Coronavirus

Early and Broad Testing Helps Explain Why COVID-19 Looks Less Lethal in Germany

Germany's crude case fatality rate is currently less than 1 percent, compared to 1.8 percent in the U.S., 6.4 percent in the U.K., and 11.4 percent in Italy.

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One relative bright spot in the COVID-19 pandemic has been Germany, where the number of deaths as a share of confirmed cases—the crude case fatality rate, or CFR—is currently about 0.9 percent. Since the number of actual infections is likely to be several times larger than the official figures suggest, the true CFR in Germany may be somewhere near the lower end of the (very wide) range that U.S. public health officials consider reasonable based on current (very limited) data: 0.1 percent (the estimated CFR for the seasonal flu) to 1 percent (10 times as deadly as the seasonal flu).

By comparison, the crude CFR for COVID-19 is currently 1.8 percent in the United States, 4 percent in China, 6.4 percent in the U.K., 8.6 percent in Spain, and a jaw-dropping 11.4 percent in Italy. Is Germany doing something right, or has it just been lucky so far?

Writing from Berlin in The New York Times, German journalist

"Between countries, there are several reasons why the death rate might vary, but they're very small compared to the impact of how many people get tested," Liam Smeeth, an epidemiologist at the London School of Hygiene and Tropical Medicine, told Time. "Germany very rapidly rolled out testing to a very large number of people, relative to the population."

Wider testing not only helps limit transmission. It also reduces the gap between confirmed cases and total infections, which in turn reduces the crude CFR.

"Germany has also been better at protecting its older residents, who are at much greater risk," States banned visits to the elderly, and policymakers issued urgent warnings to limit contact with older people. Many seem to have quarantined themselves. The results are clear: Patients over the age of 80 make up around 3 percent of the infected, though they account for 7 percent of the population. The median age for those infected is estimated to be 46; in Italy, it's 63."

The median age of the general population is actually a bit higher in Germany than in Italy. But in Germany a disproportionate number of people who have tested positive for the virus are young. may have to do with infections that young people contracted while skiing in the Italian Alps or participating in pre-Lent carnival events.

Germany's crude CFR has nearly doubled since last week, and it may climb further as the virus spreads and people who are already infected develop symptoms. But COVID-19 still looks far less lethal in Germany than it does in many other countries, a contrast that underlines the importance of early and wide testing—something the United States conspicuously failed to do.

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  1. Early and Broad Testing…

    I never thought I’d see the day that Jacob would come out in favor of testing broads.

    /deliberately obtuse

    1. Jump AFTER testing, always.

  2. Looks less lethal.

  3. I just bought a brand new BMW after having made $6375 this past one month and just over 12k last 4 week. This is the best and most financially rewarding job I’ve ever had. I actually started this few Weeks ago and almost immediately started to bring home minimum 74BUCKS p/h… Read More

    1. Bah! I’ll remain unemployed a take the free Yugo that my Uncle Josip passed down.

  4. So it turns out that testing can give us real, actionable data and help assuage public fears and get people back to work when safe.

    Trump cultists one week ago when Trump was lying about testing roll outs: “Hurrrdurrr what does testing even do for us anyway?”

    1. So it turns out that testing can give us real, actionable data and help assuage public fears and get people back to work when safe.
      ——–
      It was the only thing that ever could. How could we know if we need to flatten the curve, or for how long, without knowing where on the curve we even are?

      The central planning response to this has been 10000% terrible, and as the days go on I’m more and more convinced they aren’t interested in useful data, only scary data.

      The day that a significant number of people can test and see they’ve already gotten over this, the crisis evaporates. It seems like government is trying to delay that day as long as possible.

      1. The day that a significant number of people can test and see they’ve already gotten over this, the crisis evaporates. It seems like government is trying to delay that day as long as possible.

