What Explains the Difference Between Estimated COVID-19 Fatality Rates in New York and California?

Are the California numbers wildly off, or is New York different in important ways?


One of the points raised by critics of two recent California studies that estimated a surprisingly low fatality rate for COVID-19 can be summarized in four words: What about New York? If just 0.1 percent of people infected by the COVID-19 virus can be expected to die from the disease, as the low end of the range indicated by antibody tests in Santa Clara County and Los Angeles County suggests, the current death toll in New York City would imply that more than 100 percent of the population has been infected.

We probably can rule out that possibility, even without taking into account the test results that New York Gov. Andrew Cuomo announced today, which suggest that a fifth of the city's residents have antibodies to the coronavirus. By comparison, the Santa Clara County and Los Angeles County studies estimated that the share of residents infected by the virus as of early April was around 3 percent and 4 percent, respectively. Given New York City's population density, it makes sense that a substantially larger share of residents would be infected there than in most other areas of the country. But population density alone does not account for the remarkably severe impact of COVID-19 in New York, and other possible explanations have been floated, including demographic factors, social distancing policies, overburdened hospitals, and multiple sources of infection from international travelers.

The current crude case fatality rate (CFR) in New York City—confirmed deaths as a share of confirmed cases—is more than 7 percent. If you include "probable deaths"—cases where infection was not confirmed by virus tests but suspected based on symptoms and circumstances—the crude CFR rises to nearly 11 percent. By comparison, the national average is currently 5.7 percent.

That average disguises wide geographic variation. In Texas, where I live, the current crude CFR is 2.6 percent. It is 1.5 percent in Wyoming, 3.3 percent in Florida, 3.9 percent in California, 5.4 percent in New Jersey, and 6.2 percent in Louisiana.

New York state accounts for nearly a third of COVID-19 deaths in the United States, and New York City by itself accounts for a fifth (including just confirmed fatalities). The city has recorded more than 100 deaths per 100,000 residents, compared to about 15 nationwide, two in Texas, four in California, and 60 in New Jersey.

So what's going on in New York City? Even judging from confirmed cases, it's clear that a relatively large share of the population is infected. And we know that confirmed cases underestimate total infections, since testing has been skewed toward people with severe symptoms, which are not typical. The size of that gap—the issue at the heart of the controversy over the California studies—is crucial in estimating the overall fatality rate among people infected by the virus.

Cuomo said about 14 percent of 3,000 people randomly selected from shoppers across the state tested positive for antibodies to the COVID-19 virus. That sample may not be representative of the general population, since people who are sick or think they may have been exposed to the virus are probably less likely to be out in public. But assuming the sample is representative, the results suggest that something like 2.7 million New Yorkers have been infected, which in turn implies a statewide infection fatality rate (IFR) in the neighborhood of 0.6 percent—three times the upper estimate from the California studies.

Cuomo said the antibody tests suggest that 21 percent of New York City's population has been infected, which implies about the same IFR. By comparison, antibody prevalence was about 17 percent on Long Island, 12 percent in Westchester and Rockland counties, and less than 4 percent elsewhere in the state.

It makes sense that the virus would be especially prevalent in New York City. With 27,000 people per square mile, the city has by far the highest population density of any jurisdiction in the United States. With so many people living in close proximity to each other, jostling each other on sidewalks, and crowding together in subways, stores, bars, and restaurants, it would be surprising if New York City did not have an unusually high infection rate.

But population density is not the whole story. When George Rutherford, an epidemiologist and biostatistician at the University of California, San Francisco, looked at COVID-19 cases and deaths across boroughs and counties within New York City, he found they were not correlated with population density. Staten Island, for example, had a lot more cases per 100,000 residents than Manhattan did.

Richard Florida, an urban studies scholar at the University of Toronto, argues that economic class also plays an important role in the epidemic. "Covid-19 is hitting hardest not in uber-dense Manhattan but in the less-dense outer boroughs, like the Bronx, Queens, and even far less dense Staten Island," he writes in a CityLab essay. "The density that transmits the virus is when people are crammed together in multifamily, multi-generational households or in factories or frontline service work in close physical proximity to one another or the public….There is a huge difference between rich dense places, where people can shelter in place, work remotely, and have all of their food and other needs delivered to them, and poor dense places, which push people out onto the streets, into stores, and onto crowded transit with one another."

The spread of COVID-19 in New York City also was hastened by the introduction of the virus via many travelers from other countries. "Studies of the viral genome have shown that whereas California had about eight initial introductions, mainly from Asia, dozens of people (up to 100) brought the virus into New York, mainly from Europe," Jeanna Bryner notes on Live Science. "Each of those introductions creates its own 'chain of transmission,' passing the virus to individuals who then, in turn, pass it to others." According to modeling by researchers at Northeastern University, New York City may have had more than 10,000 infections by March 1, when its first confirmed case was reported.

Another possible factor is the timing of mandatory social distancing policies. Cuomo issued a business closure and stay-at-home order on March 20, the day after California Gov. Gavin Newsom imposed similar restrictions and four days after six counties in the San Francisco Bay Area ordered lockdowns. Assuming three weeks from infection to death, Rutherford, the epidemiologist, told Bryner earlier this month, the first case in the Bay Area happened about two weeks before the local lockdown. In New York City, he said, about four weeks elapsed between the estimated introduction of the virus and the stay-at-home order.

In light of the newly documented COVID-19 death in Santa Clara County on February 6, that comparison seems dubious. That case involved a woman who apparently was infected through transmission in the local community, which suggests the virus was already spreading in the Bay Area by mid-January, two months before the lockdowns there.

It may turn out that New York City not only has more infections per capita than other jurisdictions but also has a higher infection fatality rate, which would be consistent with Cuomo's numbers and the city's relatively high crude CFR. Rutherford thinks a stressed health care system may help explain that difference. "As the hospital systems get overwhelmed, the mortality rate goes up proportionately," he told Bryner, citing data from China.

Epidemic-related hospital use peaked in New York state on April 8, according to data from the University of Washington's Institute for Health Metrics and Evaluation (IHME). At that point, the IHME says, the number of available ICU beds fell about 5,500 short of what was needed.

New York City's experience with COVID-19 could mean that the IFR estimates from the California studies are wildly off (although the New York prevalence figures make it seem more plausible that 3 to 4 percent of people in places like Los Angeles County and Santa Clara County had been infected by early April). It also could mean that a much larger share of the population is infected in New York City, as Cuomo's numbers suggest, and that people with the disease tend to do worse there for reasons that may include an overburdened health care system. Or all three of those things could be true to some extent. We won't have a clearer answer until additional research sheds light on the actual prevalence of the virus in different parts of the country.

[This post has been revised to update fatality figures and correct the timing of lockdowns in the San Francisco Bay Area.]

NEXT: Prisoner in Ohio Halfway House Complains About Lack of COVID-19 Preparations. He's Sent Back to Prison. Now Ohio Prisons are Exploding with COVID-19.

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  1. What about the demographics of people dying? I had read something like 90% of the people who died in NYC were obese and had something like hypertension or diabetes

    Add to that the sunlight factor. Sunlight boosts the immune system. People in NYC might go outside, but it's usually pretty shady unless it's noon. Usually only the middle class go to the parks.

    California is the opposite. Even crowded cities tend to get a lot of daylight since you don't have giant buildings right on top of each other. Even SF

    Hopsitalization might play a role, but realistically, something like 90% of people who go on a ventilator will die. There's no real treatment.

    1. Sunlight could be a huge difference. Could also explain why no big outbreaks in Florida or Arizona, despite people coming from all over during flu season. NYC should be more compared to a place like Seattle, which experiences similar weather during the winter.

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      2. I think it may have a lot to do with it. Texas also has a comparatively low case and fatality rate. The only southern state that has a fairly high one is Louisiana. The Mardi Gras crowds might have had something to do with it. Puerto Rico and Hawaii are also comparatively low.
        And mass transit in New York probably has something to do with their high rates. The outer boroughs and New Jersey often have to travel by mass transit to their jobs in "the city".

        1. I find that explanation uncompelling, both intuitively, because ambient sunlight on bodies and airborne droplets doesn’t seem like it would be that helpful, and also because places like Lombardy are quite sunny, aren’t they, and yet got hammered. I’d also expect this to be a relatively easily revealed factor. Not impossible, still.

          1. "because places like Lombardy are quite sunny, aren’t they,"

            No it's in the shadow of the Alps.

            1. And even more so during the winter. Sicily may be sunny in January, but not Milan.

    2. Mayor de Blow-me-o told people to go out to China town.

      Feb 9: Councilman Mark D. Levine stated on Twitter, “In powerful show of defiance of coronavirus scare, huge crowds gathering in NYC’s Chinatown for ceremony ahead of annual Lunar New Year parade. Chants of ‘Be Strong Wuhan!’ If you are staying away, you are missing out.”

