not know if the projections (death) are materializing or not. We also dont know if the measure are working or not. Its March 22.

Edit and I'm not sure what historical data you are referring too. There are plenty of historical pandemics that were far worse or far better than this.

---

Exponential is the new buzzword yet nobody has brought up proportional. If the flu kills X, and the Swine flu kills Y, and pneumonia kills Z, why haven't past government responses been proportional? (Please don't go into infection rate because it's not relevant to my point). CV shows up, it becomes a media firestorm and now here we are. WTF? If 1.5% death rate is the norm, what can we expect for .5%?

Besides, if they really believed what they were saying (politicians) there response is woefully inadequate.

If the argument moves to "overwhelming the system", why didn't we address it in 2009 during the Swine flu? Is it because there wasn't a problem? Probably. If the concern is that CV will overwhelm it, why not focus on helping hospitals out? The solutions being implemented don't match the crime so to speak. Also, I'm 55 and have yet to see an accurate government prediction, yet I'm supposed to believe this one. I'm not a skeptic, I'm a product. A product of failed government. Don't blame me.

---

Good thing plenty of people whp are experts in the field and don't work for the government are also equally concerned. And if you ignore that then you can always fall back on your gut instinct, which I'm sure is well informed.

What should their response be then? The government is using every tool it has besides forcing people to stay home - what is inadequate about that?

Swine Flu was a concern. Schools were shut down... however, hospitalization rates were lower, it was less contagiois, it was less likely to cause death, and humans had some natural immunity to it being exposed to the seasonal flu regularly. Our body was well equipped to have an immune response on day one. Also the incubation period was shorter. CV19 is worse in every category I just described than Swine Flu. Therefore, it requires a different response. The problem is hospitals only have so much physical equipment to deal with things like this. Sure they are asking for aid from the government, but part of the issue is hospital beds and ventilators for which there isn't a massive supply sitting on the open market ready to be bought. PPE is well short of where it needs to be. If a hospital has say 110% of the max capacity they've ever needed of ICU beds and ventilators, and something puts some 3% of the local population or more into a condition where they need equipment on top of the standard baseline demand for that equipment... Then you end up with many times the demand you have supply for. Again the problem is we need to slow the rate of people gettint sick down. There's only one way to do that when we have no real medical tools to slow or stop this thing - keep people away from each other. 80% of infections have been passed by people who had no symptoms, yet. The only way to stop transmission is to drop those infections.

---

What would you expect "experts" to say? They have no skin in the game.

Are they responsible for the results of their views? No. Hell, even the politicians aren't when you boil it down.

---

You have zero credibility. Your argument is "WAHHHHHHHHHH, life has changed! NOT FAIR!"

---

Thanks for bringing your tactful insight to the discussion.

FriendlyAg said:

---

The_Fox said:

---

FriendlyAg said:

---

Rattler12 said:

---

Sid Farkas said:

---

Social Distanced said:

---

He doesn't seem angry to me.

---

Yeah. Not angry. But really really wrong

When this is over we will all likely know and love someone who either dies or is permanently damaged by the virus, even with extreme measures in place

However it could be even worse if we just relax and go back to normal life now.

I happen to believe government involvement will almost completely recede when the virus does. its easy to get frustrated when the people who disagree seem to have no appreciation for the complexity of the situation and simply go full throttle on the "evil gubmit" meme (it just sounds so dumb in this situation)

...I said it here before: anyone who ignores the government orders and their families should be denied a hospital bed and ventilator and be held criminally and civilly liable for anyone they make sick (directly or indirectly)

---

I already have 15, 20 maybe 30 people or more that I have known and loved and that have died from something. Life has gone on. Deaths are just as much a part of living as births are. Bad things happen to good people. This will pass and life will go on. I choose not to live in fear and panic mode. Does that make me really really wrong?

---

No one is disagreeing. The measures that are being taken are there to reduce death. Are you against reducing death?

---

Possibly? What is the economic cost per life saved?

---

Let me rephrase-- If a doctor looks you in the eyes and ask you to do your part to stay home in order to save someone's life, would you?

---

I already am and a Dr didn't have to ask me to do it.

Search key is your friend. Troutslime was the poster that said it was silly for us to shut the schools down, employees shouldn't be sending "concerning" employees home, and didn't think there would be any kind of issues with hospitals being over-run.