        You are looking for testing to confirm your delusions and biases about what this is. Iceland HAS tested – 5571 non-symptomatic people with no known contacts with anyone positive. As random as any sample of the ‘who hasn’t been infected by this’ universe can be when you have to jab a swab up their nose to collect it. 48 of them tested positive – that’s 0.8%

        There isn’t some 5% or 10% or 20% or 50% that has been exposed and gotten over this. The number infected so far is much closer to 0.8%. And probably a lot less here in the US. More in New York, less in South Dakota. But not much anywhere.

        1. And Iceland probably regrets wasting those 5571 tests merely for the informational value. Because the week after they did that, they announced they would only be able to import 3000 tests the next week instead of 5000. They depend on an external supply chain too.

          There is a worldwide shortage of some parts of the supply chain here. Wasting tests to test people who you expect to be negative and/or who don’t need treatment is a colossal waste of that. Which in fact will kill people if you can’t test them and they do need that result to help determine their treatment.

          1. Knowing how many asymptomatic people are infected is a really valuable number for being able to model the spread of the disease, which has huge implications for public policy. But a much more conservatively sized population could have been evaluated to arrive at the same number.

        2. I’d say at 1 of those 48 had contact with someone who was infected.

          1. I’d guess all 48 did. But whatever contact they had was unknown so not part of any tracing. And very much part of the general community spread – eg touching door knobs or gas pumps, infected in a large group, etc – that is the core of all claims that some large % of peeps have already been infected, had a mild case, and are now immune hence the disease is nothing to worry about.

        3. Only in your world can people not have gotten over this 3-14 day sickness in the last three months.

          1. Only in your world can ‘I’ve never had any symptoms of anything, therefore I must have been infected and am now certainly immune’ be the basis for anything whatsoever.

            When an antibody test is available, you can bet that Iceland will be the first to test that. And you will then jump up and down protesting it if the result is anything less than ‘herd immunity already achieved therefore nothing needs to be done’

            1. Why would Iceland be the first to test it, and why would I care about what Iceland’s rates are? We’re talking about America. You know, the place where this thing was floating around undetected for weeks before we thought to start looking for it.

              1. The contagiousness RO of the virus does not follow the observer effect. The virus has the same RO whether we observed that or not. In particular it is delusional to believe that merely because we, somewhat uniquely, weren’t paying attention that it, totally uniquely, ran rampant here and infected everyone asymptomatically so everyone is now immune and we, uniquely, now have ‘herd immunity’

    2. Please quote the specific individuals Tony.

      1. Don’t hold your breath. He’ll ignore your question, then make the same claim in a couple days.

    3. What a weird comment.

      The people most skeptical of the panic are also the ones saying full testing would show the mortality rate being lower than reported. This includes people you would categorize as “Trump cultists.”

      At the same time, we’d need antibody tests, too, and it should be preferably done in a remote way that doesn’t overwhelm hospitals with people with no symptoms taking tests.

      We also have plenty of data already from countries with doing testing, though, so you would think that would go at least part measure in reducing the panic-driven media reporting.

      1. We need to start doing a lot of medical testing remotely. We can get more data at a much lower cost.

    4. It is amazing how poor of a reading comprehension level you have.

  5. The most important part of the economy is BOOMING due to the Chinese flu….

    The National Cannabis Industry Association pointed to the sales spike as clear evidence of how essential cannabis is to many American consumers.

    “The sales spikes we saw around the country in cannabis businesses over the last two weeks is indicative of a combination of factors, including the fact that it is actually essential to the health and wellness of many consumers, coupled with the uncertainty of continued availability as the pandemic response progresses and intensifies,” NCIA’s media director Morgan Fox told L.A. Weekly.

    Fox believes the fact that an increasing number of state and local governments are either declaring cannabis businesses “essential” or facilitating continued access in some form is a great sign of the legitimacy and acceptance of regulated cannabis providers. He said that it also shows the recognition of cannabis itself as a valuable medicine, therapeutic product and safer alternative to alcohol.

    https://420intel.com/articles/2020/03/30/coronavirus-and-cannabis-every-single-day-has-been-busier-420

    Vape ’em if you got ’em!