      February 13
      Mayor de Blasio conducted a taped interview with NBC News that ran during MSNBC’s Morning Joe. He said, “We have an extraordinary public health apparatus here in New York City . . . and what became clear to me was it was really about telling the people of our city, this is something we can handle, but you got to follow some basic rules. . . . This should not stop you from going about your life. It should not stop you from going to Chinatown and going out to eat. I am going to do that today myself.”

      Either that, or joos.

      1. Huh. First, Hollywood has lots of joos too. Next, do you think it's sunlight or warmth? Most of Cali is quite pleasant even in February and March. I wonder how Colorado compares? We get more sunny days than Florida, but it can get pretty cold in February and March.

        1. February and March didn't seem very sunny this year. And we do get lots of tourism in the ski areas. If I recall that was the source of our first confirmed case.

        2. "We get more sunny days than Florida, "

          The way that's measured makes it a meaningless metric.

        3. Sunlight is the factor. Sunlight on bare skin produces Vitamin D 3 in the skin, and that strengthens the immune system. Coler places with sun tend to have the folks covered up more than, say, Malibu or Sicily.
          What I wonder is WHY government don't get poractive smart and begin handing out free vitamin D, C, and zinc tabs. At less than ten cents per day, the cost to dole this out to EVERYONE i America would be somewhere around. $Mn34. NYC alone probabl spent ten times that dealing with this nonesense. So WHO is gonna git smart about it/

          The eedjits lock us al up in our own fourwall prisons, play tyrant nannie and tell us what we may/mayn't do, yet say nary a peep about HOW to prepare our immune systems to defeat this thing WHEN it comes.

          1. Which could bolster the case that sheltering in place may not be all that good of an idea. Again, I'm not going to bet money on the fact that UV is the corona killer, but anything that's promising.

      1. I am IN that age category, have never had any flu shot, have never gotten the flu, have gotten a cold bad enough to make me lay low for ONE DAY maybe three times in the past two decades, then back up and running after that. HOW can this be? Simple.... eat a healtjhy diet, stay physically active, don't do stupid things (smoke, drink heavily, do crazy drugs, heck I almos tnever even take prescripitoin drugs.. don't need them. Recent blood work have every factor within normal limits.
        I refuse to play the "everbuddy gwine die" games, am out and about normally, and no fear of catching this thing, let alone being laid low by it.

    3. Totally agree about the sunshine and Vitamin D

      Most of the value of hospitalization is simply getting treated for low blood oxygen. Doesn't require full ventilation - and doctors are rethinking ventilation as well as they see more patients

      1. Fuck off and die.

        1. not an option

    4. More than half (63% according to the city's published data this afternoon) have been over 70 years old. Maybe it's harder for the elderly in that city to truly isolate? How many of them had to ride transit to handle their daily errands, or live in a household with someone that does? Of the people under 70 who have died, the majority have some other condition (or conditions), the data said that obesity, diabetes and hypertension were the most common and gave percentages of each but considering how commonly those conditions can overlap it's probably not appropriate to assume that the sum of those portions represents a total "compromised" percentage.

      The city doesn't have a disproportionately high population of people over 65, so it would seem likely that those who are in the city are for some reason less able to avoid exposure and infection than the elderly residents of other areas.

      With rent control being a much longer-lived policy in NYC than in CA, elderly tenants who have been in one place for decades might be "trapped" in their current rentals (most of which probably lack very good ventilation that would allow them to actually isolate from their younger neighbors) by virtue of not being able to afford to move anywhere else, especially if they don't want to leave the area?

    5. 40% of the U.S. is obese.

      1. The Rock is morbidly obese.

        1. How.

      2. No he means actually obese.

        1. as in C>H?

    6. If we're talking death, rather than infections, you have to take into account how causes of death are being recorded.
      I have a hunch NY is drastically over counting the covid, at the expense of less sensational causes

      1. Comparing deaths from COVID-19 to excess deaths (computed by subtracting deaths this year from the average of deaths) shows we are somewhat under-reporting.

        1. Assuming that all excess deaths are caused by Coronavirus. Due to the fear put out about going to a hospital many people are putting off life saving treatment and dying of other ailments. If you count those as COVID 19 then you are over counting.

          1. "Due to the fear put out about going to a hospital many people are putting off life saving treatment and dying of other ailments."

            You really think that is the case? Are people less likely to go the hospital for heart attack and stroke? I don't really understand what type of life threatening situation people would be less likely to go to doctor for. If you assume rational actors (this is a libertarian site after all) then on average people stop going to the hospital only when their risk of getting sick at the hospital outweighs the benefits from the hospital. Is there any evidence of the effect you describe?

            I mean maybe it's a small effect, but I guess what I'm saying is the best available data directly counters the claim that "COVID deaths are over-reported because people would have died anyways".

            Plus, if people are not getting treated for other ailments because hospital resources are stretched thin by COVID, then it doesn't exactly justify being less concerned about COVID-19.

            1. "...You really think that is the case? Are people less likely to go the hospital for heart attack and stroke?.."
              "A shelter-in-place side effect: Bay Area people are afraid to go to the hospital"
              "Hany Metwally sat at home for four days with chest pains, too tired to move from his easy chair. He already had a stent in his chest for a heart condition and knew he should see a doctor, but his fear of exposure to the coronavirus was greater than his fear of an oncoming heart attack.
              On the fifth day, his son, Mohammed, 22, loaded Metwally into his Lincoln Town Car and delivered his father to the nearest hospital, Sutter’s Alta Bates Summit Medical Center in Oakland. A day later, Dr. Junaid Khan spent five hours performing an open heart surgery that required three bypasses around Metwally’s blocked arteries."

              "Plus, if people are not getting treated for other ailments because hospital resources are stretched thin by COVID, then it doesn’t exactly justify being less concerned about COVID-19."
              Got any support for that *IF*?
              Maybe you're full of shit.

              1. Huh, interesting article. I guess I was wrong and it is probably a real effect. My point is though that it probably not the main source of excess deaths. And some of the "not going to hospitals" could be rational (since for older people, the death rate is quite high), though probably not in California where the prevalence is not too high right now.

                As for the IF, it's pretty clear that hospitals in NYC are near, at, or above capacity. I would guess care degrade in the type of circumstances they are dealing with, though I don't think there's been enough research on how much hospitals been overwhelmed *actually matters*.

                And I'm sorry if my line of questioning came off as overly aggressive.

                1. My best guess is the ability of vulnerable people to isolate themselves better in California.

                  It could be all these serology surveys done in malls ( New York ) or on streets ( Chelsea ) or Favebook ( Santa Clara) are selecting a population that is not self isolating and therefore less susceptible. But mortality is mostly happening in elderly who may have lower antibody prebalance as they followed the guidelines to stay away from others. In other words the numerator and denominator may be coming from groups with different CFR .

            2. It is such a problem in London that the NHS in the UK has started running promotion ads telling people to still come in for life threatening illnesses other than COVID-19. So yes, it does appear to be a problem in the industrialized west.

              1. it's almost as if the media has spent the last few months trying to scare the living shit out of the public over this or something.

                1. Ding ding ding!

      2. I tend to agree, how are they counting the deaths and are they testing for the presence of any other infections…Flu for instance. Is there any reason a person could not have both and it certainly would not help to have the flu at the same time? This could also explain the high numbers in New York vs. Texas say as the flu season is pretty much over here but would probably still be going strong in the northern states. I discount the obesity factor, don’t know where we are on the list but I know we are not the skinniest state so the rates should be higher here if that was the main factor.

      3. a couple or articles I've seen have MOST NYC deaths being chalked up to this stupid virus. Just like in Northern Italy. There, some 90% of the ones who died had one or more serious comorbidity factors. Things like heart failure, pulmonary edema, kindey failure, serious lung disease from heavy smoking, diabetes, signficant obesity.

        I've also read that in NYC a very similar conditioin prevails. And that EVERY death, from whatever cause, was put down as due to coronia if a post mortem blood check returned positive for VC. Heart attack patient comes in, doesn't make it, test is CV+, goes down in the book as a CV death. Sad... and dishonest.
        Another place I read that hospitals get $13K per death.. BUT if it is attributed to CV, they get three times that.

        Ya think that mightn't be a little poke to list as many as possible as CV, whether it was causal or coincidental? If I were the moneybags guy AND dishonest, I'd sure do it. Once the cremation happens, there is no reexamination possible. Convenient.

    7. What about viral dose? California is essentially a large suburb. most exposures were probably low dose, one-time affairs. NYC is a very dense city that has huge public transit. With most viruses, the initial dose of the virus is determinative as to whether that infection is survivable or not. It is likely that people exposed in the NY subway, households, and workplaces were exposed to larger and more prolonged doses of the virus, and therefore would on average have more severe infections. Also, repeated exposures to slightly different strains before a person has taken 2 weeks or so to build the required immunity could make infections more serious. Somebody who rides a packed subway every day is more likely to have repeated exposures to different strains.
      One thing that can cut down viral dose is universal mask wearing. maybe that won't stop you from getting infected, but will lead to greater survivability.

