Coronavirus Case Counts Are Meaningless*

[Mista]

A long but fascinating read, for those who are interested. I will just provide the link and the conclusion below since the numbers can't really be copy-pasted.

Coronavirus Case Counts Are Meaningless*
*Unless you know something about testing. And even then, it gets complicated.
https://fivethirtyeight.com/features/coronavirus-case-counts-are-meaningless/

But if you’re not accounting for testing patterns, it can throw your conclusions entirely out of whack. You don’t just run the risk of being a little bit wrong: Your analysis could be off by an order of magnitude. Or even worse, you might be led in the opposite direction of what is actually happening. A country where the case count is increasing because it’s doing more testing, for instance, might actually be getting its epidemic under control. Alternatively, in a country where the reported number of new cases is declining, the situation could actually be getting worse, either because its system is too overwhelmed to do adequate testing or because it’s ramping down on testing for PR reasons.

Failure to account for testing strategies can also render comparisons between states and countries meaningless. According to two recent epidemiological studies, which tried to infer the true number of infected people from the reported number of deaths, there is roughly a 20-fold difference in case detection rates between the countries that are doing the best job of it, such as Norway and the worst job, such as the United Kingdom. (The United States is probably somewhere in the middle of the pack by this standard.) That means, for example, that in one country that reports 1,000 COVID-19 cases, there could actually be 5,000 infected people, and in another country that reports 1,000 cases, there might be 100,000!

There are quite a few things to look at here. The most obvious and probably the most important one is simply that a 15-day delay between when someone gets infected and when their case shows up in the data as a positive test makes a huge difference. Even if everything else was going perfectly — 100 percent of the population was being tested and the tests are 100 percent accurate — with an R of 2.6, a 15-day delay would result in there being about 18 times more newly infected people in the population than the number of newly reported positive tests at any given time.

I already gave away the conclusion at the top of the story, so I’m just going to repeat it once more, hoping that this article has helped to convince you of it: The number of reported COVID-19 cases is not a very useful indicator of anything unless you also know something about how tests are being conducted.

In fact, in some cases, places with lower nominal case counts may actually be worse off. In general, a high number of tests is associated with a more robust medical infrastructure and a more adept government response to the coronavirus. The countries that are doing a lot of testing also tend to have low fatality rates — not just low case fatality rates (how many people die as a fraction of known cases) but also lower rates of death as a share of the overall population. Germany, for example, which is conducting about 50,000 tests per day — seven times more than the U.K. — has more than twice as many reported cases as the U.K., but they’ve also had only about one-third as many deaths.

Put another way: Doing more tests is good, and likely leads to better long-run outcomes, even if it also results in higher case counts that people will freak out about in the short run. I don’t usually like to be so didactic, but I hope you’ll be a more educated consumer of COVID-19 data instead of just looking at case counts ticking upward on cable news screens without context. That context includes not only reporting about the amount of testing, but also indications such as hospital strain, which are more robust since they aren’t subject to as many vagaries about how tests are conducted.
Even if you’re not from New York, Gov. Andrew Cuomo’s daily briefings are worth watching because they do the best job I’ve seen of providing this context.

And if you do want to play with your own scenarios to see how all of this works… here’s the link to that Excel sheet. Have fun, but keep in mind that even though there are a lot of parameters you can tweak, the scenarios are still a fairly crude simplification of the complex situation on the ground in any given state or country.

 

[Indos]

The number of death is more accurate to understand the magnitude of infection in any country, and since hospitals are aware of sysmtomp of Covid 19 case, I believe any critical patient with Covid 19 symstomp will be tested, so death figure is quite reliable to see the magnitude of the out break in any country.

 

[casual]

Number of deaths is not accurate either since it would still require a positive test to be counted as a coronavirus death. Number of people going to the ER is a better metric.

 

[Menthol]

I always use the time to predict how big the infection rate is.

Because many countries don't test it to the whole population and even not practicing social distancing nor lockdown.

Especially in my country... *sad*

 

[Menthol]

The number of death is more accurate to understand the magnitude of infection in any country, and since hospitals are aware of sysmtomp of Covid 19 case, I believe any critical patient with Covid 19 symstomp will be tested, so death figure is quite reliable to see the magnitude of the out break in any country.

The number of death, besides age and historical sickness...

Medical staff skills and equipment also play a huge role.

As well as early detection.


I think we should not rely on the Chinese report because their scenario and situation are different.

In our case, most of the people who went to the hospital are those who are already very sick.

Our survivor and death ratio could be higher than in China.

The rest are only having mild symptoms and cured by themselves, never included in the official report.

 

[Indos]

The number of death, besides age and historical sickness...

Medical staff skills and equipment also play a huge role.

As well as early detection.


I think we should not rely on the Chinese report because their scenario and situation are different.

In our case, most of the people who went to the hospital are those who are already very sick.

Our survivor and death ratio could be higher than in China.

The rest are only having mild symptoms and cured by themselves, never included in the official report.

Actually people with mild symptomps are also treated by our hospital just like what I saw on Youtube channel who interview one of the Covid 19 patients who has been cured. And dont forget that Wisma Athletes that can handle 3000 patients is treating Covid 19 patients with mild symptompt condition.