So pretty much every single thing that medical professionals, the CDC, and White House alike have all acknowledged or suggested, Troutslime said a week or so ago wasn't necessary or wasn't going to happen.

Basically he's a poster worth bookmarking as the ultimate fade.

FriendlyAg said:

---

Rattler12 said:

---

FriendlyAg said:

---

Rattler12 said:

---

Sid Farkas said:

---

Social Distanced said:

---

He doesn't seem angry to me.

---

Yeah. Not angry. But really really wrong

When this is over we will all likely know and love someone who either dies or is permanently damaged by the virus, even with extreme measures in place

However it could be even worse if we just relax and go back to normal life now.

I happen to believe government involvement will almost completely recede when the virus does. its easy to get frustrated when the people who disagree seem to have no appreciation for the complexity of the situation and simply go full throttle on the "evil gubmit" meme (it just sounds so dumb in this situation)

...I said it here before: anyone who ignores the government orders and their families should be denied a hospital bed and ventilator and be held criminally and civilly liable for anyone they make sick (directly or indirectly)

---

I already have 15, 20 maybe 30 people or more that I have known and loved and that have died from something. Life has gone on. Deaths are just as much a part of living as births are. Bad things happen to good people. This will pass and life will go on. I choose not to live in fear and panic mode. Does that make me really really wrong?

---

No one is disagreeing. The measures that are being taken are there to reduce death. Are you against reducing death?

---

Are you Ok with taking us back 200 years on an economic basis? I'm in if you're in.

---

No, but I am also not going to choose saving money over saving a million people's lives. The market will rebound. Don't sell. Buy continuously and your cost average will go down.

---

Pensions? People at retirement age don't matter? You assume everyone has time to recover.

Troutslime said:

---

FriendlyAg said:

---

Troutslime said:

---

Gordo14 said:

---

Troutslime said:

---

Quote:

---

We do not know if the projections (death) are materializing or not. We also dont know if the measure are working or not. Its March 22.

Edit and I'm not sure what historical data you are referring too. There are plenty of historical pandemics that were far worse or far better than this.

---

Exponential is the new buzzword yet nobody has brought up proportional. If the flu kills X, and the Swine flu kills Y, and pneumonia kills Z, why haven't past government responses been proportional? (Please don't go into infection rate because it's not relevant to my point). CV shows up, it becomes a media firestorm and now here we are. WTF? If 1.5% death rate is the norm, what can we expect for .5%?

Besides, if they really believed what they were saying (politicians) there response is woefully inadequate.

If the argument moves to "overwhelming the system", why didn't we address it in 2009 during the Swine flu? Is it because there wasn't a problem? Probably. If the concern is that CV will overwhelm it, why not focus on helping hospitals out? The solutions being implemented don't match the crime so to speak. Also, I'm 55 and have yet to see an accurate government prediction, yet I'm supposed to believe this one. I'm not a skeptic, I'm a product. A product of failed government. Don't blame me.

---

Good thing plenty of people whp are experts in the field and don't work for the government are also equally concerned. And if you ignore that then you can always fall back on your gut instinct, which I'm sure is well informed.

What should their response be then? The government is using every tool it has besides forcing people to stay home - what is inadequate about that?

Swine Flu was a concern. Schools were shut down... however, hospitalization rates were lower, it was less contagiois, it was less likely to cause death, and humans had some natural immunity to it being exposed to the seasonal flu regularly. Our body was well equipped to have an immune response on day one. Also the incubation period was shorter. CV19 is worse in every category I just described than Swine Flu. Therefore, it requires a different response. The problem is hospitals only have so much physical equipment to deal with things like this. Sure they are asking for aid from the government, but part of the issue is hospital beds and ventilators for which there isn't a massive supply sitting on the open market ready to be bought. PPE is well short of where it needs to be. If a hospital has say 110% of the max capacity they've ever needed of ICU beds and ventilators, and something puts some 3% of the local population or more into a condition where they need equipment on top of the standard baseline demand for that equipment... Then you end up with many times the demand you have supply for. Again the problem is we need to slow the rate of people gettint sick down. There's only one way to do that when we have no real medical tools to slow or stop this thing - keep people away from each other. 80% of infections have been passed by people who had no symptoms, yet. The only way to stop transmission is to drop those infections.

---

What would you expect "experts" to say? They have no skin in the game.