  2. Best theory I have heard: lots of people in NYC have shitty lungs because of 9/11.

    You know what this means.........BACK TO AFGHANISTAN!

    Wait, what's that? What do you mean we never left?

    1. Subways in NYC, not so many in CA.

      1. Yeah, it's probably this. Everyone in LA drives.

      2. Also probably induces a higher viral load at onset, which can determine how nasty the infection is.

        1. Yes. Why is there so little public information and discussion about this? The blanket closures of facilities/activities would need to be questioned if we were behaving rationally based on inoculant dosage.

    1. Exactly. And culture won’t get addressed at all in the news. A lot more smokers in the East Coast, plus maybe an older crowd that is more gregarious. And people associate in dense, dark, non well ventilated areas, or areas with heavily recycled air. Crap weather , high density, and mass transport also make a huge negative difference. But, why did Italy, Spain, and Iran have excessive troubles?

  3. Also I've heard that NYC sent positive people back into their nursing homes? I have only seen Tweets cited, though, so I don't believe it yet.

      1. Gracias!

      1. Thank you!

      2. What I don't understand is why so many leftists are praising Cuomo to the high hills over his handling of this when everything is so fucked up in his state relative to elsewhere. I wonder if it was in part a political calculation to have his brother "catch it."

    1. Definitely true in Italy:

      However, the virus was not only spread to "clean" — i.e. infection-free — hospitals by admitting positive patients. In early March, as the number of infected was doubling every few days, authorities allowed overwhelmed hospitals to transfer those who tested positive but weren't gravely ill into assisted-living facilities for the elderly.

      "It was like throwing a lit match onto a haystack," said Borghetti, who spoke out against the directive at the time. "Some facilities refused to take in the positive patients. For those that did [take them in], it was devastating."

  4. Testing.

    The numbers stay low if you don't test, and I think NY is just testing a ton more people, being "ground zero" and all.

    In NY we are all about testing the shit out of everybody now, and diagnosing them with SARS-COV-2 even if the test comes back negative.

    1. Correct. I'm surprised they didn't even touch on this in the article. NY has tested 5 times more people per capita than CA. This bad habit by the media of not normalizing data is frustrating because it leads to bad conclusions.

      1. "...This bad habit by the media of not normalizing data is frustrating because it leads to bad conclusions."

        Which leads politicos to bad decisions and financial depressions.

        1. Media: “That’s a feature, not a bug!”

      2. As they said in The Wire "But them bodies..."

        Deaths per million is not a perfect statistic, but it's the best one.

  5. New York is filthy even when you're outside, and buildings block the sunlight. Texas not so much.

  6. Another things, why aren't we seeing a lot more dead retail workers?

    I work at Walmart. We have like 2.2 million people in the US who work there. We are constantly exposed to customers (and each other). There should be thousands of us dead. But there aren't

    There's two from Chicago (one of whom as diabetic). But I haven't heard about any others. Presumably there are. But if there were a lot, we'd hear about it.

    And it's not like we do any serious cleaning. And we just started to have to wear masks this week.

    1. The virus attacks the brain. Obv Walmart workers are safe.

      1. Then how do you explain Chris Cuomo getting the coronavirus, smart guy?

        1. Maybe it attacks the ego?

        2. Fredo always gets the short end of the stick.

        3. You all just have to read the Cuomo's Coronavirus diary.

          The "party of science" indeed.

          "Resonance breathing and Pranayama helped expand my lungs. “Through them, we utilize the ‘breathing mechanism’ (inhale and exhale) to influence, or direct, the flow of vital life energy deep within the physical body (as well as the energetic body),” says yogi Erika Halweil of the breathing exercises she teaches. “Deep breathing exercises activate a life force within us to help us attain a higher state of vibratory energy. They create space in the body and a feeling of joy and ease in the mind and heart.” I like Deepak Chopra and Eddie Stern’s Breathing app, as well as Calm, which I listen to with my kids at bedtime."
          "I made a liver-cleansing beverage with one raw garlic clove, one orange, one lemon, a tablespoon of cayenne pepper, a spoonful of olive oil, a crunch of ginger and a piece of turmeric."
          "I also used a PEMF (pulsed electromagnetic field) portable machine, which optimizes the ability of cells to start healing. It uses low-energy fields to stimulate the self-healing mechanisms of the cells after a physical injury or a viral attack on the body’s tissues or bones. “For COVID-19, it increases the speed with which your lungs and whole body can recover,” says Tapp Francke, the founder and holistic nutritionist at StandWellness"
          "Every day, Chris and I both ate Ayurvedic food from Corey de Rosa at Tapovana to-go in Bridgehampton"

          Remember, these are the people who shit themselves when the plebs talk about prayer.

          1. That's comedy gold. Someone needs to do a live dramatic reading, with laugh track.

    2. I have heard that roughly 1% of workers are involved in public-facing grocery store jobs, so even just statistically we'd expect nearly 5,000 dead grocery store workers by now. I have also only heard of the two you mentioned.

      1. There was a Kroger worker that I heard died.

      2. I am sure there are more than 2 deaths, but as you’ve both said, if the numbers were large, they would already be making noise about it, So, 2 main possibilities. 1) the virus does not transmit as easily as we thought, and/or doesn’t really spread from asymptomatic people, and may not transmit well in a retail kind of environment. It spreads greats in packed bars, cruise ships, nursing homes, aircraft carriers, workplaces where people work on top of each other, and... who knows? 2) It has affected retail workers but we just haven’t seen the second hand spike yet, and that will be evident within a month if it is going to happen. Right now, less than 5% of the nation has it or has had it, and people who know they are sick are typically staying home, but people manning the stores could be at risk. The numbers didn’t really get significant until mid march. It has been a little more than a month since the NBA suspended their season.

        1. Retail workers' age distribution skews lower than the nursing homes which are having most of the serious cases and deaths? I.e., Jane Walmart might catch the virus, but shrug it off as a bad head cold, and not go to the doctor. Joe Oldfart---who doesn't give a shit about doctor costs because, 1, Medicare pays for it, and 2, it's some of the only socializing he gets to do---on the other hand, reports any sniffle he gets to the doctor, and his sniffles turn out worse on average than Jane's do.

        2. I think you are onto something. Look at the places that had big outbreaks. NYC (and its MTA), Mardi Gras, a convention in Boston, cruise ships, Navy ships, meat packing plants, churches in S Korea, etc. Every single one of them has the feature of large numbers of people packed together for long periods of time. What this implies is a few individuals who are at peak virus shedding (but with no or minimal symptoms) are infecting many other people in packed situations. Simply requiring universal mask wearing indoors outside of home and not allowing large gatherings should prevent large outbreaks from happening.

          Of course, anything we do will put selection pressures on the virus, and new strains will evolve over time that may have different spread patterns. There is a huge random element that makes such future evolution hard to predict.

    3. If your numbers are correct you've raised a very good question.

      1. *Big if true

      2. Because grocery workers are mostly under 50. And practically nobody over 80.

        1. Red was here.

    4. Wild ass guess? Grocery workers are relatively young and healthy compared to other jobs? They aren't olympian level health and fitness, but the very act of minor constant physical labor puts them in a better place than the average office worker who doesn't move from their sitting desk for 8 hours a day.

    5. This is a great point. I have mentioned this previously - these so-called lockdowns (which are not really lockdowns) funnel everyone to these big box stores for necessities. No matter who in the household goes, everything comes home, including viruses. Millions have been, or are being exposed.

      That said, these recent antibody studies (which regardless of sampling method have been consistent in the data pointing the same direction), were no shock - they show millions likely were exposed in the population, but something else is being missed.

      I propose that there is some level of cross-immunity from previous coronavirus infections. Coronaviruses are postulated to cause 1/3 of "colds" annually. We keep being told this virus is 'novel' and no one has immunity - but is that true?

      Go back to the cruise ships (Diamond Princess, current Navy vessel). Same idea. I don't know the exact # (and there was no antibody test at the time), but there was a large percentage of folks on that ship that never tested positive at all. No way they were not exposed at some point...... Cross immunity?

      1. Autodidactarian - this is the same conclusion I came to - people have immunity to it from some other virus - ostensibly it must be a variant of coronavirus.

        Perhaps California gets a lot of 3rd world exposure from the immigrants that New York doesn’t?

        1. Particularly ASIANS.

          CA has a whole lot of Asians. I’d wager that the biggest cities on the west coast (SD, LA, SF, PORT, SEA, VAN) have a couple thousand per day traveling from China alone. Maybe more people than that. LAX alone probably has 1000 people coming from China a day. Probably more than that. So one could argue that the west coast probably has LOTS of exposure to Asian cooties, especially in comparison to everywhere else.

        2. What Granite said.

        3. I agree, same with Texas, my daughter’s preschool was like a little UN and they would bring those bugs to school with them. Every month they would send home a note with her alerting to child having been infected with diseases I had not heard of here…when was the last time we had a Scarlet fever outbreak in the US?

