Author Topic: How long can we wait while flattening the curve?  (Read 675272 times)

BostonBrit

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Re: How long can we wait while flattening the curve?
« Reply #400 on: April 02, 2020, 10:27:50 PM »
But how many people get the flu and never get tested or report it? You cannot take the numbers from flu or anything else as the true number of people that have it as many just as with Covid do not report or seek medical treatment.


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So 20,000 people a year die from the flu... and 5,000 people have died from this in the last week... with rates expected to double every 3 days.

So same-same.
« Last Edit: April 02, 2020, 10:32:05 PM by BostonBrit »

Travis

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Re: How long can we wait while flattening the curve?
« Reply #401 on: April 03, 2020, 01:09:11 AM »
But how many people get the flu and never get tested or report it? You cannot take the numbers from flu or anything else as the true number of people that have it as many just as with Covid do not report or seek medical treatment.


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So 20,000 people a year die from the flu... and 5,000 people have died from this in the last week... with rates expected to double every 3 days.

So same-same.

In the last month I've seen a number of posts that look like "X thousands die from the flu each year. This is no big deal." If the flu infection/death numbers are true and for the moment comparable to COVID-19 numbers, why do we not hear of ERs and ICUs being crushed with flu cases each year?

MoseyingAlong

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Re: How long can we wait while flattening the curve?
« Reply #402 on: April 03, 2020, 01:26:41 AM »
But how many people get the flu and never get tested or report it? You cannot take the numbers from flu or anything else as the true number of people that have it as many just as with Covid do not report or seek medical treatment.


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So 20,000 people a year die from the flu... and 5,000 people have died from this in the last week... with rates expected to double every 3 days.

So same-same.

In the last month I've seen a number of posts that look like "X thousands die from the flu each year. This is no big deal." If the flu infection/death numbers are true and for the moment comparable to COVID-19 numbers, why do we not hear of ERs and ICUs being crushed with flu cases each year?

Because the flu is business as usual and we plan for (try to staff for) the annual fullhouse. Some years it's worse than anticipated and the ED overflows.
COVID19 is worse, more contagious and deadly, but a whole lot of people don't realize how bad the flu is most years because we're just used to it.

MoseyingAlong

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Re: How long can we wait while flattening the curve?
« Reply #403 on: April 03, 2020, 01:36:25 AM »

In the last month I've seen a number of posts that look like "X thousands die from the flu each year. This is no big deal." If the flu infection/death numbers are true and for the moment comparable to COVID-19 numbers, why do we not hear of ERs and ICUs being crushed with flu cases each year?

Because the flu is business as usual and we plan for (try to staff for) the annual fullhouse. Some years it's worse than anticipated and the ED overflows.
COVID19 is worse, more contagious and deadly, but a whole lot of people don't realize how bad the flu is most years because we're just used to it.

Adding. The CDC reports that there have been 155 pediatric deaths from the flu this season. How many of them have been front page news?
The flu is a serious problem that we don't treat that way.

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #404 on: April 03, 2020, 03:04:59 AM »
Far fewer people with the flu require ventilators. There's just a higher level of care - more equipment, more staff, etc - with this thing. As well remember that this is coming as well as the flu, not instead of it. It's like saying, "why are you worried about a big natural gas bill? You get big electricity bills all the time."

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Re: How long can we wait while flattening the curve?
« Reply #405 on: April 03, 2020, 03:15:01 AM »
Being as I am a tad older than the 18 - 44 age group, my death rate is also higher.  What I am looking at is not my chance of dying of covid-19 as against the flu (and I remember having the flu as an adult, it was nasty and for one night in particular rather worrying) but my relative chance of dying of covid-19 as against anything else.  Given that I have had a reassuringly healthy report on my cardiovascular system, there is little to no cancer or dementia in my family background and my driving is unadventurously slow and local, covid-19 is probably my biggest risk of death in a very long time.  Fortunately I'm FIREd and my social distancing/social isolation is no real loss to the economy.

AnnaGrowsAMustache

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Re: How long can we wait while flattening the curve?
« Reply #406 on: April 03, 2020, 03:45:15 AM »
But how many people get the flu and never get tested or report it? You cannot take the numbers from flu or anything else as the true number of people that have it as many just as with Covid do not report or seek medical treatment.


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So 20,000 people a year die from the flu... and 5,000 people have died from this in the last week... with rates expected to double every 3 days.

So same-same.

In the last month I've seen a number of posts that look like "X thousands die from the flu each year. This is no big deal." If the flu infection/death numbers are true and for the moment comparable to COVID-19 numbers, why do we not hear of ERs and ICUs being crushed with flu cases each year?

The flu is a known seasonal factor that is planned for. Staff are vaccinated against it, and treatment options are well explored.

Corona virus is crashing the system because
- we were not expecting it and were not prepared with existing resources
- staff are not immune to it and have to be stood down after each exposure, sometimes dozens at a time
- we don't know how to treat it, so we're only treating the results, which is why people end up on ventilators at much higher rates than the flu
- people are taking a long time to die from corona virus compared to the flu, so taking up resources for longer
- corona is far more infectious than the flu, so the cases are increasing, not dropping off
- the death rate of corona is far higher than the flu, completely apart from the fact that many are dying because of the crashed health system
- the response to corona has been poor, in part because of the factors above but also because of political considerations. The flu response is rarely impeded by political factors. We don't see every year a president whining about the amount of PPE that has been requested for flu. No politician is trying to cover their arse in an election year because of flu.