Are they responsible for the results of their views? No. Hell, even the politicians aren't when you boil it down.

---

You have zero credibility. Your argument is "WAHHHHHHHHHH, life has changed! NOT FAIR!"

---

Thanks for bringing your tactful insight to the discussion.

---

I have tried tact... Look at my any number of responses. It's not good enough for you. You just stick your head further into the sand.

k2aggie07 said:

---

Do you really think the people who do this for a living haven't considered undetected cases?

Every paper being published right now is making a distinction between symptomatic case fatality (sCFR) and infected fatality (IFR). They're using a bunch of different metrics to try to back into the number of undetected cases. Read this, it really is fascinating. These folks aren't dumb. They're not missing glaringly obvious errors in their methods. They know they have ascertainment bias. They know there are cases they're missing.

And if we can't compare CFR of COVID19 to seasonal flu, can we drop the seasonal flu comparison altogether then?????

---

This x 1000. All the experts have been saying as testing increases the mortality rate will decrease. If all you care about is mortality rate you are missing the bigger picture which is just as important in the rate of infection and estimates for total infection which make the flu look like the common cold.

Keep spouting off that number. 1M...it makes you and the rest who spout it off look foolish.

FriendlyAg said:

---

Troutslime said:

---

FriendlyAg said:

---

Troutslime said:

---

Gordo14 said:

---

Troutslime said:

---

Quote:

---

We do not know if the projections (death) are materializing or not. We also dont know if the measure are working or not. Its March 22.

Edit and I'm not sure what historical data you are referring too. There are plenty of historical pandemics that were far worse or far better than this.

---

Exponential is the new buzzword yet nobody has brought up proportional. If the flu kills X, and the Swine flu kills Y, and pneumonia kills Z, why haven't past government responses been proportional? (Please don't go into infection rate because it's not relevant to my point). CV shows up, it becomes a media firestorm and now here we are. WTF? If 1.5% death rate is the norm, what can we expect for .5%?

Besides, if they really believed what they were saying (politicians) there response is woefully inadequate.

If the argument moves to "overwhelming the system", why didn't we address it in 2009 during the Swine flu? Is it because there wasn't a problem? Probably. If the concern is that CV will overwhelm it, why not focus on helping hospitals out? The solutions being implemented don't match the crime so to speak. Also, I'm 55 and have yet to see an accurate government prediction, yet I'm supposed to believe this one. I'm not a skeptic, I'm a product. A product of failed government. Don't blame me.

---

Good thing plenty of people whp are experts in the field and don't work for the government are also equally concerned. And if you ignore that then you can always fall back on your gut instinct, which I'm sure is well informed.

What should their response be then? The government is using every tool it has besides forcing people to stay home - what is inadequate about that?

Swine Flu was a concern. Schools were shut down... however, hospitalization rates were lower, it was less contagiois, it was less likely to cause death, and humans had some natural immunity to it being exposed to the seasonal flu regularly. Our body was well equipped to have an immune response on day one. Also the incubation period was shorter. CV19 is worse in every category I just described than Swine Flu. Therefore, it requires a different response. The problem is hospitals only have so much physical equipment to deal with things like this. Sure they are asking for aid from the government, but part of the issue is hospital beds and ventilators for which there isn't a massive supply sitting on the open market ready to be bought. PPE is well short of where it needs to be. If a hospital has say 110% of the max capacity they've ever needed of ICU beds and ventilators, and something puts some 3% of the local population or more into a condition where they need equipment on top of the standard baseline demand for that equipment... Then you end up with many times the demand you have supply for. Again the problem is we need to slow the rate of people gettint sick down. There's only one way to do that when we have no real medical tools to slow or stop this thing - keep people away from each other. 80% of infections have been passed by people who had no symptoms, yet. The only way to stop transmission is to drop those infections.

---

What would you expect "experts" to say? They have no skin in the game.

Are they responsible for the results of their views? No. Hell, even the politicians aren't when you boil it down.

---

You have zero credibility. Your argument is "WAHHHHHHHHHH, life has changed! NOT FAIR!"

---

Thanks for bringing your tactful insight to the discussion.

---

I have tried tact... Look at my any number of responses. It's not good enough for you. You just stick your head further into the sand.

---

You sure are convinced it's not your head in the sand.

Where have you and I traded discussion?