Tomorrow, Reported Coronavirus Deaths in Italy (Pop. 60M) Likely to Surpass China (Pop 1380M)

This is relying on the data on WorldoMeters.info, which reports 475 new deaths yesterday in Italy, for a total of 2978, and 11 new deaths in China, for a total of 3237. I realize, of course, that there's always the risk of different reporting rates and cause-of-death diagnosis rates in different countries.

Comments

[Bob from Ohio]

Plus the risk of a toltalitarian government lying its a** off.

[Eugene Volokh]

Yes, that's part of what I was trying to get at as to "risk of different reporting rates." Too subtle?

[Libertymike]

No, too craven.

Why not exhibit some testicular fortitude and aver that the number of deaths attributable to the Wuflu are bogus? As Tom DiLorenzo noted at LRC this morning, a 95 year old Florida man was said to be a Covid-19 victim notwithstanding the fact that the nonagenerian had a plethora of pathologies with his cause of death actually being bacterial pneumonia.

[Rossami]

Because it's equally likely that the Italian reports are just as made-up as the Chinese numbers.

[David Nieporent]

I'm glad to see that DiLorenzo has moved on from pretending to be a historian to pretending to be an epidemiologist.

[Don Nico]

As an example different reporting consider Germany which reports a mortality rate of 0.024% as compared with Italy at 8%.
Italy is almost certainly overcounting while Germany us without question undercounting.
At this point I'd trust the Chinese data before the German data.

Unless it is that good Aryan blood protecting folks there

[Life of Brian]

Germany which reports a mortality rate of 0.024%

I think you meant 0.24% (latest numbers: 28 deaths out of 12327 cases, or 0.23%).

Germany us without question undercounting.

Why without question? A number of other countries (e.g., Austria, Norway, Denmark, Malaysia, Portugal) are reporting around a quarter to a third of a percent mortality rate.

[Dan Schiavetta]

I suppose they were lying about the initial outbreak too. You would not make a good epidemiologist.

[M L]

"Reported" key word.

[M L]

I'm gonna repost this..

https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/

[Patrick Henry, the 2nd]

LOVE IT

People are panicking for no reason.

[Josh R]

Or perhaps we should embrace the restrictive measures because we don't yet have the best data and the data we do have raise the legitimate possibility of the worst case if we do not implement these measures. Presumably, we will have better data in a few weeks.

[Rossami]

That is a terrific restatement of the Precautionary Principle. The problem is that we will never have sufficient data to make the decisions you want. There is always unknown and unknowable risk. Despite that, we make decisions under conditions of uncertainty every single day. Panic does not help.

[Josh R]

While we will never have complete data, I disagree that we will never have sufficient data to make decisions. I would not characterize the current measures as panic, although I would characterize the run on supplies as panic.

[NToJ]

First, it's not apparent what you mean by "the data we do have raise the legitimate possibility of the worst case". What is the "worst case" in your view? I'm not aware of any data suggesting this is an existential crisis. The modeling on no action whatsoever--which is not a true worst case scenario, it's worse than the worst case scenario imaginable based on information available--is hardly unimaginable. The Imperial Academy's report had 2M-4M dead, in the US. (~2.8M Americans die every year from all cause mortality.)

Second, if we are acting based on a paucity of "best data", why does that not militate against "the restrictive measures"? The long-term consequences of the currently imposed restrictive measures are not well understood, either. As an example, when you close schools, domestic abuse of children goes up. We don't have sufficient data yet to know how much, but we will have better data in a few weeks. How does that harm rate in decisions about what to do or not do?

[Josh R]

Your worst case numbers of 2-4 million dead seems reasonable. The negative consequences of the restrictive measures (beyond the economic impacts) such as child abuse are too speculative to justify doing nothing.

[NToJ]

"Your worst case numbers of 2-4 million dead seems reasonable."

No, they are explicitly not reasonable. They are from the Imperial College's recent model. The model predicts 2.2M dead in the US "In the (unlikely) absence of any control measures or spontaneous changes in individual behaviour" and an 81% contraction rate by the public. That's obviously absurd, especially since many of the measures the model assumed would not take place, are already in place. Even with mitigation rather than suppression, the model predicted 1.2M dead. To get to 4M, you have to assume that bed capacity in the United States is static. Which is fine for modeling purposes but utterly ludicrous for planning.

"The negative consequences of the restrictive measures (beyond the economic impacts) such as child abuse are too speculative to justify doing nothing."

Why is it that any prediction related to death by the disease is "reasonable" but the documented effects of economic impacts are all "too speculative"? There is a whole universe of research about the effects of economic depression on morbidity, mortality, happiness, etc. There's plenty of data out there.

[M L]

We're gonna abuse kids and destroy the economy (causing immeasurable indirect deaths and other harm), in order to . . . well we don't know.

[Josh R]

The 2-4 million dead is reasonable if we do nothing (some have decried what we have already done).

Please cite a study that estimates the effect on mortality of the restrictive measures.

[NToJ]

There aren't going to be studies of the effects of these restrictive measures until they have an opportunity to have an effect. At best we could get modeling (as we would with COVID), but even that will not be as useful since we are in new territory with some of the measures taken. (There is nothing novel about the mortality or apparent infection rate of COVID.)

If you want studies (in the past) modeling how pandemics affect the economy, and the potential fallout from it, I'll start posting links.

[NToJ]

Economic and Social Impact of Influenza Mitigation Strategies by Demographic Class.

[Josh R]

Of course there is a negative economic impact caused by the restrictive measures. The question is at what mortality rate of an epidemic are the restrictive measures a good idea.