YttriumNitrate

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Re: How long can we wait while flattening the curve?
« Reply #407 on: April 03, 2020, 06:50:55 AM »
That said, the burden (an estimated 41,000,000 illnesses and 60,000 deaths) is .13%. You moved the decimal place on your numbers for some reason. -W

Walt, 41 million flu illnesses everyone, the numbers I quoted are "for the 18-49 year year old bracket" since your previous comments specified 22 year olds. In 2017-2018, there were an estimated 14,428,065 flu illnesses in that demographic, with ~2,803 deaths. That's an estimated 0.019% mortality rate for 18-49 year olds.
« Last Edit: April 03, 2020, 07:02:19 AM by YttriumNitrate »

Davnasty

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Re: How long can we wait while flattening the curve?
« Reply #408 on: April 03, 2020, 07:28:11 AM »
But how many people get the flu and never get tested or report it? You cannot take the numbers from flu or anything else as the true number of people that have it as many just as with Covid do not report or seek medical treatment.


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Typically when you read stats on the flu they're adjusted to estimate total cases, not just confirmed cases.

I haven't fact-checked anyone's data in this thread, but this is probably a safe assumption.

waltworks

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Re: How long can we wait while flattening the curve?
« Reply #409 on: April 03, 2020, 08:21:30 AM »
That said, the burden (an estimated 41,000,000 illnesses and 60,000 deaths) is .13%. You moved the decimal place on your numbers for some reason. -W

Walt, 41 million flu illnesses everyone, the numbers I quoted are "for the 18-49 year year old bracket" since your previous comments specified 22 year olds. In 2017-2018, there were an estimated 14,428,065 flu illnesses in that demographic, with ~2,803 deaths. That's an estimated 0.019% mortality rate for 18-49 year olds.

Ah, got it. But again, that's estimated cases. We don't have a useful estimate for C19 yet, but I'd bet there are 10x as many cases out there among younger folks that have not been tested or come in contact with the medical system.

-W

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cerat0n1a

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Re: How long can we wait while flattening the curve?
« Reply #411 on: April 03, 2020, 08:35:24 AM »
Spanish flu disproportionately affected the young and those with the strongest immune systems. The highest mortality rates were for the 15-34 age range. In 1918-19, 99% of those who died of it in the US were under 65. A really "bad" flu year can therefore be very much worse than Covid-19 for people in this age range.

Of course, there were some special factors in play. Normally in a pandemic, natural selection favors replication of forms of the virus which don't kill their host - dead or severely ill people don't spread the virus as well as living people. In a wartime situation, the opposite was true.

afox

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Re: How long can we wait while flattening the curve?
« Reply #412 on: April 03, 2020, 09:06:21 AM »
That said, the burden (an estimated 41,000,000 illnesses and 60,000 deaths) is .13%. You moved the decimal place on your numbers for some reason. -W

Walt, 41 million flu illnesses everyone, the numbers I quoted are "for the 18-49 year year old bracket" since your previous comments specified 22 year olds. In 2017-2018, there were an estimated 14,428,065 flu illnesses in that demographic, with ~2,803 deaths. That's an estimated 0.019% mortality rate for 18-49 year olds.

Ah, got it. But again, that's estimated cases. We don't have a useful estimate for C19 yet, but I'd bet there are 10x as many cases out there among younger folks that have not been tested or come in contact with the medical system.

-W

Im not sure how the death rates for covid were estimated but keep in mind that other countries haven't had the testing limitations that the US has.
Both for flu and covid only people with severe symptoms present at a doctors office for testing.

I dont understand what your argument is @waltworks? Are you saying that the data is wrong and covid is "just a smidge" more deadly than the flu for younger people?

GuitarStv

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Re: How long can we wait while flattening the curve?
« Reply #413 on: April 03, 2020, 09:12:29 AM »
That said, the burden (an estimated 41,000,000 illnesses and 60,000 deaths) is .13%. You moved the decimal place on your numbers for some reason. -W

Walt, 41 million flu illnesses everyone, the numbers I quoted are "for the 18-49 year year old bracket" since your previous comments specified 22 year olds. In 2017-2018, there were an estimated 14,428,065 flu illnesses in that demographic, with ~2,803 deaths. That's an estimated 0.019% mortality rate for 18-49 year olds.

Ah, got it. But again, that's estimated cases. We don't have a useful estimate for C19 yet, but I'd bet there are 10x as many cases out there among younger folks that have not been tested or come in contact with the medical system.

-W

Isn't that also true of any flu numbers we have though?  Most people with the flu just stay home and get better.  No need to go to a doctor.

I think the 3 - 10x increased risk with covid-19 is probably pretty accurate.

waltworks

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Re: How long can we wait while flattening the curve?
« Reply #414 on: April 03, 2020, 09:23:07 AM »
Ah, got it. But again, that's estimated cases. We don't have a useful estimate for C19 yet, but I'd bet there are 10x as many cases out there among younger folks that have not been tested or come in contact with the medical system.

-W

Isn't that also true of any flu numbers we have though?  Most people with the flu just stay home and get better.  No need to go to a doctor.

I think the 3 - 10x increased risk with covid-19 is probably pretty accurate.

No, the number Nate is quoting is *estimated* flu cases. The CDC does this every year as the flu is pretty well understood, so a reasonable estimate can be made of the people who had it but didn't seek medical care. Most years they estimate there are 2-2.5 times as many symptomatic illnesses total as medical visits for influenza.

C19 is not well enough understood yet to generate an estimate of mild/asymptomatic cases, so the mortality rates are based on confirmed (tested) cases. There could be 10 times as many cases, there could be 100 times. We don't have enough testing for even symptomatic people, let alone enough testing to get a picture of how many mild/no symptom cases there have been.

-W

frugalnacho

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Re: How long can we wait while flattening the curve?
« Reply #415 on: April 03, 2020, 09:23:57 AM »
I've never had a flu test performed, although I'm pretty sure I've had the flu a few times in my life.  I've also never gone to the hospital for the flu, or died from it.