 

[masterchief_mirza]

Excellent points being raised here. In fact, I would go further. Not only can testing methodology lead to unintended misinterpretation and misleading results, but such results can be deliberately "harvested" with malevolent intent.

I'm wondering if India is doing as much with the recent TJ episode.

 

[prashantazazel]

I would not consider the death figures accurate either, at least for developing countries. Many deaths are being covered up.
The politicians don't want a large casualty count against the name of their state /province.

 

[Haris Ali2140]

I would not consider the death figures accurate either, at least for developing countries. Many deaths are being covered up.
The politicians don't want a large casualty count against the name of their state /province.

Sometimes its also opposite. Doctors also sometimes term a normal death as a result of Covid19

 

[Mista]

I would not consider the death figures accurate either, at least for developing countries. Many deaths are being covered up.

It happens to developed countries too such as Italy.

The Italian army has once more been called on to help transport the dead from hospitals in the northern town of Bergamo to crematoriums in nearby towns and cities.

Local funeral homes are overwhelmed by the number of fatalities from Covid-19. The military vehicles bearing the coffins are a chilling testament to the death toll resulting from the virus, and the town's mayor thinks the numbers may have been underestimated.

"There is a very wide gap, which is confirmed by the concrete experience of so many families who have elderly people who are dying either at home or in hospices," explained Giorgio Gori.

"There is a noticeable number of people who are dying due to the virus. I say this because the main cause of death is pneumonia, and some are unaccounted for, and not are registered as victims of the virus, because nobody tested these elderly people either before or after their death."

According to the mayor's office, 400 people died in Bergamo and neighbouring towns last week - that's four times the number who died the same week the previous year - yet only 91 of them had tested positive for the virus.

https://www.euronews.com/2020/03/21...h-toll-from-covid-19-likely-to-be-much-higher

France recently revised its methodology.

French health authorities on Friday confirmed that a total of 5,091 people had died in the country's hospitals and at least 1,416 in elderly care homes since the beginning of the coronavirus epidemic. Friday's one-day death toll of 588 in hospitals was its highest to date.

A total of 588 new fatalities in hospitals were recorded in the last 24 hours, said France's Director General of Health Jérôme Salomon on Friday evening - the highest single number of hospital deaths registered since the beginning of the epidemic.

Salomon said the number of people who had died from the coronavirus in the country's elderly care homes (Ehpads) has risen to 1,416 since the beginning of the epidemic. That number has risen from 884 after additional reports from Ehpad homes across the country.

Sixty-six percent of France's Ehpad nursing homes have now provided number of coronavirus fatalities in their homes, Salomon said.

Until as late as Thursday, France's daily coronavirus death tolls only included hospitals fatalities.

The government has stressed that these numbers only gave a partial picture of the total situation given that nursing homes, particularly in the east of the country, had been hard hit by the outbreak of the virus.

https://www.thelocal.fr/20200403/co...fter-elderly-care-homes-report-new-fatalities

 

[Pakistani Fighter]

I would not consider the death figures accurate either, at least for developing countries. Many deaths are being covered up.
The politicians don't want a large casualty count against the name of their state /province.

Just saw worldometer website and then Indian national health website and saw the difference. Something is fishy in India's case

 

[prashantazazel]

Just saw worldometer website and then Indian national health website and saw the difference. Something is fishy in India's case

Those two use similar sources. I'm not talking about such a minor difference.
Some states are likely under reporting the number of cases. There is some pressure on the doctors, from the administration.
Unconfirmed cases may be reported as some other disease like dengue like illness. I don't have confirmation about the cases that ended in a fatality, though.

All that aside, currently, the situation is not grim. Most people identified aren't serious. Some of my friends and me had a mild disease(lasted 20 days or so) while treating patients, and we have all recovered now.

 

[Kamikaze Pilot]

The number of death is more accurate to understand the magnitude of infection in any country, and since hospitals are aware of sysmtomp of Covid 19 case, I believe any critical patient with Covid 19 symstomp will be tested, so death figure is quite reliable to see the magnitude of the out break in any country.

Many people believe corona pandemic is a massive hoax created by corrupt media. The deaths due to natural causes like old age, already weak immune system etc or deaths due to other diseases like pneumonia or HIV/AIDS are being projected as Covid-19 deaths. The scary numbers of daily deaths are actually seen in 'normal' times also. The main propagators of this Corona myth are the media and governments of various major countries around the world. They are doing this because they have their own agenda.

- PRTP GWD

 

[Indos]

Many people believe corona pandemic is a massive hoax created by corrupt media. The deaths due to natural causes like old age, already weak immune system etc or deaths due to other diseases like pneumonia or HIV/AIDS are being projected as Covid-19 deaths. The scary numbers of daily deaths are actually seen in 'normal' times also. The main propagators of this Corona myth are the media and governments of various major countries around the world. They are doing this because they have their own agenda.

- PRTP GWD

Nope, I believe Covid 19 is real. All positive case of Covid 19 infection in Indonesia are all tested through respected Indonesian laboratorioums.