Liberate!! ... Souls from bodies or something.

Just in case anyone else has jumped to the conclusion that because I mentioned the statistical implications of overlap in mortality cohorts I'm obviously either a heartless fascist or duped by one...

The reasons I think overlap in mortality cohorts is important are;

1. High overlap undermines certain arguments against social distancing measures because there should be little net excess in treatment requirement, focusing the main problem even more in the height of the spike of cases. Without overlap there is an argument that flattening the curve will not help because it pulls staff from other vulnerable cases in the long term so providing no net gain. In other words, with overlap we only need to re-assign resources (which everyone agrees is doable), without overlap we need to produce a net increase in resources (which many think is not doable, so why bother >> herd immunity bullshit).

2. Perpetuating the idea of no overlap in order to procure these additional resources (and likewise avoid providing an excuse to those who don't want to pay for them) may well work in the short-term, but a) it's hardly a long-term strategy for procuring more investment in health care, and b) it undermines the credibility of socialist arguments if the threat does not then materialise. We shouldn't pin arguments about investment in healthcare to the severity of rare pandemics when there are perfectly sound arguments for it which are already demonstrable.

3. Using fear to bring about policy change is a dangerous strategy as the very institutions and cultural practices which are necessary to make it a success do not in themselves act as filters for the sensibleness, humanity or practicality of the policy being thus advocated. Fear can be useful politically, but it does not have a good long-term track record of maintaining positive change.

4. The extent and nature of any short-term change in demand on healthcare systems is crucially important to the management of those systems. We can bemoan the shortfall in net funding all we like, but somone still has to make ten bandages fix twelve broken arms, so to speak. They need to know what the future calls on their insufficient funds are likely to be. This is less relevant to public discussion, but public mood does filter into policymaker's discussions, they're only people after all.

5. We will have to come out of lockdown soon (partially) and continued promotion of the idea that Covid-19 is some random reaper stalking the land takes resources away from those who really need them as the hysterical-selfish (by far the largest population group) panic-buy themselves their ppe/food parcel combo (Disney-themed, Bluetooth-enabled version, only £9.99 on Amazon), while doctors make do with paper towels and some sellotape.

Edit - I forgot to add that I just don't like it if something seems wrong, so even if none of the above were true I'd still be arguing about the statistical implications of an overlap in mortality cohorts just because I think there is one, and I'd rather hope to be discussing things with people intelligent enough to know the difference between a fact which is unhelpful and one which is wrong.

It's amazing why it's now reported, as if it's news, that UV light is a virucide. No shit.

Let's recall MERS for a second and realise that the summer isn't going to solve this for us.

I think this above describes aptly seriousness of the the coronavirus into perspective.



What I'm totally surprised from the chart above is the how low the 1957-1958 Asian flu pandemic is here. That killed at least 1 million people in the World and 116 000 in the US. And the "Asian flu" has been said to have infected as many people as the Spanish flu, but a vaccine, improved health care, and the invention of antibiotics contributed to a lower mortality rate.

The source I previously mentioned.

The number of people recorded as having died 'of' a particular condition is heavily dependent on the manner in which the death certificate is recorded and examined in data harvesting. The CDC figures for ILI from 17-18 is recorded in the same way as Covid-19 (listed as a contributory factor on the death certificate), so it should be comparable, but we've no idea how doctors and coroners were instructed to list flu in 1958, so the figures are not accurately comparable.

Death certificates are notoriously difficult to extract good data from, especially across medical paradigm changes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808686/

No one is debating these facts, but once numbers get large the ambiguities get small, as a large amount of people dying of pneumonia in a region during respiratory epidemic is very likely.

The graph I just posted (if true or close to true) demonstrates the basic problem, as it would mean (if everyone got the disease) about double total deaths in the year (there is less infants that die, but there's some excess in the 60s range) happening in a short period of time would be a total disaster.

Furthermore, many people that recover still needed hospitalization and care not just at an alarming rate, but also for a long duration of time (2-3 weeks).

There's simply no way statistical coincidence with other causes of death explain the phenomena of overloaded health systems, nor any reason to expect we'd have some large effect of abatement of those other causes of death after the initial overload.

If you really want me to go into the calculations that explain my position, I can do so.