        4. I've said the same thing. China MUST have other leaks of bat viruses from its wet markets and Wuhan labs. Nobody noticed because those viruses either didn't spread too far or weren't very lethal. It is very plausible that a similar virus went through the most China connected parts of the country before, were never noticed, and people built up some partial immunity.

          One thing I have noticed over the years is that Chinese masseuses seem to always have a sniffle or a little cough during the winter months (and I have been in many different Chinese massage parlors every week for years before the state shut down all personal care businesses mid March). Obviously they catch a lot of colds from customers, but some new ones from China are probably coming in all the time too, especially because so many visit family in China during New Year Season.

      2. This would go a long way to explaining these prevalence rates:

        Diamond Princess: ~17%
        USS Roosevelt: ~15%
        Gangelt, Germany: ~ 15%
        "Pregnant Woman" cohort: ~15%
        Long Island: ~17%
        NYC: ~ 20%

        Why this apparent soft ceiling at around 15-20% prevalence? Even in populations where it should be completely unmitigated. If the hypothesis that it's incredibly infectious is correct, then shouldn't we have at least a few instances of 60% or more infection rates is a population? Maybe that data set exists, but I have not seen it.

        Everything we think we know about virology and the adaptive immune system shows that immunity is highly specific, but what if it's not.

        1. How would that explain this:

          45 ill after one choir rehearsal (out of 60), with 28 positive tests.

          It seems, in the right environment, this thing is very, very contagious.

        2. I believe a French Aircraft Carrier has >50% incidence.

          Maybe 20% is the threshold reached if strong mitigation measures are taken quickly.

      3. We obviously have some immunity because we have immune systems. For this specific version though we don't have the antibodies unless we've actually had it.

    6. You guys aren't cleaning? The King Soopers by my place has hired entire crews to do nothing but disinfect every shelf, shopping cart, etc., continuously.

      1. Maybe it depends on the store or the corporation. I've seen people wiping things down at the local Walmart and supermarket, but not with any particular enthusiasm or attention to detail.

        The one by your place versus the one in, say, Bennett or Fort Morgan may have different policies.

    7. Inoculant load! You are unlikely to have anything more than fleeting contact with a single customer. From what I can tell, this is the single most critical factor.

      This virus spreads in stationary crowds. Churches, theaters, clubs, subway cars, planes, cruise ships, aircraft carriers ...

      Closing things like ski lifts, parks and tennis courts is pure insanity.

  7. The subways were never closed.

  8. It's not just NY, the same thing seems to have happened in many, if not most countries... Hubei, NY, Daegu also suffered vastly disproprtionate deaths.

    Given that we now know there are 30+ strains, my guess is that the areas hardest hit got the worst strains first, while milder strains spread faster due to the relative lack of symptoms (similar to what is supposed to have happened with other diseases -- killing the host isn't in its best interest, biologically speaking, so the milder version becomes more common). So the initial high death rates never recur anywhere else in the country.

    This explains the growing legion of antibody/wastewater testing results suggesting infection rates are closer to the 10-50% range than the widely assumed 1-5%, as well as why the Swedish models were much closer to reality.

    1. There is something to that strain idea. Saw a world map with the main strains. The main strain that came from China to the US was either a very minor strain in China or quickly morphed into a strain that now mostly exists in the Western US. NY and the East Coast got strains that had morphed going from China to Europe and it remains a 'European' strain. Given the death tolls throughout Europe, there may be something to the idea that it is a more dangerous strain

      1. You have proven to be full of shit regarding your 'predictions' and comments in general.
        Stuff your PANIC!!! flag up your ass, you pathetic piece of cowardly shit.

  9. NYC is very dense; even in the outer boroughs, it is still very dense. NYC is roughly 25% black. On average, blacks have more heart disease, diabetes, and a bunch of other health problems. The Bronx is the hardest hit, 90% black and latino. Staten Island is mostly being hit by in the North Shore, by St. George, a black neighborhood full of Eric Garner types.

    NYC has a lot of unhealthy blacks. A lot. You walk downtown Manhattan by the courts, or basically anywhere in Bronx, and it seems like every other person is walking with a cane.

    NYC is America's asshole. People here are unhealthy as shit.

  10. I guess one question to ask is why are NYC's numbers from this survey so much worse than California's... but another one, that we shouldn't lose sight of, is why are they so much BETTER than every "I Fucking Love Science" doomer bro has been bleating about for a month and a half? If you even suggested a 1% fatality rate on a nationwide level, you would be mocked to no end as a Covidiot. That is what they based shutting down the economy on. Now here we have 0.5% in the epicenter's epicenter?

    1. If you even suggested a 1% fatality rate on a nationwide level, you would be mocked to no end as a Covidiot.

      Lying sack of shit. 1% fatality rate on a nationwide basis = 3 million fatalities. That has ALWAYS been the most extreme worst-case scenario.

      You Trump worshiping dingleberry munchers are the most dishonest rock snots. Don't know the fucking difference between 1% and 0.1% and 0.01%

      1. Shut the fuck up you self righteous arrogant prick.

      2. Wrong JFREE,

        you're the dishonest rock snot: READ THE FUCKING ARTICLE:

        "Cuomo said about 14 percent of 3,000 people randomly selected from shoppers across the state tested positive for antibodies to the COVID-19 virus. That sample may not be representative of the general population, since people who are sick or think they may have been exposed to the virus are probably less likely to be out in public. But assuming the sample is representative, the results suggest that something like 2.7 million New Yorkers have been infected, which in turn implies a statewide infection fatality rate (IFR) in the neighborhood of 0.6 percent—three times the upper estimate from the California studies."

        1. Regardless of the fucking article.

          I'M the one who projected a 0.8% fatality rate - from 800,000 to 1 million fatalities - over two months ago. I'M the one who's been stalked around the comments threads since that time by assholes who want to claim that this is the same as the flu and I am supposedly spreading 'panic' and insisting that the economy be shut down. Claims which people now want to pretend extends to - oh - any % with a 1 in it I guess since they want to pretend decimal points don't mean anything

          1. You're the one who has been fucking wrong every step of the way. You refuse to admit it you're a chicken little. You literally claimed all viruses produced a 100% infection rate. You're an idiot.

          2. If it is 0.8%, which I tend to agree with, that is equivalent to the current annual US mortality rate. Given the prevalence of deaths from assisted living centers, I've seen estimates that 50-80% of the deaths would have happened without the virus.

            So the 'new deaths from virus' is at 0.2-0.4%. Left unchecked, infecting 100% of the US, this would total about 1,000,000. But given a virus with an R0 of 5.7, herd immunity happens at ~ 80%, so that would go down to ~ 800,000 deaths.

            Given that there is no treatment, and no vaccine (which is less likely than the media is assuming), is there any evidence that all 800,000 of these people aren't going to get infected and die sometime in the next year or two anyways? Is the lockdown not just slowing the pace of inevitable deaths? What makes everyone so certain that they can play God effectively here?

            And is there anyone who thinks the effects of the lockdown isn't going to kill millions in the next few years?

            It seems that there are two tragic choices here. Yet many people have entered a fairytale denial stage where they think they can just wish all bad things away.

            Conservatives don't believe in physics. Liberals don't believe in biology. I say that half-joking all the time, but the number of places I can use the line is amazing 🙂

            1. you are looking at the first month of fatalities in almost every country where fatalities are being recorded. I would think it is obvious that the earliest to die are always going to be the weakest. That subset is not ever the same demographic as the universe of people who will die as the disease gathers steam. China, eg still has roughly double their number of recorded fatalities who are still in hospital who haven't recovered yet. those are NOT the weaker demographics who would long ago have either died or been switched off as not having a chance of real recovery if still in hospital after three months. Those are not yet recorded as deaths but there is zero reason to believe they will all (or even mostly) survive.

              Further, the major reason nursing homes and similar facilities are getting hit hard is because they share one thing with hospitals - an almost constant transfer of patients and medical staff between the two. I would have also thought it is obvious that hospitals very quickly become the major contagion vector for any contagious disease. Which means those in and around those nodes become more quickly infected - esp if they are not the folks who are being swaddled in PPE.

              It's going to take a few months for antibody tests to be both reliable enough and widespread enough to record exposure by subsets like age or location or occupation or such. Not that that matters since those who want to pretend this is 'just the flu' will ignore everything that occurs between now and whenever the second wave hits them personally upside the head. Politics is what matters to them and no info about the disease can possibly be allowed to conflict with their political preferences.

        2. Oh - and re the article - the antibody tests are
          a)way too early to prove the specificity and sensitivity of the test itself (which is a big problem). Korea and Singapore are a month ahead of us at least re serology testing - and they are finding that this virus' 'antibodies' are not at all easy to test for.
          b)the confidence interval calculations re the false positives are utter crap. Not just incompetent stats but I suspect agenda-driven too.