    1. I joke that in WA government says it’s “essential” because it’s medicine, but in reality they don’t want a bunch of people home and pissed off they can’t get any weed.

  6. When you say “broad testing” are you referring to the results of Angela Merkel’s test?

  7. Well at least I now know why Reason journalism sucks. It is apparently nothing but linking to NYTimes shit (and/or previous Reason articles) in order to repeat and repeat and repeat and repeat whatever meme has been deemed to fit ‘libertarian’ purposes.

    No Sullum. you’re wrong. Testing has almost nothing to do with why Germany is doing better and indeed quite well. In fact, Germany was late to testing (beyond the TRACING stuff). But hey – since the US was absolutely the latest to testing, that must obviously mean that the only reason the US is the world’s clusterfuck on this is because of testing. Otherwise, we should clearly be the best since we are the best. Like by definition

    1. So, seriously–why is Germany doing better?

      1. They have no barriers to preventive care and public health stuff is completely part of preventive. Which also means their older folks tend to be healthier. Or more accurately maybe, there are fewer morbidity extremes among their older.

        The lander each have their public health office that sets up those regs re hospitals. Public/private insurance have no countervailing say in that. Employers are mandated to provide paid sick leave with very little waiting period and only a dr note required.

        So when they started tracing contacts (and they did do that in the very German way unlike Lombardy), they did not charge for the test (like all preventive – not part of the deductible or copay). If test was positive, employee could take the 14 days off at full pay. That limited the spread early.

        They also have a lot of hospital beds (I think about twice per capita that we do). And the Mittelstand are the global supply chain for many niche products – and have the tech capacity to switch to other stuff. So hospitals are not having supply problems and Germany will be the last country to suffer supply problems. They’ll run up against capacity – which is what will drive up the fatality – but later than most others and maybe not this wave. They won’t have the good outcome of Iceland – but Iceland is young and Germany is old

        1. So when they started tracing contacts (and they did do that in the very German way unlike Lombardy), they did not charge for the test (like all preventive – not part of the deductible or copay). If test was positive, employee could take the 14 days off at full pay. That limited the spread early.

          So it was all about the testing. The rest of your comment is irrelevant because there were not enough tests available in the US or many other places. Germans healthier? Have you been there? Their population is not that much different than here, except fewer aged minorities. Plenty of sick old people.

          1. “Germans healthier?”

            Less obese.

          2. No. It was about the tracing.

            Testing as part of tracing is very different than ‘testing’ as some general thang. When Sullum/Bailey/etc writes ‘broad testing’ he is talking about general testing. In particular, testing as part of tracing focuses on a tiny universe – maybe 5k or 20k or 100k or whatever – building UP and out from the identified places/people/events that positives were at. We failed at tracing too – but that is a completely separate failure.

            General testing starts from a universe of 320 million peeps – and immediately requires some assumption as to how those 320 million ‘tests’ will be distributed since there aren’t even remotely that number of test resources available. It in fact starts from the assumption that market pricing is the only way to allocate that – and epidemiology and contact tracing is irrelevant compared to ‘everyone who wants a test can get a test’. It is why that has become the meme here. It is the way testing can become profit-oriented and fit neatly into a market model rather than an epidemiology/tracing model. And I suspect the CDC failure re general testing was more because they (like all public health here) are utterly corrupted and captured.

            1. Specifically re our failure. Everyone else developed their tests based on the Chinese giving the gene stuff to the WHO. There was no protected IP with any of that.

              The CDC instead tried to create its own test – which would have then had protected IP – which could have then been either sold or given to cronies. They obviously failed to develop that IP faster than the virus could spread. But the fact that they (along with the FDA) even wandered down that corrupt path is the core problem. there is no testing profit in the non-IP WHO tests. And the US no longer does anything that isn’t about creating protectable IP.

        2. Which also means their older folks tend to be healthier. Or more accurately maybe, there are fewer morbidity extremes among their older.