Hirondelle

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Re: How long can we wait while flattening the curve?
« Reply #416 on: April 03, 2020, 09:25:08 AM »
That said, the burden (an estimated 41,000,000 illnesses and 60,000 deaths) is .13%. You moved the decimal place on your numbers for some reason. -W

Walt, 41 million flu illnesses everyone, the numbers I quoted are "for the 18-49 year year old bracket" since your previous comments specified 22 year olds. In 2017-2018, there were an estimated 14,428,065 flu illnesses in that demographic, with ~2,803 deaths. That's an estimated 0.019% mortality rate for 18-49 year olds.

Ah, got it. But again, that's estimated cases. We don't have a useful estimate for C19 yet, but I'd bet there are 10x as many cases out there among younger folks that have not been tested or come in contact with the medical system.

-W

Im not sure how the death rates for covid were estimated but keep in mind that other countries haven't had the testing limitations that the US has.
Both for flu and covid only people with severe symptoms present at a doctors office for testing.

I dont understand what your argument is @waltworks? Are you saying that the data is wrong and covid is "just a smidge" more deadly than the flu for younger people?

Except Korea and maybe Germany, most countries did/do have testing limitations.

GuitarStv

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Re: How long can we wait while flattening the curve?
« Reply #417 on: April 03, 2020, 09:32:13 AM »
I've never had a flu test performed, although I'm pretty sure I've had the flu a few times in my life.  I've also never gone to the hospital for the flu, or died from it.

Same for me.  And I suspect a huge number of other people.  Which makes me really question how they're estimating the flu numbers.

Slee_stack

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Re: How long can we wait while flattening the curve?
« Reply #418 on: April 03, 2020, 09:35:02 AM »
Numbers affecting mortality rate debate:

  Actual Flu death numbers
  Actual Flu confirmed cases
  Unconfirmed Flu cases (minor,r or asymptomatic, not tested).
  Rate of Flu spread (contagiousness)
  The above (4) for COVID

COVID is accepted as being  far more contagious than Flu.
Its logical to presume far more people will contact COVID than Flu (in a given time frame). 
Its also logical to presume Unconfirmed COVID cases are higher than Unconfirmed Flu cases.

These 2 factors will ultimately determine how much more deadly COVID is than Flu...in terms of Mortality Rate.

In terms of gross numbers, there will be no debate this year.

We won't likely really know the real rates for another year or so.


If we are all guessing, I'll go with 2-3X overall higher mortality rate than Flu.  For young, healthy folks, I'll guess 1.5 or less. 

« Last Edit: April 03, 2020, 09:37:19 AM by Slee_stack »

Slee_stack

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Re: How long can we wait while flattening the curve?
« Reply #419 on: April 03, 2020, 09:42:13 AM »
On another note, USAToday reports this poll about most americans' opinion on flattening the curve:

https://www.usatoday.com/in-depth/news/nation/2020/04/03/coronavirus-poll-americans-saving-lives-economy-public-agenda/5098766002/

Its USAToday, so take it with a grain of salt.  Interesting nonetheless.

GuitarStv

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Re: How long can we wait while flattening the curve?
« Reply #420 on: April 03, 2020, 09:45:45 AM »
Numbers affecting mortality rate debate:

  Actual Flu death numbers
  Actual Flu confirmed cases
  Unconfirmed Flu cases (minor,r or asymptomatic, not tested).
  Rate of Flu spread (contagiousness)
  The above (4) for COVID

COVID is accepted as being  far more contagious than Flu.
Its logical to presume far more people will contact COVID than Flu (in a given time frame). 
Its also logical to presume Unconfirmed COVID cases are higher than Unconfirmed Flu cases.

These 2 factors will ultimately determine how much more deadly COVID is than Flu...in terms of Mortality Rate.

In terms of gross numbers, there will be no debate this year.

We won't likely really know the real rates for another year or so.


If we are all guessing, I'll go with 2-3X overall higher mortality rate than Flu.  For young, healthy folks, I'll guess 1.5 or less. 



Yeah, but all of this is just discussing death rate.

How many people have permanent lung damage after recovering from the flu?  Zero?  My guess is that these numbers will also differ for the coronavirus.

nereo

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Re: How long can we wait while flattening the curve?
« Reply #421 on: April 03, 2020, 09:46:27 AM »
I've never had a flu test performed, although I'm pretty sure I've had the flu a few times in my life.  I've also never gone to the hospital for the flu, or died from it.

Same for me.  And I suspect a huge number of other people.  Which makes me really question how they're estimating the flu numbers.
The same way you estimate any value within a large population, by treating a representative sub-sample. The CDC routinely tears for antibodies for various pathogens to account for unreported spread

One of the reasons why there is a large uncertainty among total infection rates of covid is those types of data won’t be available until much later, when we can account for such cases.

Davnasty

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Re: How long can we wait while flattening the curve?
« Reply #422 on: April 03, 2020, 09:46:50 AM »
I've never had a flu test performed, although I'm pretty sure I've had the flu a few times in my life.  I've also never gone to the hospital for the flu, or died from it.

Same for me.  And I suspect a huge number of other people.  Which makes me really question how they're estimating the flu numbers.

https://www.cdc.gov/flu/about/burden/how-cdc-estimates.htm#References

example of study used to create CDC estimates:

https://onlinelibrary.wiley.com/doi/full/10.1111/irv.12486

Quote
Methods
We used routinely collected surveillance data, outbreak field investigations, and proportions of people seeking health care from survey results to estimate the number of illnesses, medical visits, hospitalizations, and deaths due to influenza during six influenza seasons (2010‐2011 through 2015‐2016).

