Generic Virus Thread

[ml1dch]

 

Not sure that's going to make much difference to the spread.

[snowychap]

Would the majority of COVID-19 victims have died this year anyway, as some have suggested? Matthew Edwards and Stuart McDonald investigate

Quote

There has been comment and speculation in the media about the actual and likely future life expectancy of COVID-19 victims – often with an implied downplaying of the impact of the virus, as ‘they were about to die anyway’. This became a perceived official view when Professor Neil Ferguson said in a session with the UK Parliament’s Science and Technology Committee (25 March) that “the latest research suggested as many as half to two-thirds of deaths from coronavirus might have happened this year anyway, because most fatalities were among people at the end of their lives or with other health conditions”.

...rest of article on link

 

[il_serpente]

7 hours ago, snowychap said:

Would the majority of COVID-19 victims have died this year anyway, as some have suggested? Matthew Edwards and Stuart McDonald investigate

 

[KentVillan]

8 hours ago, snowychap said:

Would the majority of COVID-19 victims have died this year anyway, as some have suggested? Matthew Edwards and Stuart McDonald investigate

 

Great article, really interesting read.

There are a couple of things missing from it, though - one is care homes. I think I'm right in saying that just the status of living in a care home (regardless of pre-existing conditions) lowers life expectancy. The average life expectancy in a care home is 2 years, and about a quarter (England) to half (Scotland) of all Covid-19 victims have been care home residents.

The other missing element is the less extreme version of the argument they chose to demolish. The less extreme version is basically "yes, Covid-19 is nasty, but it's comparably nasty to a very bad flu outbreak, and therefore doesn't justify lockdown". They do make the striking point that one week in April was a 20-year record for deaths, but "total deaths" is surely the wrong measure since population has increased by nearly 10 million over that period?

I think they pick the easier argument (which admittedly has some adherents), but it would be more interesting to see them address the question of whether Covid-19 is severe enough to justify measures which may themselves have huge downsides.

They touch on this with:

Quote

However, even with such data, it is likely that some may say, ‘many of these deaths are because of, not from, COVID-19’ in the sense that healthcare resources have been deployed from, for instance, cancer care to COVID-19 care.

...but don't really address the point of how many deaths are directly caused by Covid-19, and how many are indirectly caused by things like delayed / inferior treatment for heart attacks, strokes, accidents, etc. as a consequence of lockdown. (Not the same as the point they do address on whether patients with Covid are dying of Covid.)

This isn't really a criticism of the article, as it does what it says on the tin, and I agree that clearly this is not a "nothing" event. I just think there's still some distance to travel in our understanding of this, before we can really say for certain that lockdown was the answer (and if so, when / how long).

Edited June 12, 2020 by KentVillan

[snowychap]

8 hours ago, KentVillan said:

This isn't really a criticism of the article

Well, to be fair, it is and it's a criticism which says: though it's a really interesting read, it doesn't address the questions that I want answered and I think they were responding to the wrong question, too.

You may say that they've responded to an extreme version of an argument but it is one that has been made and not infrequently. I think it is that which prompted them to do the work that they did for this article. Sure, if everyone were being much less extreme and sensible then they may not have been so minded to point out that people making (or hearing and going along with) the most extreme version or something near it have probably not got a good grasp of life expectancy of people even with much increased risk factors.

As for the comment about them not including care homes, I guess that might be for a number of reasons but chief amongst them might be a lack of decent data (the ICU report provided them with a reasonable set of data to look at).

8 hours ago, KentVillan said:

The average life expectancy in a care home is 2 years

This might well be true but without a source and detail, it's difficult to glean much from such a crude, simple average. The one thing I would take is that if the average life expectancy is 2 years then one would, on the face of that read, that there are plenty of people in care homes living longer than 2 years in to the future for this to be the average.

8 hours ago, KentVillan said:

I just think there's still some distance to travel in our understanding of this, before we can really say for certain that lockdown was the answer (and if so, when / how long).

I would not be at all suprised were the authors of the article to absolutely agree with you in that given that they say:

Quote

As with much of the work on COVID-19, the question cannot be answered fully and precisely at the moment. The issue will be better resolved once we are able to compare total deaths during a reasonable period against total deaths during the same period in previous years. For the UK, data that will allow a meaningful comparison is only just beginning to emerge.

Edit: Just to be clear, I think you made some very worthwhile points. I just think they weren't a particularly fair response to that piece.

Edited June 12, 2020 by snowychap

[snowychap]

8 hours ago, il_serpente said:

Maybe. If so, I'm one of the ones whose memory was wiped.

[Demitri_C]

The testing system for our staff at work is up and running. Have to say its really good. You take the twst and you get results within 48hrs. 

Its taken a while but they getting it right at last after all the shambles we have seen

[blandy]

9 hours ago, KentVillan said:

Great article, really interesting read.