          The reason for that is far simpler: Germany doesn’t waste a lot of money on keeping people alive who would die within less than a year anyway. That population is the primary population that drives up COVID mortality in the US. I suspect they also use different criteria for attributing death to COVID (in the US, most deaths that occur in someone with COVID are attributed to COVID).

          You know what the German health care system also does? It doesn’t redistribute from rich to poor; it has long waiting times; it doesn’t pay for most abortions; it makes strict, rational cutoffs based on QALY; it doesn’t pay for many drugs; it is financed by payments on top of taxes and charges even those on welfare; it exempts many of the providers from workplace and job regulations; it’s private and market-based for those making more than $50k/year, and it’s private a strongly regulated for those making less; it results in compensation for medical providers that few US doctors and nurses would work for.

          Yes, the German system works better than the US system, and you can bet that the Democrats would scream bloody murder if anybody tried to adopt the German system in the US.

          What you do is to cherry-pick a few features you like about the German system while neglecting the tradeoffs and high price that Germans pay for this.

          1. You have no actual clue what you are talking about. You are simply repeating lies that confirm your biases like every other know-nothing asshole ideologue. Waiting times in Germany are NOT remotely the same as waiting times in UK – or for that matter in the US. Germany has significantly longer life expectancy than here – and the old are as likely to ‘die in hospital trying to be saved’ as they are here.

            And what part of I don’t give a fucking rats ass what the D’s or R’s think about anything don’t you people ever understand. That is YOUR fucking bugaboo not mine. YOUR obsession. Where you can’t even remotely try to understand something unless you first try to fit it into some DeRp mindset.

            I am very aware of the downsides of the German system. I’ve been hiring people for decades – in more countries than you can find on a fucking map. All of which is irrelevant in this epidemic. but hey keep on DeRpty DeRpty DeRpty DeRpty

      2. Define ‘better’.

      3. Do not discount German social manners. Personal space in Germany is quite different from that of say Spain or Italy.

      4. They follow directions, unlike the Italians.

        The idea that the government could somehow prevent coronavirus from spreading is a fairly anti-libertarian idea.

    2. Germany was late? They developed the first test, a week after the Chinese reported the DNA sequence. Who was sooner?

      Jeez you’re good at ranting falsely.

      1. Beat me to it. Those guys were lightning fast.

      2. It doesn’t matter when they developed the test. They only used it for tracing contacts until a couple weeks ago.

        1. And that may be the true solution. Tracing contacts and stopping likely transmission on a focused group of people rather than a blanket ban on everyone… except those considered essential, which is like half the population apparently.

  8. Poor unreason still assuming that untested American never had KungFlu and simply recovered on their own, thereby greatly reducing the death rate below 1%.

    Hysteria from the media is unacceptable!

  9. Not really related to the article, other than a comparison of how different countries stack up but- it will be interesting to see how the US healthcare system looks coming out of this. I think deep down, at some level the left are scared that our system will do a great job handling this, much better than we have seen in some Euro countries. I wouldn’t be surprised if that is the case- we tend to have a lot of the best and brightest here, and we are good at innovating and coming up with pragmatic solutions (when bureaucracy stays out of the way). We always hear about how much more care costs here for any given situation, and let’s say we ignore any arguments to the contrary and agree with that- while the left acts like all that money is just poured directly into a giant hole (or more correctly, into the money vaults of hospital and insurance CEOs), perhaps it gets us a healthcare system that is one of the best in the world? It terrifies them that their perfect socialized systems around the world might be shown to be just not that good, while the US model, though expensive for day-to-day medical needs, can deliver the goods when it needs to.

    1. For libertarians, it sure is ANOTHER example of why central planning fails. The AMA and Congress have been colluding for decades to keep health care supply low, but now we have to shotgun our economy so that we don’t overwhelm the system? Sure would be a great time to lift that artificial doctor cap……..