          Doesn't mean the antibody tests are useless. But at an aggregate level - to figure out 'herd immunity' or total infection rate, they are useless. We'll know that stuff in a few months probably. In the meantime, they way we know the results of the tests is if individuals get sick/symptomatic while they thought they had antibodies. IOW - we will have to make decisions WITHOUT knowing the future

          1. You're the cowardly piece of shit willing to use the government to lock up everybody else for fear that YOU will get sick.
            Fuck off and die, you pathetic asshole.

          2. Your goddamn prediction dipshit is still 4 to 20 times higher than what we are realizing you subterranean wannabe bootlicking cuck.

            1. My number includes both waves this year - which I ALSO said in early February and whic you asswipes ALSO continually lie about. The nothingburger that we are going through right now. The one that mostly just tests whether we are competent or not. And the real deal this fall/winter. Where we won't have three months waiting for a virus to come here from Wuhan to prepare or fail to prepare. Where it will simply be - ladies and gentlemen boys and girls Dying time's here

              1. I don’t know how else to say it, but nobody gets out of here alive.

              2. Keep shoving those goal posts, you pathetic piece of cowardly shit. Maybe, if you make enough predictions, a couple of them will prove true, which makes you a pathetic piece of cowardly shit.
                Stuff your PANIC!!! flag up your ass, stick first. And fuck off, slaver.

              3. "My number includes both waves this year"
                IOWs one more lie.
                Fuck off and die, slaver.

              4. The second wave in fall/winter is most probably going to be a lot milder than this first one. NYC is almost at herd immunity levels right now. The rest of the country will follow.

                1. You're over-interpreting the test results. From the link, NYC/burbs tested at 21% with antibodies, the rest of the state tested at 3.6%. By race, 22% of Latinos and blacks tested positive, 9% of whites.

                  20% is not close to herd immunity. 60% is probably the level that would dampen contagion enough to snuff an outbreak out. Regardless, those existing numbers aren't gonna get close to herd immunity without a lot more deaths - and in different places and different groups than to date. Yeah NYC prob won't get hit as hard next wave. But next wave will also have combo infections - where people get both flu and covid at the same time

                2. You are assuming that new strains of the Wuhan Cold will be milder. I do not assume that. As time goes on, new strains will evolve according to selection pressures in a given locality and random chance. Some new strains will be milder, some will be deadlier, and some new strains may evolve in ways that overcome social distancing measures. Expect surprises.

      3. Um, no, the 2.2 million fatality prediction assumed an IFR much greater than 1%. It was 2.5% iirc. Not everyone was going to get infected - that's just nonsense.

        1. um, no, the Imperial College model projected a 1% fatality rate -- According to the latest estimates from the team, from the MRC Centre for Global Infectious Disease Analysis at Imperial, one percent of people with the disease will die from their infection.

          And yes - everyone infected is exactly what goes into the 'worst case' sort of modelling for a pandemic - pan=ALL, demos=people. 'Herd immunity' is just a phrase that means something specific. It does NOT mean that everyone else who wasn't infected has 'immunity' granted to them by 'the herd'. It simply means that the virus finds fewer uninfected people to infect - the RO drops below 1 - so breakouts don't grow and they can be snuffed out. Which means that last 20% or so get infected over a very long period of time. But absent a vaccine, everyone is likely to get infected at some point - just like a cold.

          1. where the 'worst case' models can tend to err on the 'lower fatality' side, is that they almost never assume the curve won't at least try to be flattened. They find it inconceivable that either a)a society would simply let sick people die without being able to see a doctor or b)that doctors would simply refuse to treat sick people who present to them. That's the hubris of us moderns.

            In truth however, there are many situations where in fact the curve isn't flattened. Where medical capacity is exceeded and not just for a short time. And in those situations - you have bodies in the streets and it looks like the Third World. Recent videos from Ecuador show what this looks like. The overall death rate is now 6-8x higher than normal. Corpses start rotting at home. There are no more caskets and no one can pick up the bodies. So people have to drag the corpses outside into the street. In those situations, the fatality rate goes through the roof because basically everyone who might need hospitalization instead just dies.

            1. It’s unanimous - kill yourself.

            2. Bring out yer dead!

            3. JFree
              April.23.2020 at 9:09 pm
              'where the bullshit, self excusing lies, more bullshit, wild ass guesses, cherry-picked data, a study which might, if you hold your mouth this way......'

              Fuck off and die, slaver.

          2. No pandemic has ever infected everyone. Not once. Believing a realistic worst case is everyone gets infected is beyond ridiculous.

          3. And what makes you think there won't be a vaccine?

            1. My estimate assumes there will be one - next year.

              The one thing that could change my estimate a lot is if there is some relatively effective treatment somewhere in the world this wave that gets verified and ramped up for the next wave. Which I hope happens and I'll be glad to be wrong if that is the case.

              But all the clowns yapping that this is just the flu are complete idiots and not worthy of anything but contempt.

          4. Also, the imperial college projected a 1% fatality rate in that report. That report does not make a prediction on total deaths, and it's not clear that's the CFR that was used in the model that made the prediction. (I simply can't tell from that link whether this is related to their total deaths prediction model or not. In fact, I can't find a report on their website from that time period which estimates a death total anywhere... what I can find is a paper where they estimate 1.38% CFR and 0.66% IFR from end of march - so just because they had one estimate at one time does not mean it was the same estimate at a different time).

            Apparently they never made the report publicly available on their website, but CATO finally got ahold of it. I'm going to pre-emptively admit I was wrong, but CATO literally only got their hands on it two days ago, so I'm misremembering which projection I'd seen, because we never saw this one. You're wrong too, btw, they assumed 0.9% IFR, but they also assumed 81% of the population gets infected. That is crazytown bonkers. (The 1918 flu pandemic only infected *maybe* 25%). It also assumed *nothing* was done, not even voluntary social distancing, which since the report was apparently given to governments ~Mar 16th, was obviously wrong *at the time it was 'published'*. CATO's analysis is here:

            Worth noting: Ferguson is apparently notorious for ridiculously bad assumptions leading to overestimated death totals.

            1. "It also assumed *nothing* was done, not even voluntary social distancing, which since the report was apparently given to governments"

              They always assume that. It's never true, but they see it as nothing which is not mandated will be guaranteed, so you'd better save everyone from themselves.

              1. "They" in this case being politicians. The researchers themselves stated much of this, but I still think it was irresponsibly reported by them since they knew politicians just see a big number and get all giddy about the opportunity to "save the world" by consolidating their power.

            2. "they assumed 0.9% IFR, but they also assumed 81% of the population gets infected. That is crazytown bonkers."

              81% is the percentage required for herd immunity when the R0 is 5.7 and the susceptibility starts at 100%.

              It is not bonkers at all if the susceptibility is really at 100%. We have no way of knowing right now. But if this virus came from a lab experiment, which IMHO is highly likely, those numbers are entirely reasonable. Obviously, people will adjust their behaviors, government-ordered or not, and the totals will come down.

              1. They assumed an R0 of ~2.5, so R0 of 5.7 is... a lot more than that.

                Susceptibility to the flu pandemics was basically 100%, and they only ever achieved ~25% population penetration. 81% might be the percentage required for herd immunity with R0 = 5.7 if people mix randomly (and I'd have to check that to be sure), but they don't mix randomly. That's not a sound statistical approximation of human behavior at all. Historical pandemic penetration is probably a much better guide.

                Also, Ferguson apparently has a habit of vastly overestimating infection rates, including for Mad Cow disease and 2009's Swine Flu, and thus projecting vastly inflated mortality numbers.

    2. To my knowledge the WHO is still sticking by their earlier predictions even though numerous studies have put those numbers in serious doubt. They honestly do not care much for science, but rather are trying to manage their tarnished reputation. That's all they care about because they are so dependent on foreign aid and their reputation was bad before this crisis, they are hurtin for certain.

      You are right, the reality of what we are seeing from actual scientists that go out and test sample populations is in direct conflict with what you see presented on your favorite political news outlet. At some point the jig will be up and then the finger pointing can begin.

      1. I think the WHO has some studies which agree with the scientific consensus. The press releases with 3.4% fatality rate were crap though.

    3. Fauci suggested 1% or lower on a national level, and he wasn't mocked (except maybe by people who thought it was "just the flu").

      1. Fauci's range was 0.2-1% (published in a medical journal, i think it was BMJ, but i can't recall at this point). The reality is probably in the middle of that.

  11. As an aside, why does Cuomo look so smug in every picture I see of him? He loves this shitstorm.

    1. People with power love using it.

      It's like that meme of gun owners getting excited at the prospect of being burgled.

    2. Notice how his stare it off in the middle distance, considering important, abstract matters?
      Sorta like 'hero tractor driver' USSR posters....

  12. "What Explains the Difference Between Estimated COVID-19 Fatality Rates in New York and California?"

    Public versus private transit.

    Sorry statists and statists masquerading as environmentalists public transit, like public schools, is a cesspool of contagion(s). Yes, many CA cities have PT, but ridership is often very low.

  13. We probably can rule out that possibility, even without taking into account the test results that New York Gov. Andrew Cuomo announced today, which suggest that a fifth of the city's residents have antibodies to the coronavirus.