Results
We estimate that the number of influenza‐related illnesses that have occurred during influenza season has ranged from 9.2 million to 35.6 million, including 140 000 to 710 000 influenza‐related hospitalizations.

And still, estimates are generally given as a very wide range. I would imagine the mortality rates are based on some sort of average within these wide ranges.

Correction: actually I think the range I bolded above is based on low-high annual estimates, as in 9.2m was the best year and 35.6 as the worst. However the 95% uncertainty interval can be a pretty wide range as well.

https://www.cdc.gov/flu/about/burden/index.html
« Last Edit: April 03, 2020, 09:57:40 AM by Davnasty »

JGS1980

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Re: How long can we wait while flattening the curve?
« Reply #423 on: April 03, 2020, 09:58:04 AM »
Let's simplify the discussion:

Top 5 deaths per day (right now) in the USA -> using CDC data

1.Heart Disease -1774 deaths per day
2.Cancer -          1641 deaths per day
3.Covid19           900 deaths per day
4.Accidents         465 deaths per day
5.Chronic Pulm    438 deaths per day (chronic lower respiratory diseases)
***Influenza 2018 93 deaths per day

https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Covid19 deaths will only increase day to day over the next 30 days.

JGS


nereo

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Re: How long can we wait while flattening the curve?
« Reply #424 on: April 03, 2020, 10:17:02 AM »
Let's simplify the discussion:

Top 5 deaths per day (right now) in the USA -> using CDC data

1.Heart Disease -1774 deaths per day
2.Cancer -          1641 deaths per day
3.Covid19           900 deaths per day
4.Accidents         465 deaths per day
5.Chronic Pulm    438 deaths per day (chronic lower respiratory diseases)
***Influenza 2018 93 deaths per day

https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Covid19 deaths will only increase day to day over the next 30 days.

JGS
That’s not simplifying, that is confounding. Those others are essentially constant, and there are largely the result of chronic conditions. Comparing those to a contagion is apples to butterflies.

24andfrugal

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Re: How long can we wait while flattening the curve?
« Reply #425 on: April 03, 2020, 10:53:50 AM »
At this point it should be crystal clear that there are far more cases than the official numbers indicate, both from the milder cases that are told not to go to the hospital and from the completely or near-completely asymptomatic people who are unaware they have it. While this implies a much wider spread, it also implies that the % of people severely impacted by this is also much lower than is popularly thought.

That said - one of the main reasons this is dangerous, as I understand it, is that it moves much more quickly than the flu. 61k people died and 810k were hospitalized with the flu in 2017, which was considered a "bad year", over the course of maybe 5 months. The projections are that we will see that many deaths in the next 4-5 *weeks*. It's like rain...40 inches of rain in a year isn't that big a deal, but 40 inches of rain in a week is catastrophic.

runbikerun

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Re: How long can we wait while flattening the curve?
« Reply #426 on: April 03, 2020, 10:54:32 AM »
Let's simplify the discussion:

Top 5 deaths per day (right now) in the USA -> using CDC data

1.Heart Disease -1774 deaths per day
2.Cancer -          1641 deaths per day
3.Covid19           900 deaths per day
4.Accidents         465 deaths per day
5.Chronic Pulm    438 deaths per day (chronic lower respiratory diseases)
***Influenza 2018 93 deaths per day

https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Covid19 deaths will only increase day to day over the next 30 days.

JGS
That’s not simplifying, that is confounding. Those others are essentially constant, and there are largely the result of chronic conditions. Comparing those to a contagion is apples to butterflies.

I think that was part of the point being made - that even in a situation where it's a novel virus and huge chunks of society are shut down to prevent its spread, Covid-19 is already the third largest cause of death on a daily basis in the US and will probably become number one quite soon.

JGS1980

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Re: How long can we wait while flattening the curve?
« Reply #427 on: April 03, 2020, 11:13:06 AM »
Let's simplify the discussion:

Top 5 deaths per day (right now) in the USA -> using CDC data

1.Heart Disease -1774 deaths per day
2.Cancer -          1641 deaths per day
3.Covid19           900 deaths per day
4.Accidents         465 deaths per day
5.Chronic Pulm    438 deaths per day (chronic lower respiratory diseases)
***Influenza 2018 93 deaths per day

https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Covid19 deaths will only increase day to day over the next 30 days.

JGS
That’s not simplifying, that is confounding. Those others are essentially constant, and there are largely the result of chronic conditions. Comparing those to a contagion is apples to butterflies.

I think that was part of the point being made - that even in a situation where it's a novel virus and huge chunks of society are shut down to prevent its spread, Covid-19 is already the third largest cause of death on a daily basis in the US and will probably become number one quite soon.

Yup RunBikeRun, the point is to answer question, "how dangerous is Covid19 right now?". Or, "How dangerous is Covid right now as compared to Influenza?" If Nereo doesn't get it, then he must be asking a different question.

nereo

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Re: How long can we wait while flattening the curve?
« Reply #428 on: April 03, 2020, 12:08:35 PM »
Let's simplify the discussion:

Top 5 deaths per day (right now) in the USA -> using CDC data

1.Heart Disease -1774 deaths per day
2.Cancer -          1641 deaths per day
3.Covid19           900 deaths per day
4.Accidents         465 deaths per day
5.Chronic Pulm    438 deaths per day (chronic lower respiratory diseases)
***Influenza 2018 93 deaths per day

https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Covid19 deaths will only increase day to day over the next 30 days.

JGS
That’s not simplifying, that is confounding. Those others are essentially constant, and there are largely the result of chronic conditions. Comparing those to a contagion is apples to butterflies.

I think that was part of the point being made - that even in a situation where it's a novel virus and huge chunks of society are shut down to prevent its spread, Covid-19 is already the third largest cause of death on a daily basis in the US and will probably become number one quite soon.