      1. Bingo! The AMA helping to limit the number of doctors is criminal. It inflates costs and makes the current doctors wealthier. Cronyism of a different sort.

    2. Yes it will be interesting to see how the different medical systems come out of this
      But don’t bet too much that it will be what you think.

      Italy is the least ‘national’ health system. The Lega Nord’s sole purpose in politics is to dismiss the rest of Italy as inferior. Lombardy is run by them and their system is very ‘privatized’ by European standards. Their website still touts their Lombardy Health ServiceLombardy has a history of attracting patients from other regions of Italy. Uh huh. Guess they forgot about public health in their zeal for cardiology, oncology, and pharma/biotech research.

      1. From your link:

        The majority of hospitals are run by the Lombardy Health Service, while about 22.4% of beds are located in private hospitals, either profit or not-for-profit.

        The LHS employs approximately 130,000 skilled healthcare workers, including 30,000 specialist physicians and 8,000 General Practitioners and Paediatricians.

        So the government runs 78% of the system. And you spout that this is somehow private? OK, more private than some other in Europe.

        But in essence you severely mischaracterized the health system in Lombardy.

        1. JSlave loves state-controlled totalitarianism. He must be happier right now than he’s ever been in his life.

        2. No I didn’t. The privatization path that Lombardy chose are the specialties that draw patients from all over. Not necessarily purely elective stuff like plastic surgery – but also the tertiary care stuff with the very expensive specialists (who BTW – are almost completely useless right now except for respiratory). The stuff of ‘medical tourism’ – and Italy (Lombardy) has been a top-10 destination for that.

          There is never a path to profit by treating locals. The path to profit is always a)eliminate preventive and GP and b)maximize the efficiency of fixed facilities costs (read churn patients and reduce avg hospital stays) and c)overbuy diagnostic/treatment equipment for the tertiary care stuff.

          It’s very much the same dynamic as here – only a bit less so. Here in the US, from 1975 to 2015, we went from:
          Federal hospitals – 132k beds to 39k beds
          Muni/state hospitals – 210k beds to 117k beds
          ‘Non-profit’ hospitals – 658k beds to 531k beds
          For-profit hospitals – 73k beds to 135k beds

          In this epidemic, both the tertiary care and the ‘churn’/efficiency model fail. All the money spent in past years on MRI’s and photon radiation treatment for prostate cancer are – pfft down the toilet. The opportunity cost of not having reserved that previous surplus – well very high now

          In the end, it doesn’t matter one whit what you think or I think. What matters is how the people of Lombardy view how their system worked. Our opinion only matters re our system – and we are still a few weeks away from even beginning to judge that.

          But methinks employer-based access, ugly costs, and very possibly the same dynamics as happened in Lombardy – well let’s just say I’m less optimistic than you that it will result in applause.

      2. Italy is the least ‘national’ health system. Lombardy is run by them and their system is very ‘privatized’ by European standards.

        Bullshit. Many European nations have mostly private providers. Many have large systems of private insurers.

        You keep making up shit to advance your narrative.

  10. Sullum fails to account for the obvious reason a fraction is smaller: because the denominator is larger.

    The less testing, the fewer confirmed cases.

    Per capita, the USA started out slow with testing, relative to deaths, which means that our ratio of deaths/confirmed cases is high.

    Testing is good. Very good. It’s the primary tool in containing contagious people. But it doesn’t help to imply that it makes for a more likely successful outcome once you get sick, because it doesn’t.

    1. My interpretation is that Sullum knows well that being tested doesn’t change one person’s outcome, but the knowledge of who is and isn’t infected allows the adjacent people to adjust their behavior to limit spread of the virus.

      You inferred, he didn’t imply that testing helps individual cases.

  11. The current US fatality rate is also based on lagging data, the rate of increase in new infections has been dropping for a couple of days, but the rate of increase in fatalities has remained more even.

    1. You mean it was “dropping for a couple of days” TWO WEEKS AGO. Since then we don’t know, but it sure looks to me like we passed the peak before these extreme control measures were put in.