    Cuomo announced that antibody testing in New York state, which only began four days previous, was already demonstrating that at minimum 13.9% of New Yorkers, had COVID-19 late stage antibodies.

    The implication of this is a shockwave to the system.

    With a population of 19,540,500 the findings point out that over 2,500,000 New Yorkers had the virus and have recovered. Keep in mind that as of this writing that only 263,000 New Yorkers have currently confirmed cases. Also as of this writing New York has reported 19,543 fatalities.

    We’ve been told that the true death rate is 7.4% in New York. We were told there would be hundreds of thousands dead. We were told that this was worse than the flu, which has still recorded more deaths to date in this past flu season—even though the CDC instructed medical personnel to start counting influenza, heart disease, pulmonary, respiratory, drug overdose, and possibly even car crash deaths as COVID-19 deaths.

    We were told that we had to upend an economy, go into solitary confinement, and divorce ourselves from normal life because this would rage beyond any previous pandemic. We were told that this virus with 846,000 current confirmed cases was worse than the H1N1 that broke out on Obama’s watch that infected 60,000,000 people. (We were conveniently not told that Obama had authorized $3.7 million U.S. tax dollars to be used at the Wuhan Institute of Virology to utilize corona viruses in bats in 2015 — but that’s yet another deception of omission.)

    But none of these “truths” turned out to be so.

    The death rate in New York State isn’t 7.4%, it is actually .75%.

    1. We’ve been told that the true death rate is 7.4% in New York.

      Wishful thinking by many.

    2. Who told you the death rate is 7.4%? It's been known all along that the confirmed case count is way undercounted. All the science has said 0.5%-1.0% for a while now. Fauci even publicly said that the fatality rate was likely 1% or less.


    Brit Hume: "It's Time to Consider the Possibility That the Coronvirus Lockdown Was a Collossal Public Policy Calamity"

    1. More important is international comparisons:

      "...As of April 22, 2020, the USA with about 5% of the world population, is experiencing about 33% of the new daily COVID-19 deaths. Countries such as South Korea, Germany and New Zealand seem to have been much better prepared for COVID-19. Other countries may be able to resume full production sooner than the USA. There even might be a time where travel within and/or to and from the USA is restricted far more, than in the rest of the developed world.

      There are some issues with the COVID-19 data. This is especially important when comparing the damage done across countries. However, the normal experience of infectious diseases impacting the USA much less than other countries, as was the case with SARS, MERS and Ebola, seems to be not the case with COVID-19.
      Data on the number of COVID-19 cases clearly is impacted by the amount of testing conducted. A jurisdiction that only tests those who require hospitalizations could report less cases per capita than a jurisdiction that tests a much wider sample of the population. However, COVID-19 deaths are a much more accurate statistic. The first cases of COVID-19 appeared about simultaneously in the United States and South Korea. As of April 21, 2020, there were a total of 237 COVID-19 deaths in South Korea as compared to 43,200 in the USA. On a per capita basis, South Korea with a population of 51,269,185 had 0.00000462 COVID-19 deaths. For the United States with a population of 331,002,651 the per capita deaths are 0.001305. Thus, the per capita COVID-19 death rate in the United States is 282 times that of South Korea..."

  15. This article speculates about why the results are different, but the most likely culprit is clear. We know the statistical analysis in the Stanford paper is wrong. Read the paper, read outside analysis, and the paper is clearly mistaken, even if the data isn't affected by selection bias.

    It seems to me that most sound research, even from the early stages of the epidemic, has been really clear that the IFR is going to be between 0.5% and 1.0%. I haven't even seen a single estimate (from scientists, not from politicians) that contradicts that. Obviously it's still somewhat uncertain what to what extent geography and other factors affect things, but the making decisions based of the 0.5%-1.0% number is almost surely right.

    1. Another study in LA came up with, in essence, the same results, and all of the studies are tending that direction - millions of exposure without any marked disease (or very mild).

      There's also proof the disease was out there much earlier than the "first" detected case in late February (Feb 6 I believe), and I bet if you kept looking you'd find cases back in December or earlier - all lost in the noise of a "bad flu season".

      This is surely part of it, and given the rate it which it looks like it spreads, there's probably some cross-immunity with other corona cold viruses.

      1. The L.A. study is by some of the same authors, doesn't have any public information besides a press release, and used the same test so most likely suffers from the same false positive problems. It's a big red flag to go to the press with results without any summary of methodology, especially after serious methodological problems have been pointed out in your last study. If you do some due diligence, you learn why people are entirely skeptical of those studies.

        Plus, the L.A. study has no bearing on the *obvious mistakes* in the Santa Clara study. They can say 0.1%-0.2% all they want, the data they provided simply don't justify that conclusion. It's not part of a trend; it's just incorrect. You can look at the study yourself and look up some of the explanations of why it's wrong if you don't believe me.

        "all of the studies are tending that direction"

        All of the studies you've heard of maybe. Or maybe not, since the very study this article is about suggests an IFR of > 0.5%. All of the research I've seen . Try searching "ifr covid-19" on Google Scholar if you don't believe me.

        "This is surely part of it, and given the rate it which it looks like it spreads, there’s probably some cross-immunity with other corona cold viruses."

        Is there any scientific source suggesting this? Not trying to necessarily attack this idea, but some supporting evidence would be good.

        1. A sentence in the middle should say "all the research I've seen is consistent with an IFR of 0.5%-1.0%. Maybe slightly lower because of demographics.

        2. "Is there any scientific source suggesting this? "

          Don't know. But for some reason the projected exposure from all serological studies seem to top out in the 20% range. Given the likelihood that exposure to the virus is much, much higher than 20% (it has to be considering everyone flocking to the "essential" businesses), there are only 2 explanations I can come up with:

          Cross immunity
          A large portion of the population is just not sensitive serologically to the virus

          I am sure there are other potential explanations, I am just throwing those out there.

    2. Even assuming it is 0.5-1.0%, why was that worth panicking over? Where's the line when we should begin panicking? FWIW, I think 0.3-0.8 is the most likely range - as high 1% seems highly unlikely.

      Keep in mind, the '68 flu had a 0.5% IFR, and nothing closed because of it. Many people who lived through it don't even remember it, and the news coverage wasn't even in the same ballpark in terms of frequency of news stories. (I did a little poking around in some free archives, and I had a hard time finding stories about the '68 flu epidemic *while it was ongoing*).

      1. "...Where’s the line when we should begin panicking?.."

        When Trump is POTUS:
        I do not even hint that there is anything like a conscious conspiracy, but Trump is in office and the legacy media have been trying since late January '17 to discredit, if possible remove him from office, and certainly do anything they can to prevent his re-election.
        By his election, he showed the bias of the press, and exposed the lies they commonly used in that bias; that is enough to prompt any coverage damaging to him, including exaggerating the effects of the flu in order to suggest guilt by innuendo. And regardless of the effects that exaggeration might have on the economy; they'll try to hang that around his neck, too.
        The press' greatest fear right now is that this is not nearly as dangerous as the PANIC articles predict, and that Trump somehow manages to kick-start a moribund economy, all before November.

      2. One comparison on fatality rates that adds some perspective to IFR percentages of 0.5% to 1.0%: according to the CDC in 2017 the infant mortality rate (death before their first birthday) in the U.S. was 5.8 deaths per 1000 live births, or ~0.58%. (Presumably ~22,000 deaths in ~3.86 million births that year.) A continuing tragedy that garners no massive response.

        1. Not sure that's relevant; claims that the US IM dates are more than average is subject to a LOT of skepticism.

      3. Hey this is a more reasonable position. I'm entirely sympathetic to the position that enforced lockdowns are potentially unnecessary. I also think if we were going to impose lockdown for 8 weeks, we may have timed it wrong (except in the case of NYC). There's a lot of uncertainty right now that makes determining the correct public policy difficult, so there's a solid argument for first doing no harm. It's definitely not a reason to "panic"; society is not going to fall apart. I think a large problem with the orders is they claim to be limited but they've been essentially indefinite; there wasn't really an attempt to craft a sustainable response with understandable end conditions.

        I think some of the things that make this more concerning than past flus (besides 1918) is that it's more virulent and I've heard coronaviruses demonstrate less seasonality. Also keep in mind that if 25% of the population gets the virus, then a 0.5% IFR means 800,000 dead, which would be the leading cause of death by a large margin.

        But one thing I won't accept is people spreading shoddy "facts" trying to justify their ideology at all costs. Facts should guide ideology, not the other way around.

        1. ^this guy gets it.

        2. -Pandemic flu isn't seasonal. The '68 flu started in july. The '57 flu started in ~June. I forget when the '18 flu started, but I seem to recall it was late spring or summer.

          -Other coronaviruses are seasonal. (4 of the 7 strains known to infect humans cause common colds, which are most definitely seasonal). Whether covid-19 is or not is an open question.