Yup RunBikeRun, the point is to answer question, "how dangerous is Covid19 right now?". Or, "How dangerous is Covid right now as compared to Influenza?" If Nereo doesn't get it, then he must be asking a different question.

Here’s the point I’m trying to make - if we do nothing substantial about heart disease or cancer (the #1 & 2 sources of mortality currently) those will not increase by a factor of 10  by the end of the month. That’s why I’m saying comparisons between those can muddy the waters.

Perhaps we are addressing slightly different questions. But I see a lot of people make the comparison between Covid and heart disease and ask “ why are we more concerned about this disease than heart attacks?”  That’s what I’m addressing.

mancityfan

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Re: How long can we wait while flattening the curve?
« Reply #429 on: April 03, 2020, 12:35:14 PM »
This is why the US may just get hit the worst. This guy is an example of all that is wrong with the attitudes of enough people, as he rails against his liberties being taken to protect everyone else:

https://www.youtube.com/watch?v=W70G5MPQf7U&t=2s

ReadySetMillionaire

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Re: How long can we wait while flattening the curve?
« Reply #430 on: April 03, 2020, 01:17:02 PM »
This is why the US may just get hit the worst. This guy is an example of all that is wrong with the attitudes of enough people, as he rails against his liberties being taken to protect everyone else:

https://www.youtube.com/watch?v=W70G5MPQf7U&t=2s

His opinions about the virus are wacky, but I agree that it's shameful to arrest people trying to exercise and get outside. As long as you are not in a big group (I'd say more than 3-4) and you are practicing social distancing, you're fine.

Our governor (Ohio) has encouraged exercise and I've obliged (I've lost four pounds despite drinking wine seemingly every night!).

Gin1984

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Re: How long can we wait while flattening the curve?
« Reply #431 on: April 03, 2020, 01:18:38 PM »
In addition to being deadlier for every age group, shouldn't it be weighted by your likelihood to actually contract the virus?  Coronavirus is highly contagious and everyone is susceptible.

I'd much rather get  infected with the coronavirus than Ebola because it's far less deadly, but the odds of me being exposed to coronavirus are so much greater than Ebola that coronavirus is a far greater threat to me.

Coronavirus is not only more deadly than influenza, but you're probably more likely to catch it than influenza.  I know there are a lot of flu infections out there too, so I don't know this to be absolutely true, but it seems likely to me. at least that's how I'm perceiving the threat.
Ebola is actually pretty easy to treat in most first world countries. We have no treatment for this.

bacchi

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Re: How long can we wait while flattening the curve?
« Reply #432 on: April 03, 2020, 01:19:49 PM »
This is why the US may just get hit the worst. This guy is an example of all that is wrong with the attitudes of enough people, as he rails against his liberties being taken to protect everyone else:

https://www.youtube.com/watch?v=W70G5MPQf7U&t=2s

That guy is fringe. He was railing against Fauci earlier this week.

« Last Edit: April 03, 2020, 01:25:29 PM by bacchi »

frugalnacho

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Re: How long can we wait while flattening the curve?
« Reply #433 on: April 03, 2020, 01:45:26 PM »
In addition to being deadlier for every age group, shouldn't it be weighted by your likelihood to actually contract the virus?  Coronavirus is highly contagious and everyone is susceptible.

I'd much rather get  infected with the coronavirus than Ebola because it's far less deadly, but the odds of me being exposed to coronavirus are so much greater than Ebola that coronavirus is a far greater threat to me.

Coronavirus is not only more deadly than influenza, but you're probably more likely to catch it than influenza.  I know there are a lot of flu infections out there too, so I don't know this to be absolutely true, but it seems likely to me. at least that's how I'm perceiving the threat.
Ebola is actually pretty easy to treat in most first world countries. We have no treatment for this.

The mortality rate for ebola is still far higher than covid-19, even with the best medical care.  I would still much rather have covid-19 than ebola. 

That's kind of beside my point anyway, which is that comparing the mortality rate of one virus directly against another in isolation doesn't accurately portray the real risk.

GardenerB

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Re: How long can we wait while flattening the curve?
« Reply #434 on: April 03, 2020, 02:50:25 PM »
Two recent BBC articles I found had some good explanation on numbers.  Actual fatality rate of course can only be estimated after the fact.  'Case fatality rate' can be shown and updated daily, but it is not the same comparison for yearly flu deaths (for example) as the true 'infection fatality rate'.

UK figures but still relevant for comparison.  Another misleading fact is people keep looking at age alone as a lower risk of death.  But, if someone is obese and young, they essentially fall into a much older age category equivalent versus someone the same age and healthy. 

https://www.bbc.com/news/health-51979654

https://www.bbc.com/future/article/20200401-coronavirus-why-death-and-mortality-rates-differ

'There are, in fact, two kinds of fatality rate. The first is the proportion of people who die who have tested positive for the disease. This is called the “case fatality rate”. The second kind is the proportion of people who die after having the infection overall; as many of these will never be picked up, this figure has to be an estimate. This is the “infection fatality rate”.
In other words, the case fatality rate describes how many people doctors can be sure are killed by the infection, versus how many people the virus kills overall, says Carl Heneghan, an epidemiologist and director of the Centre for Evidence-Based Medicine at the University of Oxford; he is also a GP in recovery from a suspected Covid-19 infection.
To see what a difference this makes, consider 100 people who have been infected with Covid-19. Ten of them have it so severely that they go into hospital, where they test positive for Covid-19. The other 90 are not tested at all. One of the hospital patients then dies from the virus. The other 99 people survive.
That would give a case fatality rate of one in 10, or 10%. But the infection fatality rate would be just one in 100, or 1%.'