I'd rather hope to be discussing things with people intelligent enough to know the difference between a fact which is unhelpful and one which is wrong. — Isaac

If you think this applies to me in this discussion, please argue the point. I said maybe you are affected by attempting to overcompensate your bias; maybe not. Either way, you are still wrong about believing the real overlap that really does exist could be big enough to result in effects you think are possible.

Here's David Spiegelhalter explaining what he means by those figures. He's very good at explaining these things (it is, afterall his job).

So, if the factors which cause fatality from Covid-19 are largely different to the factors which cause fatality in general, how do you explain the fact that fatality risk from Covid-19 tracks fatality risk in general almost exactly?

Why would a 70 year old face exactly the same increase in risk from Covid-19, compared to a 19 year old, that they do from all diseases combined without a majority of significant overlapping factors?

Say mortality from Covid-19 is determined largely by a factor-A, and mortality from heart disease is largely determined by unrelated factor-B. Your risk would be related to the prevelance of the related factor. Unless both of these factors, despite being unrelated, coincidentally increased at almost exactly the same rate with age, then the match in increase of risk with age would have to be a massive coincidence.

The fact that the risk from Covid-19 tracks almost exactly the risk in general shows that the factors causing risk in Covid-19 are likely to be the same as the ones causing risk from disease in general.

The graph I just posted (if true or close to true) demonstrates the basic problem, as it would mean (if everyone got the disease) about double total deaths in the year — boethius

No it doesn't because it is comparing the estimated risk from Covid-19 compared to the normal risk for a year taken ftom years in which Covid-19 was absent. It doesn't tell us anything about the relative risk from other diseases in a year where Covid-19 is present.

Hardly any ancient farmers died of cancer. It's not because they were super-healthy, it's mostly because they died of something else first. It's the same with these figures. The risks for a year in which Covid-19 is not present to kill you first are not going to be the same as for a year in which it is.

If you really want me to go into the calculations that explain my position, I can do so. — boethius

Yes, that's what I've been repeatedly asking you to do.

In other words, with overlap we only need to re-assign resources (which everyone agrees is doable), without overlap we need to produce a net increase in resources (which many think is not doable, so why bother >> herd immunity bullshit). — Isaac

For instance, if you want to debate your arguments even assuming your premise, the above simply doesn't hold. Even if there's overlap, I've been mostly talking about overlap of a temporal nature (people dying now that would die in the near future, such as within a year), and there's no way to re-assign resources from the future to the present. Furthermore, lot's of health-care resources simply don't apply to respiratory infection, and therefore can't be reassigned; therefore, for both reasons, even if your overlap theory is true, there needs to be "net increase in resources".

True, it is not doable to scale in parallel to a unmitigated pandemic; yes, the fascists say "why bother, let's keep the economy humming and the dividends flowing". But this is a false dichotomy. We can lower infection rate by social distancing to something that is below health care capacity (such as many countries have demonstrated) or then at least not so far beyond capacity to reach a total health system collapse (every country late to the game is doing). We can at the same time scale resources as best we can.

5. We will have to come out of lockdown soon (partially) and continued promotion of the idea that Covid-19 is some random reaper stalking the land takes resources away from those who really need them as the hysterical-selfish (by far the largest population group) panic-buy themselves their ppe/food parcel combo (Disney-themed, Bluetooth-enabled version, only £9.99 on Amazon), — Isaac

Again, nor I, nor anyone else has here has claimed it's a "random reaper", just "random within risk groups that are large enough and existing risks low enough that Covid deaths do not coincide with 'weakest heart' deaths type hypothesis". Furthermore, people aren't panic buying due to such a fear in any case, most young people and even a lot of elderly people don't fear getting the virus, but people are panic buying because they think other people are panic buying or then not even panic but in the hopes of price gauging, because of the lock-downs not the virus itself.

while doctors make do with paper towels and some sellotape. — Isaac

Both the panic buying in itself and doctors going without due to panic and hoarding are false dichotomies. Government can easily solve such a problem through rationing, and many governments have. In the US this would be socialism and "a republican" administration doesn't want to set precedents that socialism can help on some issues (except giving corporations as well as 2 week old companies created by sycophants money).

there's no way to re-assign resources from the future to the present. — boethius

There is. Loans, postponing leave, postponing retirement, postponing investment plans. There's all sorts of ways of borrowing from the future.