          -Virulence is only one parameter. There are other reasons to think covid-19 is of less concern than any raw population-wide IFR would lead you to believe. For example, it skews strongly towards the older end of the population. And while seasonal flu also skews old (although not as old), pandemic flu skews much younger. (The shocking thing about the '18 flu was how many younger adults it killed). The average age of covid-19 fatalities is in the mid-80s, which, given the rapidly increasing probabilities with age, implies well over half of fatalities are over the average (ie, the median is going to be higher than the mean).

          -The raw IFR isn't particularly useful when the age skew is as strong as it is with covid-19, because some people's risk is miniscule, while other people's risk is relatively large. The true IFR for 20-39 year olds is probably 0.01% or lower.

          -So, known at-risk groups. Likely very low mortality in many groups outside those groups. The right policy was always take steps to protect the elderly, not lock down the entire economy. (That NY has done the opposite, not only locked down the economy but even effectively encouraged spread within nursing homes, is unforgivable.)

          1. "And while seasonal flu also skews old (although not as old), pandemic flu skews much younger. (The shocking thing about the ’18 flu was how many younger adults it killed). "

            This is what terrifies me about the over-broad lockdown. The '18 flu only skewed younger in the second, autumn wave. What if we are locking down our youth right now so that we make them much, much more vulnerable in the fall?

      4. 0.7% = Where’s the line when we should begin panicking?

      5. "Even assuming it is 0.5-1.0%, why was that worth panicking over?"

        The panic is happening because, with this level of contagiousness, the deaths all happen at once. relatively speaking - over a few weeks.

        0.4-0.6% deaths that were going to be part of this years mortality rate anyway, but were all pushed into a short period of time. And another 0.2-0.4% deaths that wouldn't have happened absent SARS-CoV-2.

        We humans hate deaths that happen all at once. Think airplanes, nuclear reactors and mass shootings. The lockdown's job is to slow the death rate.

        1. If the 'experts' can't demonstrate a sense of scope which looks at the longterm, they've proven they don't deserve to run things.

          The panic was avoidable. It was ginned up by alarmist media coverage and fueled by politician over-reaction.

          1. I am in 100% agreement with you. I'm just pointing out 'why' I think all the people in charge went from apathy to panic overnight.

            But knowing human nature, and our tendency to panic in the face of mass deaths, these situations need to be taken charge of up front.

            If a strong leader had put all the focus on vulnerable seniors, the lockdown could have been avoided (maybe not sports venues etc..)

            The absurdity here is that the entire working age population is not at any meaningful risk from this thing. Seniors are the easiest people to quarantine.

        2. That is correct, because the natural assumption is that an accelerating trend will continue. Deaths occur all at once because this virus has a long incubation period during which many people are contagious, many never show symptoms at all but are contagious, the disease lingers for a long time and progresses slowly, and the hospitalizations and deaths consume an unusually large amount of hospital resources per patient than flu. Also, medical workers can be immunized to flu, but not to this - except by catching it and recovering.

  16. Purely anecdotally, but it seems every time I hear something about what they're doing in California I'm hearing about a mayor or a city council or some board of health and whenever I hear about what they're doing in New York it's Andrew Cuomo. Hard to fathom, but it seems like maybe in California Governor Trudeau Newsome is content to let the lower-level jurisdictions use their own discretion in following state guidelines whereas Governor Dickhead Dickface feels the need to stroke his ego by involving himself in every little decision, even to the point of publicly slapping around Mayor DeBlasio when DeBlasio seemed to think he might have something to say about who's running things in NYC.

    Maybe it's a New York thing, President Trump seems to have that same "bride at every wedding, corpse at every funeral" ego problem and if you know that was first said about Teddy Roosevelt, you can probably guess where the Roosevelts were from. In any case, maybe there's something there about central planning versus local autonomy at work.

    1. Uh, not so fast.
      Newsom is the agent who simply closed 60%-70% of the CA economy, and 'strongly suggested' (like with guns) people stay home.
      Local governments have jumped on the bandwagon, but Newsom has the team's reins in his hands.

    2. One thing that's unique about New York is that 40% of the population is in NYC proper and even more in the surrounding counties. So Cuomo can just focus on the city. California's metropolitan areas are a lot more spread out.

  17. So, it's pretty obvious that AGE is the big variable here that is most likely to explain fatality differences.

    -Are the demographics of Santa Clara different than NY? How about the demographics of covid-19 deaths?

    -Is the living situations of older people different in Santa Clara than NY? More isolated? Less nursing homes?

    -Did CA do more to protect nursing homes? NY not only didn't do anything, they sent infected elderly patients back to nursing homes to recover!

    Comorbidities are another big issue. Does NY have a higher frequency of severe comorbidities for covid-19?

    And the last major thing to look at is how are deaths ascribed to covid-19? Nationally we've already shifted from "dying from covid-19" to "dying with covid-19" (that is, tested positive and died, whether or not covid-19 caused it) to "probably dying with covid-19". Each of those changes in counting methodology retroactively added more deaths of more uncertain connection to actual covid-19 causes. And if CA and NY are counting differently, that makes a huge difference.

    1. It'd have to be a pretty huge difference to explain why California's fatality rate per million is about 4% of New York's. I don't think they're counting THAT differently.

      1. There's a reason i give that 3rd. My bet is that the elderly are infected at markedly higher rates in NY, and since they're the most vulnerable, that leads to outsized death rates.

        What we really need is properly age stratified testing and death totals, so we can see what the age-specific infection rates and death rates are. When your IFR by age ranges from estimates of almost 0 (children) to ~18%, that's simply too important a variable to ignore.

      2. Also, the last step of going to 'likely died with covid-19' increased New York's death total ascribed to covid-19 by almost 50%, so differences in counting could theoretically have a large effect.

      3. Viral dose is probably another big variable that will differ by locality. Most CA exposures are probably one time affairs, after which the infected person has 2 weeks or so to build some immunity before getting exposed again. A person who rides a packed NY subway car twice a day every day is probably exposed to repeated doses of different strains continually, and the chance of a virus running away from his immune response is greater. Also, there are more strains circulating in NYC.

    2. The other factor is hospital capacity per capita. NY, as far as I know, is the only place where need for health care eclipsed ability of the region to provide it.

      1. Except it didn't actually. They *projected* they were going to exceed capacity. I don't think they ever did. They're certainly well below their projected utilization. And the naval hospital parked in the harbor had just a handful of patients onboard last i knew.

  18. Because New Yorkers are more annoying than Californians? (talking rank and file, NY and CA politicians are closer to equally annoying)

  19. I'd figure that the elderly population of NYC in particular has probably lived there most of their lives. I can't imagine someone retiring and saying "Now's my chance to go live in the big city"

    Even though big city air is certainly better than it was 40 years ago, its still pretty dang dirty. Can't imagine that 40 or 50 years of big city air is good for your lungs.

    I'd expect that elderly city folk are made more vulnerable by a lifetime of breathing dirty city air.

    On the other hand, California has a lot of old folk too and California has a lot more dirty cities.

    1. It’s all about subways and shitty weather.

      1. "Results: We found that an increase of only 1 g/m3
        in PM2.5 is associated with a 15% increase
        in the COVID-19 death rate, 95% confidence interval (CI) (5%, 25%). Results are statistically
        significant and robust to secondary and sensitivity analyses."

        For each 7 grams of particulates per cubic meter of air, the mortality rate goes up 100%.

    2. Ya, I was gonna say, I thought there was evidence that air quality was a major factor in fatality rates. That certainly was the case with SARS.

      Also initial loading might play a role. A lot of doctors seem have an increased chance of severe symptoms, which would indicate that getting a large amount of the virus initially helps overwhelm the immune system. Population density might cause an increase in initial loading for a lot of people. I don't know if that's been studied though, so I might be full of it on that.

  20. Viral load? Catching it on a plane or a subway would give you a much higher dose than many other situations.

    1. So would being on a cruise ship; didn't seem to do much there.

      1. Cruise ship common areas are a bit larger and more spread out than subways and aircraft.

        Corridors and elevators are the only real choke points and people really don't spend a whole lot of time in them.

    2. Lol, I just said that above and then saw your speculation.

  21. Californians are in virtual quarantine on the freeways for 3,4 hours everyday. That (and the fact that covid likely hit there earlier and resulted in some herd immunity) probably helped mitigated the spread.

    CA is one big piece of land, and even big cities like LA are more spread out. Suburbs rule OC and high rise apartments are relatively rare.

    1. The one upside to the current "lockdown" is that the freeways actually move again. Most of the 90-120 minute commutes are back down to the 10-20 minutes they'd take if the freeways weren't overloaded and congested.

      I could probably get from my house near LAX to Vegas in a bit over 4 hours now (instead of it taking almost that long to get to Ontario and onto the 15) when the sun is up, if the strip weren't in full-on "Omega Man" mode.