  12. Seems logical until you see the caveat that Italy had even more prevalent testing. That they have the highest death rate AND more testing is a pretty devastating blow to the “more tests will show a lower death rate” theory. Seems like this would point to Germany’s focus on the elderly as what is truly driving their low death rate…

    I’ve been hearing now for almost 2 weeks that once we get tests out there, the CFR will start plummeting. Certainly hasn’t happened yet…

    1. I’ve been hearing now for almost 2 weeks that once we get tests out there, the CFR will start plummeting. Certainly hasn’t happened yet…
      ———–
      That’s because we’re only testing the most severe cases, due to……..wait for it…….a lack of tests.

      1. The positive test rate here is still only 12%. So most of the idiots calling up 911 asking to be tested are fucking everything up.

        1. In most places you can’t get a test without a doctors orders. NBA is different, as are some other groups.

        2. JesseAZ, that 12% makes for a very large denominator for the US, doesn’t it?

    2. Not over the top enough for that handle. I’m gonna need you to turn the outrage up to at least 7.

    3. Seems like this would point to Germany’s focus on the elderly as what is truly driving their low death rate…

      If by “focus on the elderly” you mean “pushing them off the cliff before they can die of COVID.”

      Seriously: Germany and most other countries use far tougher guidelines for what treatments they will pay for for the elderly. If your healthcare policies kill off seniors with serious chronic conditions faster, you’ll look a lot better on COVID statistics.

  13. You were tested (negative) last week. Is there anything you would like today? The young people at Amazon warehouses are going on strike from fear of COVID-19 which would be a typical flu bug for them. Social pressure made everyone commit to the foolish understanding.

  14. Mass roll out of the cheap AF antibody tests are the only way we’re going to get past this nonsense.

    I agreed with shutting down big events, maybe even bars etc… But shutting down everything has gone too far. We need to keep hospitals from being overwhelmed, but keeping them at 50% capacity does nothing. I just talked to an ER doctor in Seattle and she said all the hospitals are basically just chillin’, not even close to capacity. And our curve has basically already gone flat.

    This effectively means we’ve over corrected. People NEED to get infected, preferably young healthy people. Then we need to verify who has had it or not. People that have can return to getting shit done. Some of the antibody tests that are already proved effective cost as little as $10 fucking dollars, and give you results at home! No need to even waste a doctors time.

    We need that shit rolled out by the 10s of millions ASAP. It’s the only way the madness will end.

    1. And yet there are articles claiming hospitals all over are overwhelmed . Maybe NY city. Here in Ohio, no.

      1. Exactly.

        Which is why a national policy for any of this is absurd. Even state wide policies are absurd. Seattle is one of the hardest hit spots, and straight from the horses mouth we’re not even at capacity, AND the stats show our new cases have already flat lined.

        Truth is rural Washington, probably even Spokane (2nd biggest city) could be doing nothing beyond major gatherings being cancelled, and it would be fine.

        NY seems to be the sold place that is totally out of control in the USA. After that a couple cities probably need mid level restrictions as mentioned. NY is probably the only place that needs a full on lock down to get things under control though.

        Politicians are so fucking dumb it hurts.