In the US this would be socialism and "a republican" administration doesn't want to set precedents that socialism can help on some issues — boethius

Right. So you're wrong when you say that governments can deal with these problems through rationing then aren't you? Governments are elected by (Influential sectors of) populations, populations which at the moment are increasingly right wing, so government can't help in the way you suggest. It's no good planning a response strategy based on a pipe dream of what we'd like the world to be. "The first thing we need to do invent a time machine and ensure we get a more socialist government elected", is that your plan?

Yes, that's what I've been repeatedly asking you to do. — Isaac

You have not been repeatedly asking me to do this, and I have not volunteered as calculations don't actually solve the disagreement.

Your claim is that within these risk groups such as heart disease, there is a hidden risk group of "weakest heart" and these are those dying of Covid and are subsequently culled from the heard and don't die / burden the health system later.

Demonstrating how my point about these groups being large makes the overlap small using calculations doesn't solve the above difference. And, it seemed you accepted that my point about large groups held, so there was not need for me to demonstrate it.

I gave lot's of reasons why there is no such subgroup of "weakest heart" as lot's of factors affecting real death from heart disease are in the future and therefore Covid cannot select for.

My whole position is based on a well known statistical fact that as selection from a group becomes a small, the chance of colliding with some other small selector is small. If we are both picking 1 out of a hundred hats at random, it's unlikely we'll pick the same hat. Now, it's not random given the whole population, there are risk groups, but if these risk groups are large (such as heart disease or obesity) then collision remain small (1 out of a thousand instead of 1 out of million). The set we're selecting from needs to become very small or then the number of selection very big of one or both selectors for there to be collisions.

However, for your benefit I will bring out all the theorems and things we "certainly" (highly, highly likely) know about the pandemic so far, to demonstrate why overlap will be very small of all kinds; both confounding causes of death and overlap with "would die soon anyways".

There is. Loans, postponing leave, postponing retirement, postponing investment plans. There's all sorts of ways of borrowing from the future. — Isaac

Not physical resources. A loan doesn't help a doctor today treat a Covid patient, only real material and human resources (which cannot come from the future).

Right. So you're wrong when you say that governments can deal with these problems through rationing then aren't you? — Isaac

Government have already implemented rationing successfully, even some chains voluntarily implemented rationing.

For instance, in Japan there is a limit to masks you can buy and a large fine for buying more (because rationing obviously works to prevent perverse distribution of resources in an emergency).

I gave lot's of reasons why there is no such subgroup of "weakest heart" as lot's of factors affecting real death from heart disease are in the future and therefore Covid cannot select for. — boethius

No, you gave a small number of minor factors without any citations to back them up and nothing to counter the cited evidence I provided of the major factors which do overlap.

My whole position is based on a well known statistical fact that as selection from a group becomes a small, the chance of colliding with some other small selector is small — boethius

Yes, and you've yet to demonstrate, with evidence, that the selection is small (relative to the group {at most risk}, nor that there is 'some other' selector rather than exactly the same one.

A loan doesn't help a doctor today treat a Covid patient, only real material and human resources (which cannot come from the future) — boethius

It's a start. A start which is more likely to be made if people are not overduely concerned about preserving resources for some future apocalypse.

Government have already implemented rationing successfully, even some chains voluntarily implemented rationing. — boethius

So your complaint about the US government in this regard was about what?

if you want to debate your arguments even assuming your premise, the above simply doesn't hold. — boethius

Actually, please just ignore the last two paragraphs of my last post. I don't really want to discuss that. I just wanted to explain some of the reasons I thought it was important that we don't avoid the possibility of an overlap. It really makes no difference at all if I'm wrong about all of them (presuming we're not deciding what's right on the basis of what it would be convenient to be right).

I don't want to hold two discussions at once (one is hard enough to keep up with). There's enough to discuss just on whether there is an overlap without adding whether it would be beneficial to publicise that fact (a completely unrelated question).

No, you gave a small number of minor factors without any citations to back them up and nothing to counter the cited evidence I provided of the major factors which do overlap. — Isaac

You didn't disagree with future contingencies affecting heart disease outcome; therefore, I need not cite it as you seem to agree and I used common knowledge examples.