  22. I think Steve Hilton is correct. 1/5? 20% infection? If you let it go for a while, we can reach herd immunity. Open NY, protect vunerable. Having said that sample of 3,000 is too.. small. You need to do more. Do your job governor. I think at least 3,000 in each bourough in NYC, long island county, west chester county, new jersey, metro close connecticut. Then do 1,000 in Albany and Buffalo? Give us better picture. Also when you have 1/5, you can possibly thinking about contact tracing. Get your act together, Cuomo.

    1. The sample is also not sufficiently random. Literally 1/4 of NY's deaths are from nursing homes - which is a shockingly large fraction even given this is the most vulnerable population. It's almost certainly the case that the infection rate among nursing home populations is higher than 20%.

      That said, it is a serological study, so it's automatically better than confirmed case numbers.

      1. Squirrelloid...For NJ, it is even worse. The deaths from victims 80+ years are ~40% of total. And it is scary here in the People's Republic of NJ. The majority of nursing homes here were hiding the fact they had residents/employees testing positive, until the state laid down the hammer and required disclosure (which should have been a total no-brainer, IMO). Now it is publicized on the NJ department health website.

        Where Phailing Phil Murphy and his Health Commissar Judith M. Persichilli have been utterly incompetent is testing. Truly and utterly incompetent. They have done a wretched job. If you look at the stats on tests from The Covid 19 Project and NJ Health websites, you can see that we just suck at a) reliable delivery of tests we have to physical test sites, and b) delivery of test results to people who were tested. We have a roughly 10-day delay in delivering results. Unreal. After a month, there has been no appreciable improvement in testing, the backlog more or less unchanged. And honestly, you can drive end to end in the People's Republic in 3 hours, so the piss poor delivery of tests to sites is just amazing, given the small size of the state.

        Who knows WTH we will find when serological testing actually gets rolled out. It is a total crapshoot. But we need it here ASAP.

  23. New York simply has a more severe outbreak of unnecessary deaths by ventilator. Remember in the early days Cuomo kept screaming "We need more ventilators!", then it turned out that not only did he not need more, but that patients were being killed by the ventilators.

  24. It takes two pieces to get a infection mortality rate.

    The denominator should be say 15% of the population - or 50%, or whatever the antibody tests show, We simply don't know the result, but indications are (Germany, Diamond Princess, Italy, New York, Stanford) that perhaps the number of asymptomatics is 20 times to 100 times the observed infected.

    The numerator of New York and California are both greatly overstated, and do not share a methodology. No consistency.

    7000 people die each day in the US, who are burdened by serious comorbidity (NOT hypertension, NOT obesity, but yes to heart disease, cancer, diabetes etc). We call it "natural causes. Doctors normally put "natural causes on the death certificates, and make no attempt to identity the probabilities of each morbidity being responsible for the death. Fifty years ago, a group of actuaries in Toronto tried to identify causes of death for these people with serious underlying disease. We could not. We could only adopt a probability for each cause.

    C19 adds to the disease burden, but doctors in New York are being told to show any death where the deceased had, or was suspected of having, C19 as being a death CAUSED by C19. Dead wrong. Many of these people would be in the 7000 people who die each day. Maybe C19 added to their disease burden, but most of them died WITH C19, not BECAUSE OF C19.

    My suggestion is to use a 20% probability for C19, for the group with SUD. So, if 40,000 people with SUDs died WITH C19, let's assign .2 x 40000 = 8000 as the number of deaths CAUSED by C19.

    I was in Panera Bread today, and the attendant told me that if someone gets run over by a car, but has C19, the doctor has been instructed and encouraged to count that as C19. Reducto ad absurdam, but you get the idea.

    The true infection death rate for the US at this point April 23, 2020 C19 flu, and yes it is just another flu, like C18, C17 and the rest, should be:

    47,000 x 1.5 (allowing for later deaths from this cohort) x 0.2 = 14,100 WHO DIED BECAUSE OF C19 flu

    divided by

    18,000,000 asymptomatics (5% of the US population), about 25 times the 700,000 reported symptomatics

    equals 0.08% - yep, less than the flu rate of 0.1%

    Let's protect the vulnerable folks wiith SUDs, and then let everybody get back to work.

    Enough hysteria already.

    Pete Actuary California

    1. I get your point but 20% seems random. Better to attribute "with Covid" deaths the same method as "with flu".

      There is no C-17 or C-18. Covid-19 is named after 2019. It's the sixth or eight coronavirus affecting humans. And it's a different class from flus. It can have a similar death rate but it's important to be clear it's not technically a flu.

      1. Actuary Projections seems to represent he works as an actuary, and I have no reason to doubt him, so 20% as an initial guess might be a reasonable one based on his actuarial knowledge. (Obviously autopsies would be needed to get a better value).

        You're absolutely right about covid-19 being named for the year, about it being different from flu, and almost right on the number of coronaviruses (it's 7, including covid-19. 4 common colds, SARS, and MERS are the other 6).

  25. The intensity of transmission due to density may make a difference. Being exposed in close quarters to multiple carriers on the subway, at work, and at home in a single day in NY could be common, and lead to a high viral load that causes a more serious infection. Meanwhile in car-centric California most infections might be from a single passing exposure, providing immunity with no or mild symptoms

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  27. My hunch is that the CFR will be all over the place for a while and then settle and decline. Here is why --
    First, The people most susceptible to (dying from) the disease are either going to die or be more conscious and mindful of not being exposed.
    Second, there is every reason to believe that this virus will evolve around normal lines and that the most deadly strains (viruses that kill their hosts can use those hosts to reproduce) will be replaced by milder ones.
    Third, our treatments will become more sophisticated


  29. COVID-19 is the most dangerous virus in the world.
    Great! Thanks for your posting and time

  30. NYC is also filthy. Maybe that has something to do with it.

  31. None of the articles I've read about the course of COVID-19 seem to mention Iceland. Why ever not? With widespread testing, they should have a much clearer picture of the trajectory of the disease: how long do infected people remain asymptomatic, what fraction of those infected develop severe symptoms, what fraction of those infected die, what fraction of recovered individuals show antibodies, how long do the antibodies persist?

    If we could get a clear picture of the infection fatality rate from Iceland's or South Korea's data, then we could work backward from the observed fatality rate in various portions of the US to get a better estimate of the infected fraction of the population, and that'd give us some idea how much to trust, say, the Santa Clara study. So why have we seen almost nothing in these articles about those countries' data?

  32. Another possibility that's totally speculative, and based a bit on a likely "conspiracy theory" (although one that I'll lay out why it might be more reasonable than most).

    It's very hard for anyone without an address to get alcohol right now, but liquor stores in California (at least in L.A.) are on the "essential business" list. Alcohol is one of the few substances that can have fatal withdrawal for severe addicts that try to go "cold turkey". It would seem likely that homeless alcoholics in NYC may be largely getting forced into detoxing, and in the severe cases they're likely to end up dying either in the street or on an ER; the ER is where the "conspiracy theory" comes into play. In a scenario where a detoxing alcoholic ends up dying in an ER, the current federal emergency policies may create a scenario where the hospital administration faces a choice between getting a partial payment for whatever treatment was given from Medicaid, or getting total payment via the CDC or CARES act if they list the case as a "COVID-19" death; while there is a CT going around about a lot of places reporting trumped-up COVID numbers, it's possible that the current policy environment creates a very real incentive for that to happen. There's probably an added "bonus" in all this that it seems very likely that anyone living on the street in NYC would have been exposed more than once in the last 2 months, and with a homeless population of 62k+ in the city, even a small "outlier" subset (and addicion among the homeless is hardly an "outlier" condition) of that population could account for hundreds of instances of the scenario I've described.

  33. The NYC burbs are hit because thats where the people live, who work in NYC (Manhattan)..and they get sick because of the accursed subways and busses, which were filthy to start with, and remain uncleaned.

  34. The two studies aren't that far apart. Maybe the California study skewed younger because people signed up on Facebook. Maybe Californians are healthier and less obese and have better immune systems because they get more sunlight.

    Even New York's study is showing a true fatality rate of around 0.5%. California could easily be 0.2%.

    Just because some lockdown panic government will save us types don't like the results doesn't mean the Stanford study is discredited.

  35. There are a number of likely reasons for the discrepancy, and the truth is probably a mixture of all of them:
    -- Viral dose. Initial viral doses probably differ a lot by locality. A brief one-time exposure in CA could be different than repeated exposures to different strains every day in a NYC subway car.
    -- Selection effects for the antibody testing. Different levels of randomness occur when subjects are recruited differently.
    -- Strains. NYC has a big mix of mostly European strains, but most CA strains are closer to the original Wuhan strain.
    -- Prior exposure to similar bat viruses. Similar (but less lethal) bat viruses must have leaked from China before, and people in CA may have been more exposed without knowing it.
    -- Different levels of exposure of old people. Young and old may simply mix in close quarters more in NYC, probably on public transit.

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  37. "What Explains the Difference Between Estimated COVID-19 Fatality Rates in New York and California?"

    NY's numbers are shit.
    It's not NY/CA, it's NY/everywhere else.

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