    2. Right. If “they” are being honest about why these insane measures need to be put in place- to flatten the curve and not overload healthcare capacity- then no patients is not good either. If we are to believe that no matter what, millions and millions will need hospital care from this before it ends, and the whole problem is limited capacity for that hospital care in terms of facilities and personnel, then it is exceedingly wasteful to allow these resources to sit idle. In a perfect world, we could throttle the number of infections to keep all those beds full and personnel busy without overloading. Obviously we can’t quite do that, and I get they are concerned about the looming specter of millions of already infected people just sitting there incubating and any day the whole thing will break loose everywhere. But with that said, we are in the third week of full blown nationwide freakout here, and while the 14 day incubation period number gets thrown out a lot as if it is the normal period, everything I’ve seen shows that 14 days is the high end, and most people that are going to get symptoms show them within 5 days, and if they are going to die, are dead in around 10 more days (and receiving hospital care for some time before that- let’s say starting 10 days after infection on average). Point is, if it is out there, uncontrolled and unknown AND will require hospitalization for any appreciable proportion of people who contract it, we should be seeing that in our hospitals within a couple weeks after we determine it is widespread. I understand that the time passed thus far doesn’t PROVE that what they are afraid of WON’T happen, but I think the nation and the medical community at some point can’t be afraid to start asking- where are the patients? They are certainly there in NYC and New Orleans and maybe Detroit and some other areas. But what evidence is there to suggest that those are the rule rather than the exception as compared to most of America?

      1. if it is out there, uncontrolled and unknown AND will require hospitalization for any appreciable proportion of people who contract it, we should be seeing that in our hospitals within a couple weeks after we determine it is widespread. I understand that the time passed thus far doesn’t PROVE that what they are afraid of WON’T happen, but I think the nation and the medical community at some point can’t be afraid to start asking- where are the patients?

        That’s a very legitimate question. Obviously there is a lag from detecting cases – to hospitalization – and then to ICU – and then to outcome death/recovered/lingering (two of which will offset new cases so active cases can turn down).

        Here in CO (the only state I’m following – and they are providing good data too – and CO is generally considered one of the healthiest states):
        Mar 21 – cases 475 hospitalized 49 – hosp% 10%
        Mar 24 – cases 912 hospitalized 84 – hosp% 9%
        Mar 27 – cases 1734 hospitalized 239 – hosp% 14%
        Mar 30 – cases 2637 hospitalized 414 – hosp% 16%

        We have 1850 ICU beds in CO. Assume 30-40% of them are available. But there’s apparently a huge difference in time there between covid19 patients (2+ weeks – esp if young) v non-covid (4-5 days). So it doesn’t take much longer for the cases to rise, for the hospitalization lag to fully kick in (I assume maybe 20% early then declining a bit), and then for the ICU lag to kick in too. CO isn’t near capacity yet. The deaths right now are just the easy older prey (only 5 of 41 under 60) without much hospital burden. But the hospitalization burden is not that old – 3% of 20’s; 7% of 30’s; 11% of 40’s; 18% of 50’s; 22% of 60’s; 28% of 70+. That is not a distribution where you want those hospitalizations to turn into fatalities merely because hospitals are full (a la Lombardy).

        CO just announced their ICU expansion plan – an additional 1000 by May and an additional 5000 by summer (presumably for the fall 2nd wave not a continuing 1st wave). This lockdown is just to buy time for the May rampup. The better it works, and with a bit of warm weather luck, the nearer this lockdown ends and starts at a very low level of contagious again

      2. “In a perfect world, we could throttle the number of infections to keep all those beds full and personnel busy without overloading.”

        This is exactly what the ER doctor and I both agreed on! She said if more people don’t get sick, and we don’t keep it close to max, then it will just explode later… So she agreed that if we find out definitively that our curve has flattened, then we need to ease up to let more people get sick!

        And JFree, the data in a few places seems to be showing we’ll never hit capacity at these rates. Washington is basically flat, and may start declining if I had to guess from the way the numbers look.

        This is not desirable. We need to keeps things hovering close to capacity. Unless some already extant drug cures this shit, like the malaria drug, we simply have to accept that almost everybody will HAVE to catch this sooner or later.

        If pols have any brains they will ease up on restrictions in the next week or so if the data trends continue to look the way they seem to look in places like Washington. Even if particular areas, like Seattle, need to stay more restricted, not having it be state wide would be a HUGE help economically. I guarantee if Seattle isn’t at capacity yet, Spokane isn’t even feeling it at all.

        1. the data in a few places seems to be showing we’ll never hit capacity at these rates.