[NToJ]

@Josh R,

Yes, and don't you think that's a question that should be answered before engaging in large-scale suppression policies if their efficacy is unproven, and the unintended consequences are not understood? My issue is that when you say "We must do something and should not let our lack of perfect information prevent us from acting!" you apply it only to policies that prevent disease, and not to policies that prevent economic harm (and its resultant mortality). But as you've now conceded, we can't have a useful policy discussion until we understand "at what mortality rate of an epidemic are the restrictive measures a good idea." How would we know, unless we understand the costs associated with the restrictive measures? What does "good idea" here mean if it doesn't factor in our understanding of the bad consequences of the policy?

[Josh R]

you’ve now conceded, we can’t have a useful policy discussion until we understand “at what mortality rate of an epidemic are the restrictive measures a good idea

Without batting an eye, a projected low-end total of 600,000 deaths in the USA is enough to convince me that the restrictive measures are justified for now. I could be convinced otherwise if there were credible data showing the number of deaths caused by the restrictive measures.

[NToJ]

Here's a good one in hindsight re: Chinese mitigation efforts against H1N1. Was Mandatory Quarantine Necessary in China for Controlling the 2009 H1N1 Pandemic?

[NToJ]

Good study from 2011 on the economic considerations for government rather than decentralized (i.e. no) response:

Economic considerations for social distancing and behavioral based policies during an epidemic.

[NToJ]

If you want generalized studies on the mortality effects (as one example) of economic decline, there are countless studies. They tend to show all-cause mortality rates for men increase as employment decreases. For an example see here.

[NToJ]

I am willing (but think it should be unnecessary) to demonstrate that restrictive anti-epidemic measures have a negative effect on the economy.

[Karl Hungus]

"John P.A. Ioannidis is professor of medicine, of epidemiology and population health, of biomedical data science, and of statistics at Stanford University and co-director of Stanford’s Meta-Research Innovation Center."

I think this guy's pretty much got the bases covered in terms of his résumé.

[M L]

No kiddin.

[rsteinmetz]

How do you diagnose death differently? Zombies?

[Bob from Ohio]

The virus causes pneumonia-like symptoms. Just assign the death to that.

Plus many victims have underlying health problem or are old. So the death is attributed to that.

[cmcc_aus]

In Iran perhaps those who are dumped into mass graves are assumed to have been anti-regime protesters. Obviously COVID itself is anti-regime so anybody carrying it might be.

[Liberty Lover]

I am beginning to think Allah is anti-regime!

[Don Nico]

Yes that is what Germany does. Anything but telling the truth that people died prematurely because of covid-19

[Armchair Lawyer]

If someone dies, and you don't test for the corona virus, well then you can't report they died of the corona virus.

If you want to report less people dying of the corona virus, then just don't test for it.

[Dan Schiavetta]

That was the Trump administration strategy clear up to last week.

[Eugene Volokh]

Thanks -- I replaced "death diagnosis" with the more precise "cause-of-death diagnosis."

[Rev. Arthur L. Kirkland]

That's quite a hoax.

[Rev. Arthur L. Kirkland]

Oops! Not a hoax.

War.

[Karl Hungus]

Here's a surprise—Italy loses more people to the flu each year than their neighbors:

https://www.ijidonline.com/article/S1201-9712(19)30328-5/abstract

[AmosArch]

Italians also have a ton of old people and the few children they do have tend to be of the grownup variety that still live with mamma e papa. Its really sad to see a society that can produce some pretty attractive women wither on the vine due to 'modern' ideas about family and gender and economic factors.

[jsnider]

If only there was a financial incentive for modern people to have children.

[Liberty Lover]

It is way to early to believe any statistics are accurate. We will have to wait this out, and determine the statistics later. Proviso, "figures don't lie, but liars figure".

[Skyhawk]

Well, the reason Italy has so many cases is due to the large numbers of Chinese migrant workers that work in Italy.
It's high time the rest of the world forces China to do something about their hygiene and treatment of animals.
That's where every pandemic disease originates along with every new flu strain.

[Rev. Arthur L. Kirkland]

"It’s high time the rest of the world forces China to do something about their hygiene and treatment of animals."

"Often libertarian"

[Jason Cavanaugh]

Because whether someone appears to fit your understanding of what "often" and "Libertarian" mean is certainly more important that stopping terrible social practices which have now resulted in at least TWO pandemics in the last 20 years.

Get over yourself, clown.

[Sarcastr0]

I'm not sure we know this is the but-for cause.

And industrialization is the best way to ensure better sanitation, absent annexing the country. But I'm not sure we want to help the industrialization of our main global competitor.

Anyhow, I hope those saying we're overreacting are correct. I'm just pretty sure they're wrong.

[Gasman]

Partly off topic for this thread, but it is still coronavirus related...

Will life insurers be able to wiggle off the hook for pandemic related deaths? Is pandemic going to get swept in with the natural disaster exclusion clauses that might appear within insurance contracts.

Began pondering this as my University has exempted docs 60+ from direct COVID related patient care, and I realized I am now the oldest front line physician in my group (therefore presumptive highest risk of those still on the front-lines). Ouch.

[M L]

Richard Epstein with the smackdown

https://www.hoover.org/research/coronavirus-isnt-pandemic

[Josh R]

Of course we don't expect the cases to continue to grow exponentially. The question is how quickly we get to an inflection with versus without forced government intervention. We, including Epstein, don't know that answer.

[arpiniant1]

It is in no way a 'smackdown'

he raises questions but with few answers, posits beliefs with no backup
Yes he raises questions, some interesting ones

I am not listening first to a dweeb who makes a living doubting gov't
I am listening first to the people who study disease for a living