There are a couple of things missing from it, though - one is care homes. I think I'm right in saying that just the status of living in a care home (regardless of pre-existing conditions) lowers life expectancy. The average life expectancy in a care home is 2 years, and about a quarter (England) to half (Scotland) of all Covid-19 victims have been care home residents.

The other missing element is the less extreme version of the argument they chose to demolish. The less extreme version is basically "yes, Covid-19 is nasty, but it's comparably nasty to a very bad flu outbreak, and therefore doesn't justify lockdown". They do make the striking point that one week in April was a 20-year record for deaths, but "total deaths" is surely the wrong measure since population has increased by nearly 10 million over that period?

I think they pick the easier argument (which admittedly has some adherents), but it would be more interesting to see them address the question of whether Covid-19 is severe enough to justify measures which may themselves have huge downsides.

They touch on this with:

...but don't really address the point of how many deaths are directly caused by Covid-19, and how many are indirectly caused by things like delayed / inferior treatment for heart attacks, strokes, accidents, etc. as a consequence of lockdown. (Not the same as the point they do address on whether patients with Covid are dying of Covid.)

This isn't really a criticism of the article, as it does what it says on the tin, and I agree that clearly this is not a "nothing" event. I just think there's still some distance to travel in our understanding of this, before we can really say for certain that lockdown was the answer (and if so, when / how long).

I started to write something along similar lines last night, then gave up, thinking it'd only lead to people grabbing the wrong end of the stick because I'd not write it very well, so I abandoned it. Thanks for doing what I bottled out of.

One thing I was going to write was that from their work, they calculated that (with their pessimistic, fat old smoker assumption) around 8% of the number of deaths "would have occurred anyway", which though pessimistic, does indicate some sort of ball park figure, if perhaps a bit high. But the point I bottled it was in trying to write down the flaws, apart from the ones they already identify, in that number. In terms of Covi, we just can't see any indication of the increase in deaths, not from virus, caused by lock-down, so we can't see how many virus infected people "would have died anyway" - it might be (at one extreme) that almost none would, and the 8% is nearly all people who missed treatment because it was cancelled by hospitals to deal with virus people, or at the other extreme it might be that the 8% is nearly all virus victims. And then there's the whole way the UK has handled things, v eleswhere. How much did lack of PPE, or lack of testing worsen our figures, compared to abroad, for example?

or TL;DR "this".

[Genie]

I just popped to local shop for milk, wearing a mask. I was the only person in the shop to have a mask on (including the staff) and got several looks like I was an alien.

[snowychap]

5 minutes ago, Genie said:

I just popped to local shop for milk, wearing a mask. I was the only person in the shop to have a mask on (including the staff) and got several looks like I was an alien.

Did you forget your trousers, again?

Edited June 12, 2020 by snowychap

[villaglint]

2 minutes ago, Genie said:

I just popped to local shop for milk, wearing a mask. I was the only person in the shop to have a mask on (including the staff) and got several looks like I was an alien.

I did this the other day. There was a long queue outside the shop and I was the only one in a mask. Got a lot of looks but who cares. After being stood in the queue for a few minutes I realised I didn't have my wallet. During lockdown I hardly ever need it. 

Felt like a right plonker as I then had to trudge back to my car and go all the way back home. 

 

[Brumerican]

2 minutes ago, Genie said:

I just popped to local shop for milk, wearing a mask. I was the only person in the shop to have a mask on (including the staff) and got several looks like I was an alien.

Farts can quantum tunnel through pants and denim.

You're basically shopping in cosplay.

[snowychap]

18 minutes ago, blandy said:

 the 8% is nearly all people who missed treatment because it was cancelled by hospitals to deal with virus people, or at the other extreme it might be that the 8% is nearly all virus victims.

I'm sorry but I'm must be missing the point you're making as this doesn't appear to relate to what the piece is talking about.

Their estimated deaths number is the number, using their 'fairly extreme model point', of those 5578 Covid-19 critical care patients that they would estimate would have been likely to have died in the period (i.e. before the end of the year) without the virus having happened, isn't it?

If you're going to be querying the impact of 'missed treatment because it was cancelled by hospitals', a perfectly valid question but not the one they were addressing, then you're going to need a different dataset and a different methodology from the one being used within the article to make a specific point.

Unless I've misunderstood what you are trying to say, I think you're making a similar error with regard to the article as @KentVillan here. I may well have misunderstood, though.

 

[chrisp65]

44 minutes ago, Genie said:

I just popped to local shop for milk, wearing a mask. I was the only person in the shop to have a mask on (including the staff) and got several looks like I was an alien.

I’ve had a couple of work visits deep in to england, and my take is covid is basically over.

I’ve turned up on site with my own bottle of drinking water, sanitiser, gloves, mask etc., and others are all stood around chatting and sending someone off to get 5 or 6 coffees from Costa.

It has felt really weird, and it really does put the pressure on to conform and lose the mask and gloves.