KBecks

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Re: How long can we wait while flattening the curve?
« Reply #435 on: April 05, 2020, 05:30:01 AM »
Joshua Kennon wrote an interesting blog piece about the virus vs. the economy. He suggests that we may face an unrecoverable economic depression if the shutdown lasts too long. Also, check the comments in both articles. 

https://www.joshuakennon.com/what-price-should-we-pay-to-fight-covid-19/

https://www.joshuakennon.com/u-s-covid-19-projections-slashed-to-100000-to-200000-deaths/

After reading both, I am scared.  I am optimistic for the possible drug combination and better testing and for a vaccine.  But  I hope that this is not the beginning of economic collapse.





Buffaloski Boris

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Re: How long can we wait while flattening the curve?
« Reply #436 on: April 05, 2020, 07:06:27 AM »
Joshua Kennon wrote an interesting blog piece about the virus vs. the economy. He suggests that we may face an unrecoverable economic depression if the shutdown lasts too long. Also, check the comments in both articles. 

https://www.joshuakennon.com/what-price-should-we-pay-to-fight-covid-19/

https://www.joshuakennon.com/u-s-covid-19-projections-slashed-to-100000-to-200000-deaths/

After reading both, I am scared.  I am optimistic for the possible drug combination and better testing and for a vaccine.  But  I hope that this is not the beginning of economic collapse.

The question here is how long we're locked down?  In Virginia, which I think is being unusually straightforward regarding the expected duration, the lockdown is until June 10th. I think that's at and perhaps beyond the outer limits of what will be tolerated. At some point, many people just aren't going to obey the stay at home orders.  And conversely other folks are going to have to be coaxed from their homes months from now. The Chinese are noting problems with agoraphobia after their lockdown. 

Gin1984

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Re: How long can we wait while flattening the curve?
« Reply #437 on: April 05, 2020, 07:10:16 AM »
Joshua Kennon wrote an interesting blog piece about the virus vs. the economy. He suggests that we may face an unrecoverable economic depression if the shutdown lasts too long. Also, check the comments in both articles. 

https://www.joshuakennon.com/what-price-should-we-pay-to-fight-covid-19/

https://www.joshuakennon.com/u-s-covid-19-projections-slashed-to-100000-to-200000-deaths/

After reading both, I am scared.  I am optimistic for the possible drug combination and better testing and for a vaccine.  But  I hope that this is not the beginning of economic collapse.

The question here is how long we're locked down?  In Virginia, which I think is being unusually straightforward regarding the expected duration, the lockdown is until June 10th. I think that's at and perhaps beyond the outer limits of what will be tolerated. At some point, many people just aren't going to obey the stay at home orders.  And conversely other folks are going to have to be coaxed from their homes months from now. The Chinese are noting problems with agoraphobia after their lockdown.
Well, the amount of time is dependent on how stupid people are....

KBecks

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Re: How long can we wait while flattening the curve?
« Reply #438 on: April 05, 2020, 07:39:30 AM »
Kennon's main point is that we are going to have to accept that some deaths are going to happen, just as we would expect war casualties.  People who are vulnerable should self-isolate, sick people should stay home and quarantine, and sooner than later, everyone else needs to get back to work (of course, taking precautions). 

Hopefully, we are flattening the curve.  And a re-opening should probably be gradual and very well thought out about what can open up and what should be limited (maybe interstate and international travel for a longer time?)

People are going to get crushed financially, and Kennon argues that there will be extreme effects and poverty for *generations*. He believes we will cause our own unrecoverable economic collapse if we are shut down too long, and the countdown is on.

Buffaloski Boris

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Re: How long can we wait while flattening the curve?
« Reply #439 on: April 05, 2020, 07:46:34 AM »
Joshua Kennon wrote an interesting blog piece about the virus vs. the economy. He suggests that we may face an unrecoverable economic depression if the shutdown lasts too long. Also, check the comments in both articles. 

https://www.joshuakennon.com/what-price-should-we-pay-to-fight-covid-19/

https://www.joshuakennon.com/u-s-covid-19-projections-slashed-to-100000-to-200000-deaths/

After reading both, I am scared.  I am optimistic for the possible drug combination and better testing and for a vaccine.  But  I hope that this is not the beginning of economic collapse.

The question here is how long we're locked down?  In Virginia, which I think is being unusually straightforward regarding the expected duration, the lockdown is until June 10th. I think that's at and perhaps beyond the outer limits of what will be tolerated. At some point, many people just aren't going to obey the stay at home orders.  And conversely other folks are going to have to be coaxed from their homes months from now. The Chinese are noting problems with agoraphobia after their lockdown.
Well, the amount of time is dependent on how stupid people are....
If stupidity was the standard, then Virginia would need to stay on lock down until, oh, July of 2036. 

Halfsees

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Re: How long can we wait while flattening the curve?
« Reply #440 on: April 05, 2020, 07:51:27 AM »
Joshua Kennon wrote an interesting blog piece about the virus vs. the economy. He suggests that we may face an unrecoverable economic depression if the shutdown lasts too long. Also, check the comments in both articles. 

https://www.joshuakennon.com/what-price-should-we-pay-to-fight-covid-19/

https://www.joshuakennon.com/u-s-covid-19-projections-slashed-to-100000-to-200000-deaths/

After reading both, I am scared.  I am optimistic for the possible drug combination and better testing and for a vaccine.  But  I hope that this is not the beginning of economic collapse.

The question here is how long we're locked down?  In Virginia, which I think is being unusually straightforward regarding the expected duration, the lockdown is until June 10th. I think that's at and perhaps beyond the outer limits of what will be tolerated. At some point, many people just aren't going to obey the stay at home orders.  And conversely other folks are going to have to be coaxed from their homes months from now. The Chinese are noting problems with agoraphobia after their lockdown.
Well, the amount of time is dependent on how stupid people are....