So, if you don't point and say "I'd need proof to assume stressful events that might happen in the future could impact heart outcomes" then I can't know you don't also accept this common wisdom.

Instead, you cited evidence that supports my view, that risk factors are very large groups such as heart disease, obesity, etc. not evidence that it is only the "severe risk subgroups doctors say will likely die anyways soon" nor any evidence that such groups exist despite doctors not knowing about them.

If you provide citations that support my point, why do I need to do anything?

And again, no where have I said factors don't overlap, the point at issue is whether these overlapping factors are coming from large groups that have small factors (many with a small chance of death in both sets; i.e. risk of death from both selectors) or small groups with big factors (few with a large chance of death from each).

Yes, and you've yet to demonstrate, with evidence, that the selection is small (relative to the group {at most risk}, nor that there is 'some other' selector rather than exactly the same one. — Isaac

This is your hypothesis, and there's no evidence for it, therefore "there is no reason to assume it", therefore it's not a reasonable risk to take.

Furthermore, it wold overturn the prevailing view in medicine that most deaths in a given year are fundamentally unpredictable (there are very, very small groups in "90% risk of death this year" but there are very, very large groups with "10%, 5%, 1%, 0.5%, 0.1%" and and most deaths come from these groups in a given year because although probabilities are small membership is large).

But if you are not aware just how sensitive "selector collisions" are to the summed probabilities of selectors being small, then it's difficult to intuit these large number statistical theorems (which are clearly at play with the evolution of Covid, otherwise nearly every country wouldn't be experiencing the same simultaneously, just managing better or worse, as there would be dominating small number variations that result in very different outcomes due to pure chance).

So I will explain these theorems and why chances of the overlap you are talking about become so small as risk groups become large and chances of death from both Covid and underlying conditions are small that the broad facts about the pandemic support my position without the need for laborious analysis taking into consideration all sorts of subtleties.

There is a clear dominating driver of events which is Covid, once containment fails, kills enough people in a short period of time as to overwhelm health systems; society (relatively rich societies anyway) simply can't function without a health system and so, even the most "initially downplayed to the max" governments take social distancing action and try to ramp up resources to deal with the situation (with the exception of Brasil, so a convenient, although tragic, control case for this analysis).

That or they're dying of intubation. During the Civil War (spoiler alert, South lost), soldiers did whatever they could to avoid being treated because the treatment usually killed them. — Hanover

Actually there is a theory that mechanical ventilation, which is potentially dangerous for any set of lungs, is particularly hard on COVID-19 lungs. We were intubating early, but we stopped that. We've started waiting as long as we can.

Makes sense. The sign for "you've contracted the virus and have a pre-existing immune system problem" is where the sign language guy bends over the Governor and simulates impregnating him. — Hanover

So when the sign language person is female?

Why don't you just take it up with the experts, they both have blogs. I can't be bothered with this condescending "I'll teach you where you've gone wrong" crap.

Prof Sir David Spiegelhalter {Professor of Mathematical Statistics at Cambridge), - "there will be a substantial overlap, Many people who die of Covid [the disease caused by coronavirus] would have died anyway within a short period," - he can be argued with at https://mobile.twitter.com/d_spiegel

Prof Neil Ferguson, the lead modeller at Imperial College London, has suggested it [the deaths of those who would have died anyway] "might be as much as half or two thirds of the deaths we see, because these are people at the end of their lives or who have underlying conditions.". - he can be contacted at https://www.imperial.ac.uk/people/neil.ferguson

When both Professer Spiegelhalter and Professer Ferguson have agreed that they're wrong and you're right, perhaps you'll have the authority to 'teach' the rest of us where we've gone wrong.

Being freshly laid-off and in the midst of a pandemic/recession is worrisome, to say the least. We can't help but worry. From the stoic point of view, it's all out of our control so there's no point in worrying. What we do have control of is doing the best we can under the circumstances. You've got valuable skills, good credentials, and work in a field that can be done online (with social distancing), so you're actually in a position with a lot of potential for employment, freelance work, or entrepreneurial endeavors. We can worry and see opportunities and move forward.

And to tie you over until you find something relevant to your skills and experience, you might consider delivery work.