[KentVillan]

6 hours ago, snowychap said:

This might well be true but without a source and detail, it's difficult to glean much from such a crude, simple average. The one thing I would take is that if the average life expectancy is 2 years then one would, on the face of that read, that there are plenty of people in care homes living longer than 2 years in to the future for this to be the average.

The 2-year figure is taken from some fairly old Bupa research from 2011. Hard to know which direction that has moved in in the past decade - on the one hand it could be that mortality has decreased because of slight improvements in healthcare, on the other hand, we know the Cameron govt really destroyed social care during austerity.

https://www.pssru.ac.uk/pub/3211.pdf

Quote

In the Bupa sample, the average length of stay was 801 days, but with a considerable tail of long-stayers. Half of residents had died by 462 days. Around 27% of people lived for more than three years, with the longest stayer living for over 20 years. People had a 55% chance of living for the first year after admission, which increased to nearly 70% for the second year before falling back over subsequent years.

So a mean of 801 days, and a median of 462 days.

There is also another piece of research that looks at relative mortality in care homes, and finds that it is much higher than in the community, even adjusting for other factors: https://academic.oup.com/ageing/article/42/2/209/27127

Quote

• Age and sex-adjusted mortality is approximately four times higher in nursing homes than the community and three times as high in residential homes.

• Despite high mortality, over two-thirds of UK care home residents, on a particular day, will be alive 1 year later.

So this suggests that just under 1/3 of care home residents don't survive the first year, which is still a very high level of mortality, and not inconsistent with the Bupa research.

But more importantly, it shows that the care home setting brings unique challenges beyond just the age and comorbidities of the residents. So unless you include that as a variable in the actuarial model, you may not be comparing like with like. 

Edited June 12, 2020 by KentVillan
1/3 of care home residents DON'T survive...

[bannedfromHandV]

Just throwing it out there but I still don’t know personally of a single person who’s been positively tested as having or having had the virus.

And I think that applies to the majority of people so it’s really not that surprising that the bulk of people aren’t wearing masks 

It’s not that I don’t believe it’s out there but I think people are beginning to grasp that the risks are actually really really low and the measures to prevent those risks are becoming tedious and over exaggerated.

Or I’m full of shit.

One of the two.

[StefanAVFC]

This govt are so depressing

 

[KentVillan]

29 minutes ago, bannedfromHandV said:

Just throwing it out there but I still don’t know personally of a single person who’s been positively tested as having or having had the virus.

And I think that applies to the majority of people so it’s really not that surprising that the bulk of people aren’t wearing masks 

It’s not that I don’t believe it’s out there but I think people are beginning to grasp that the risks are actually really really low and the measures to prevent those risks are becoming tedious and over exaggerated.

Or I’m full of shit.

One of the two.

I think it's more that the virus has been heavily concentrated in certain locations and communities. If you're not in one of those, you aren't really aware of it.

A big failure of the UK government was not being able to guide the public on where things stood at a much more detailed level geographically. Imposing nationwide measures flew in the face of the lessons from Korea (especially) and Germany, where the responses have been much more localised.

[AVFC_Hitz]

59 minutes ago, bannedfromHandV said:

Just throwing it out there but I still don’t know personally of a single person who’s been positively tested as having or having had the virus.

And I think that applies to the majority of people so it’s really not that surprising that the bulk of people aren’t wearing masks 

It’s not that I don’t believe it’s out there but I think people are beginning to grasp that the risks are actually really really low and the measures to prevent those risks are becoming tedious and over exaggerated.

Or I’m full of shit.

One of the two.

My Nan fell down in the garden the other day and broke her arm. She spent 4 nights in Redditch hospital. When I got the news my first thoughts weren't about her arm but "shit, I hope she doesn't get Covid"- thankfully she hasn't/didn't but it's weird times we live in.

[snowychap]

2 hours ago, KentVillan said:

So this suggests that just under 1/3 of care home residents survive the first year, which is still a very high level of mortality

You mean don't survive, no, as it says that 'over two-thirds of UK care home residents, on a particular day, will be alive 1 year later'?

I appreciate the further info - stupidly, I'd forgotten about the BUPA stuff which I think has been posted before in the thread. My apologies.

When you say:

2 hours ago, KentVillan said:

it shows that the care home setting brings unique challenges beyond just the age and comorbidities of the residents. So unless you include that as a variable in the actuarial model, you may not be comparing like with like.

I think that makes a lot of sense and, I dare say, so might the authors of that piece. Obviously, I'm not here to defend their work and I'm sure they'd make a much better job than I have or could.

Without more complete data in order to cover this area, too, I think you might be justified in saying that, whilst what they say in the article is interesting and relatively robust, more complete data should tell a better and perhaps, a different story.

I guess I'd just say that one of the things they were responding to was a Ferguson comment at the end of March so it might be suggested that Ferguson's comments weren't probably taking in to account care home deaths too much, either.

Edited June 12, 2020 by snowychap