In other words, forever?

NaN

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Re: How long can we wait while flattening the curve?
« Reply #441 on: April 05, 2020, 08:11:27 AM »
Right, I wish the sky is falling crowd would read this article from a respected Stanford University Epidemiologist and researcher.

https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/

The "respected" Stanford research you quote said: "10,000 deaths ... is buried within the noise of the estimate of deaths from “influenza-like illness.”"

@Viking Thor : Just curious to see how your thoughts have evolved. Have you changed your mind yet? We will likely reach 10k deaths by today or tomorrow. Further, we haven't even realized what that peak "death rate" will be. Look at Italy's statistics - they finally leveled off at about 750 deaths/per day and have been at the "flattened" level for two weeks. Even if we are at our peak today, we easily reach 30k deaths in two weeks, with many weeks of decreasing numbers. That is 50k additional deaths on top of the ballpark numbers on the flu every year. That is assuming we reached our peak. Even skeptic in chief seems to be convinced 100k deaths would be a great outcome now.


KBecks

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Re: How long can we wait while flattening the curve?
« Reply #442 on: April 05, 2020, 08:41:58 AM »
Interesting article from Medium that questions when coronavirus first started spreading in the US, titled, The Curve is Already Flat:

https://medium.com/morozko-method/the-curve-is-already-flat-2de80eed1bd0

ItsALongStory

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Re: How long can we wait while flattening the curve?
« Reply #443 on: April 05, 2020, 08:44:30 AM »
Right, I wish the sky is falling crowd would read this article from a respected Stanford University Epidemiologist and researcher.

https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/

The "respected" Stanford research you quote said: "10,000 deaths ... is buried within the noise of the estimate of deaths from “influenza-like illness.”"

@Viking Thor : Just curious to see how your thoughts have evolved. Have you changed your mind yet? We will likely reach 10k deaths by today or tomorrow. Further, we haven't even realized what that peak "death rate" will be. Look at Italy's statistics - they finally leveled off at about 750 deaths/per day and have been at the "flattened" level for two weeks. Even if we are at our peak today, we easily reach 30k deaths in two weeks, with many weeks of decreasing numbers. That is 50k additional deaths on top of the ballpark numbers on the flu every year. That is assuming we reached our peak. Even skeptic in chief seems to be convinced 100k deaths would be a great outcome now.

All researchers were clearly using flawed data, either purposely misrepresented or not by China primarily. Testing has been the big caveat all along even in more 'trustworthy' nations like Italy or Spain. This will make anyone involved in this kind of stuff a lot more hesitant to make projections in the future.

mizzourah2006

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Re: How long can we wait while flattening the curve?
« Reply #444 on: April 05, 2020, 09:35:57 AM »
In addition to being deadlier for every age group, shouldn't it be weighted by your likelihood to actually contract the virus?  Coronavirus is highly contagious and everyone is susceptible.

I'd much rather get  infected with the coronavirus than Ebola because it's far less deadly, but the odds of me being exposed to coronavirus are so much greater than Ebola that coronavirus is a far greater threat to me.

Coronavirus is not only more deadly than influenza, but you're probably more likely to catch it than influenza. I know there are a lot of flu infections out there too, so I don't know this to be absolutely true, but it seems likely to me. at least that's how I'm perceiving the threat.

I think this is only true because we have a flu vaccine that a large proportion of the population gets each year and we don't have any anti-bodies for this particular coronavirus. Is there evidence that this is in fact more contagious though? I always kind of figured viral shedding was viral shedding. I guess the fact that many people are asymptomatic or that the symptoms are delayed while the virus is replicating could make it more contagious, but I don't know this for a fact.

But how many people get the flu and never get tested or report it? You cannot take the numbers from flu or anything else as the true number of people that have it as many just as with Covid do not report or seek medical treatment.


Sent from my iPhone using Tapatalk

So 20,000 people a year die from the flu... and 5,000 people have died from this in the last week... with rates expected to double every 3 days.

So same-same.

The # I saw for the flu so far this year in the US was 46k.
« Last Edit: April 05, 2020, 09:47:09 AM by mizzourah2006 »

mizzourah2006

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Re: How long can we wait while flattening the curve?
« Reply #445 on: April 05, 2020, 09:44:18 AM »
Let's simplify the discussion:

Top 5 deaths per day (right now) in the USA -> using CDC data

1.Heart Disease -1774 deaths per day
2.Cancer -          1641 deaths per day
3.Covid19           900 deaths per day
4.Accidents         465 deaths per day
5.Chronic Pulm    438 deaths per day (chronic lower respiratory diseases)
***Influenza 2018 93 deaths per day

https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Covid19 deaths will only increase day to day over the next 30 days.

JGS
That’s not simplifying, that is confounding. Those others are essentially constant, and there are largely the result of chronic conditions. Comparing those to a contagion is apples to butterflies.

I think that was part of the point being made - that even in a situation where it's a novel virus and huge chunks of society are shut down to prevent its spread, Covid-19 is already the third largest cause of death on a daily basis in the US and will probably become number one quite soon.

This is taking the peak and using that #. There have been ~ 95 days in the year so far and 8,516 deaths. That doesn't seem to equal 900 deaths per day. Given this is an average of deaths per day it would imply roughly 330k deaths from the virus this year. Time will tell, but that seems far higher than any projections I've seen.