Edit: sorry, typical "here's a solution" reply.

It sucks for sure and I can imagine this causes a serious amount of stress. Do you have someone close to really talk about it?

Why don't you just take it up with the experts, they both have blogs. I can't be bothered with this condescending "I'll teach you where you've gone wrong" crap. — Isaac

You just stated in your previous comment that you've been asking for the basic statistics all this time.

But yes, explaining a position requires explaining it. If you don't want to debate, probably a debate forum isn't a good place to be.

Prof Sir David Spiegelhalter {Professor of Mathematical Statistics at Cambridge), - "there will be a substantial overlap, Many people who die of Covid [the disease caused by coronavirus] would have died anyway within a short period," — Isaac

This statement depends on what he means by "substantive". Most people might think it to be "a lot", but in this context it is just some measurable effect.

That does not mean there will be no extra deaths - but, Sir David says, there will be "a substantial overlap".

"Many people who die of Covid [the disease caused by coronavirus] would have died anyway within a short period," he says.

Knowing exactly how many is impossible to tell at this stage. — BBC

This is the context. The statement here does not support the idea that this effect is large, just that we will see it.

If he thought it was the majority or "nearly all" he would have said so.

The basic math he uses is "Nearly 10% of people aged over 80 will die in the next year, Prof Sir David Spiegelhalter at the University of Cambridge points out, and the risk of them dying if infected with coronavirus is almost exactly the same".

I'm not sure he's trying to mislead lay people on purpose, as many will interpret that statement to mean your risk of dying this year is the same with or without Covid. Rather, coincidentally, risk of death of Covid happens to be similar to your yearly risk of death. The missing key element he or the reporter leave out is that based on this information the risks are commutative. So, with an unmitigated spread where all ~80 year olds get Covid, 10% of them die, but then another 10% of those remaining go onto die within the year; so 19% total deaths this year.

Now, if we include other risk factors, yes, we could expect less due to this; but unless the disease somehow targets those 10% that would normally die (10% of 80 year olds die and then significantly fewer die for a whole year), the the change is small.

Furthermore, it's simply irresponsible to not mention that maybe surviving Covid increases the risk profile in these groups, so you get more deaths due to long term lung damage instead of less deaths due to overlap.

In otherwords, this expert does not support your position but has made an ambiguous easily misunderstood statement about a lack of knowledge.

It seems the journalist paraphrased a longer rambling explanation of the details with "knowing exactly how many is impossible to tell at this stage". So, it's clearly not a prediction in any case.

Prof Neil Ferguson, the lead modeller at Imperial College London, has suggested it [the deaths of those who would have died anyway] "might be as much as half or two thirds of the deaths we see, because these are people at the end of their lives or who have underlying conditions. — Isaac

I read the article where this citation comes up. I'm going to give the benefit of the doubt for Prof Ferguson that he was temporarily hallucinating about statistics at the time, as he himself was recovering from Covid. And again, it's a "who knows" kind of statement.

But if you read his modelling paper Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand then you see an unmitigated death toll from Covid of 2.2 million in the United States from May to July.

Total US deaths in 2018 was 2.8 million. There's simply no way Prof Ferguson is saying you could have 2.2 million deaths in 3 months and then going less half to a third of otherwise expected deaths happening for the rest of the year.

Likewise, if you read the paper of the expert you're citing, you'll see a massive overburdening of the health care system in unmitigated spread as well as the problem of it happening again and again and again each time a lockdown is lifted.

When he talks about "half to two thirds would have died anyways" he seems to be talking about a situation where social distancing is done really, really well and the disease is limited to being like a hospital disease that kills terminally ill people since they cluster around hospitals.

And again, without mentioning that the effects of Covid could replenish these risk groups that would likely die within the year, it is simply a mistake on the part of this expert. Experts can still make these kinds of errors in interviews, which is why citations of published papers are usually preferred supporting evidence.

I don't know if he's specifically revised this statement, but 2 days ago he was interviewed and said:

“What we really need is the ability to put something in their place. If we want to reopen schools, let people get back to work, then we need to keep transmission down in another manner.

“And I should say, it’s not going to be going back to normal. We will have to maintain some level of social distancing – a significant level of social distancing – probably indefinitely until we have a vaccine available.”