          It’s less about growing through capacity than it is about patients not able to be weaned off ICU. China data is not good – but it is internally consistent and been around long enough to have a lot of recovered. After two full months, there’s as much ‘not yet recovered’ as ‘dead’. Some is obviously just missing data – but there is lingering stuff too. People still in ICU – all younger and healthier (old can’t survive that long in ICU) but got a serious case. Every patient like that will simply consume capacity. The analogy could be the iron lung machines during polio.

          1. Yeah, it’s possible if enough people linger long enough that could happen… But we’re also doing all kinds of crazy shit like building field hospitals, manufacturing fuck tons of ventilators, etc.

            So again, it is entirely possible we may never truly max out capacity… Which is a bad thing. We can’t say 100% for certain how many people will get it period, how many people will get it bad but recover quick, and how many people will linger… Which is what we would truly need to know to be able to do the math accurately… But it doesn’t seem like we’re going to get too bad given the trend line here.

            SK started with more ventilators than us, but never went as extreme as we have with shutdowns… We’re really just going to have to wait and see how things progress. I guess my only hope is that if things are looking good as more data piles up, and it appears we won’t max things out, that the pols do the sane thing and begin even slightly easing up on restrictions… Because there is no point in staying too far below max capacity.

      1. Ugh.

        This is why this stuff ALL needs to be local. If an area isn’t swamped, they should be doing surgeries etc still. In NYC that probably wouldn’t be prudent.

        As with most matters in the world LOCAL decisions based on LOCAL factors is the best way to go. There’s no reason small town South Dakota needs to shut down their local factory that makes widgets or whatever when they don’t have a single case… Yet total shutdown might be reasonable in NYC. Case by case thinking is needed.

    3. 100% this, yet it seems like nobody in charge has thought of this. It’s just panic all the way down.

      1. Well, politicians aren’t exactly known for being the brightest most of the time are they? Most of the “important” medical people seem to be equally stupid on this issue. I was surprised that the doctor I was talking to had the sense to realize this was the best way forward giving what all the talking head doctors are saying in the media.

  15. I dont’t think Germany is doing better.
    1. They are about 10 days behind Italy
    2. No post-mortal testing, unlike e.g. Italy. Unknown positive cases are still high
    3. Berlin (3.5 Mio) for example ist testing max. 3000 cases per day which means the infection rate curve for this state flattens out pretty quick.
    4. I would like to see the test distribution along age groups. And that compared to Italy or Spain. Main origin of first group of positive cases were by carneval attendants and skiing tourists (Tyrolian ski resorts) – the typical age group is 18 to 60.

  16. The main reason is Germany is testing many more people, including many who carry the disease but have no symptoms. Since that is about halve the carriers of the disease, their death rate is automatically cut in half.

  17. This is an argument about statistics and with statistics if you torture the data enough you can prove pretty much anything desired. In this case testing people with COVID-19 symptoms versus testing regardless if they have COVID-19 symptoms. Add to this how deaths are calculated and reported, such as death due to COVID-19 versus death with COVID-19. Did the person die from COVID-19 directly or did they die due to some other condition and COVID-19 just compounded the situation like any other virus or infection would have.

    I do agree that once a easy and inexpensive antibody test is developed and produced, that the general public should be tested to gather the true data set. From this data set future plans can be made so we learn from our missteps and prepare for when the next epidemic or pandemic occurs.

    1. Yup! At $10 a pop it would be INSANE to not test 100% of the population.

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  19. The larger your test population, the more accurate your data. Currently, the US is concentrating on testing those who are sick and seek treatment. This raises the percentage of the seriously ill and the fatalities. When all is said and done, in all likelihood, the US morbidity rate will be well under 1% assuming we are able to eventually test a majority of Americans. That is the outcome experienced by those countries that have done massive testing.

  20. Why deaths in Italy higher than Germany?
    It’s a data error! If someone dies & has multiple diseases but is suspected of also having the virus, Italy calls it a virus death while Germany calls it as from their other fatal diseases! This is the real reason– not testing.

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