Davnasty

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Re: How long can we wait while flattening the curve?
« Reply #446 on: April 05, 2020, 10:43:22 AM »
Joshua Kennon wrote an interesting blog piece about the virus vs. the economy. He suggests that we may face an unrecoverable economic depression if the shutdown lasts too long. Also, check the comments in both articles. 

https://www.joshuakennon.com/what-price-should-we-pay-to-fight-covid-19/

https://www.joshuakennon.com/u-s-covid-19-projections-slashed-to-100000-to-200000-deaths/

After reading both, I am scared.  I am optimistic for the possible drug combination and better testing and for a vaccine.  But  I hope that this is not the beginning of economic collapse.

His primary contention is not wrong, life has a dollar value and we need to weigh the costs of our decisions, not simply yield to our emotions. But the intense fear-mongering paired with a lack of data and citations for his claims was too much for me, I'll admit I couldn't get through the whole post.

Quote
Desperate to flatten the curve in their local communities, and without properly weighing the net trade-offs involved, they began enforcing lock-downs on society, closing businesses against their will and forbidding people to congregate in even mid-size groups.

I see this claim made quite a bit, but nothing to back it up. How does he know they haven't properly weighed the trade-offs? He presents the decisions we've made as if they've only been advised by healthcare researchers but that is not true. You can be sure that the economists advising the governments of the world are voicing their opinions right now.

Quote
My guess: We have approximately twelve to sixteen weeks of shut-down before a Great Depression can be avoided.  That is by necessity an imprecise figure but it’s the closest I can get. Accordingly, I refuse to support an indefinite shut-down longer than that period because I feel to do so would be immoral.

Again, how did he arrive at this guess? he offers no data on economic impacts we've seen so far, no timelines to indicate a point of no return, he gives nothing more than a list of ways we will be impacted with a complete lack of data. This would be fine if he meant it to be a conversation starter, but he actually uses these one-off thoughts to draw conclusions as to what should be done. Preposterous.

Then he refers to our current situation as the "shut-down" without acknowledging that there are differing degrees of shut-downs. Most likely restrictions will be lifted in phases based on research that was done prior to the pandemic and is being done right now. The author flippantly disregards the massive efforts in research to advise the governments of the world.

My greatest concern is that governments choose to bend to the fear and emotions of their citizens rather than listen to the experts but unlike the author I acknowledge that that could go in either direction. Some overweight the fear of death and others overweight the fear of economic impacts while forgetting that we'll see much of that economic impact regardless of whether we "shut-down" the economy or not.

tl;dr I think the author's reactions are driven by fear and emotions in the same way as those he seeks to criticize. Of course human lives don't have infinite value. Of course the shut-down can't go on forever. So where's the data to support his rationally superior assessment?

ETA: Here's a more thorough look at the pros & cons of economic restrictions with data and research to back it up. I can't say I agree with all of it as I've only skimmed so far.

https://www.politico.com/news/magazine/2020/04/02/coronavirus-economy-reopen-deaths-balance-analysis-159248#4
« Last Edit: April 05, 2020, 11:02:34 AM by Davnasty »

rob in cal

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Re: How long can we wait while flattening the curve?
« Reply #447 on: April 05, 2020, 02:47:24 PM »
  I'm intrigued, and somewhat optimistic, about whats happening with deaths in several of the US states where death numbers per day are stagnating and not growing exponentially, not showing NYC area skyrocketing. Now perhaps its underreporting, a further lag time before takeoff, who knows, but states like Georgia, Illinois, Connecticut, Massachusets, California, even Michigan, (which hit 80 deaths a few days ago, but hasn't moved much since then) while they might be showing some growth in daily death rate, and certainly are reporting significant new cases every day, so far they seem to be avoiding anything like NYC area death number dynamics.

Abe

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Re: How long can we wait while flattening the curve?
« Reply #448 on: April 05, 2020, 04:11:39 PM »
I’ve been tracking the Johns Hopkins data on a state basis for a month, and so far California and Washington has been relatively flat with deaths per day. I don’t think cases is a useful metric for various reasons explained before due to lack of testing capability. But deaths are deaths, and so far every outbreak the deaths have tracked 1-2 weeks behind cases being reported.

The troubling thing is that Italy’s had about 2 weeks of stable death rates since they peaked. It looks more like a mesa rather than a “peak”. NY has tracked almost exactly with Italy in terms of deaths per day, so I expect a similar curve. Too early to say about other sites with sharp upticks, but death curves have definitely been Lower everywhere other than NY/NJ. Fingers crossed it’s limited to there, then all the economists can bitch and moan about us “over-reacting”. Better to have that argument than the “what do we do with all the rotting corpses” argument.

runbikerun

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Re: How long can we wait while flattening the curve?
« Reply #449 on: April 06, 2020, 02:17:37 PM »
This is taking the peak and using that #. There have been ~ 95 days in the year so far and 8,516 deaths. That doesn't seem to equal 900 deaths per day. Given this is an average of deaths per day it would imply roughly 330k deaths from the virus this year. Time will tell, but that seems far higher than any projections I've seen.

It really shouldn't be necessary to explain why it makes absolutely no sense to take an average figure for each of the 95 days of the year so far.

Confirmed Covid-19 deaths yesterday: 1,175
Confirmed Covid-19 deaths the day before: 1,352
Confirmed Covid-19 deaths the day before that: 1,186
Confirmed Covid-19 deaths the day before that: 1,075
Confirmed Covid-19 deaths the day before that: 940

Right now, Covid-19 is demonstrably the second or third most effective killer of Americans on a daily basis and has been for almost a week. Terrifyingly, those numbers almost certainly don't fully reflect the death toll; a huge number of people are going to die without a positive diagnosis. And yet, even without those deaths being counted, it's killing more Americans each day than almost anything else. It's producing a 9/11 in verified death toll almost three times a week.

 

Wow, a phone plan for fifteen bucks!