He said that despite the “billions of pounds per day” cost to the economy – by putting in place infrastructure to tackle the virus – it was a “small price to pay” to tackle the outbreak of the virus.

Pressed on whether the government was moving towards an exit strategy, Prof Ferguson went on: “I’m not completely sure. I would like to see action accelerated. I don’t have a deep insight into what’s going on in government but decisions certainly need to be accelerated and real progress made. — independent reporting a BBC 4 interview

This doesn't seem the position of someone who thinks up to two thirds of people dying of Covid are those that would have died within the year.

I agree. Especially when there is a understandable desire to keep the numbers of deaths low. Hence what sometimes happens are these sudden upticks in the figures with later studies.

In otherwords, this expert does not support your position but has made an ambiguous easily misunderstood statement about a lack of knowledge. — boethius

Spiegelhalter clarifies his statements (as a result of their misunderstanding) on twitter:

"I fully admit the graph doesn’t tell the story: it just shows that short-term Covid risks are numerically similar to annual risks (on average). So getting Covid might roughly double the risk of dying this year. That’s it. Some would have died anyway, but that’s not the main point"

https://twitter.com/d_spiegel/status/1248971466357555205?s=20

https://twitter.com/d_spiegel/status/1248966611400364032?s=20

Note the difference between flu and flu & pneumonia. Something I found out several weeks ago was that in the West deaths from flu and death from flu & pneumonia were counted as flu deaths, whilst in the East many countries ONLY counted flu deaths as flu deaths and pneumonia deaths as pneumonia deaths.

— Andrew M

I fully admit the graph doesn’t tell the story: it just shows that short-term Covid risks are numerically similar to annual risks (on average). So getting Covid might roughly double the risk of dying this year. That’s it.

Interesting. From the statistics I've seen, the global death totals as projected annually for this year do not mark an anomaly.

The brutal fact is: when it's your time to go, it's your time to get going.

Given that the figures that they are working with are the official figures (officially registered deaths), and that the data is old, it still doesn’t say much other than to make the problem look better than it is - because most people have no idea how to interpret statistical mathematics!

Interesting. From the statistics I've seen, the global death totals as projected annually for this year do not mark an anomaly. — Merkwurdichliebe

Because, depending on where you are, the deaths haven’t happened yet and/or haven’t been officially registered. I did post the official figures from the UK government on the previous pages to highlight this - the official figures in the UK only run up to April 3, the next update (which will show the real effect) will be in a few days.

Go back a few weeks and people in the US were saying ‘no problem here!’ Because once you’re infected you don’t drop dead on the spot. There is a substantial lag between infection and death in most cases - we’re talking in excess of a month in some cases.

It never ceases to amaze me the lengths people will go to to maintain their chosen narrative.

Apparently when Spiegelhalter uses the words 'many' and 'substantial', he means 'hardly any'.

Professor Ferguson, despite giving a cogent speech, was suddenly overtaken by an hallucination when he mentions a two thirds overlap.

Professor Spiegelhalter (a professor of mathematical statistics) apparently doesn't understand mathematical statistics.

Him saying the overlap 'is not the point' of the graph has somehow become him saying that there is no substantial overlap (oh, sorry I forgot 'substantial' now means 'very small' - I will have to get the hang of this newspeak)

I should never have started trying to have a reasonable discussion again.

Anyone else actually get the 'rona? :party:

Go back a few weeks and people in the US were saying ‘no problem here!’ Because once you’re infected you don’t drop dead on the spot. There is a substantial lag between infection and death in most cases - we’re talking in excess of a month in some cases. — I like sushi

And those deaths are very complicated. An overabundance of cases involve preexisting conditions that are exacerbated by covid infection. So, it becomes very difficult to separate the true covid fatalities from the compounded cases. At this point, from the vantage points of bystanders like you and I, until one of us is dead, it is all speculation. I'm unnaturally averse to hype, forgive me, I was heavily impacted by Bush and the Iraq War.

It never ceases to amaze me the lengths people will go to to maintain their chosen narrative. — Isaac

You must be easily amazed.

I should never have started trying to have a reasonable discussion again. — Isaac

That you attempted it amazes me, and I thank you for that.