California vs. Florida - Approachs to COVID?
First, STAY HOME AND STAY SAFE until further notice:
On March 19, California had 1,000 confirmed cases of coronavirus. That same day, it was the first state to issue a stay at home order for the whole state.
Three days later on March 22, Florida also hit 1,000 confirmed cases of coronavirus. It did not issue a stay at home order until the Governor reluctantly did on April 3. It was one of the last states. (Although 7 never did.)
Florida has been widely criticized for its late response. Florida (Miami) was supposed to be one of the next "hot spots" after NYC. It has also been criticized for allowing church services, wrestling, massage parlors as "essential businesses." Anecdotal evidence from the internet indicates many people in Florida are still moving about, without masks, etc. On the other hand, California was praised for its quick response.
Both states continued to see an increase in cases over time, but then....
Florida appears to have flattened its curve.
California appears to have flattened its curve.
Both states appear to be past the peak according to the IHME model (which also indicates Florida has done less distancing measures). (Of course, models are only as good as what you know at the time.)
It is hard to see how one approach has been significantly better than the other after a month. Is there more to it?
California has more cases and more deaths, but it also has more people. Florida is filled with more elderly people, but its hospitals have not been overrun as predicted.
Is it possible that regular social distancing alone is enough? Why hasn't there been a bigger difference to date? Shouldn't four weeks tell us something or is it too early to tell?
As states begin to re-open, shouldn't we examine how different approaches have been effective?
Anyway, STAY HOME AND STAY SAFE until further notice.
I think the real trick, that no one is talking about, is hot-ice.
I live out west. The study just completed by USC shows mortality at 0.1%, much lower than previously thought. Almost all of them are elderly. A much higher percentage will die from the economic fallout.
If the death rate is 0.1%, then 100% of the population of New York State would need to have been infected by the virus in order to reach their current death total.
More than that actually. .16% of the city has already died.
New York State Death Count: 19,693 (worldometers)
New York State Population: 19.45 million (google)
Divide deaths by population and you get .00101, so it is very slightly over 100% of people.
City not State.
You do know that NYC added nearly 4,000 deaths that were never confirmed COVID, but just assumed to be after the fact.
That is a huge part of their numbers so far.
Even if that is true (which coming from you, it probably isn't), then it's roughly 80% of the total state population.
They were people with COVID symptoms, but they died before being tested, either because there weren't enough tests or they waited to go to the hospital and by the time they got there (if they went at all) they were too far gone. These are all people for whom a medical professional listed COVID as their cause of death.
Your implication is that those people should not be counted as COVID victims because a test never confirmed it was COVID. The same logic suggests that nobody should be counted as dying from the bubonic plague in the 14th century because it hasn't been confirmed by testing.
If those people didn't die of COVID, I'd like to hear your explanation for why the death rate in NYC has more than doubled. That's a New York Times link; if you don't like that as a source, here is a quote from a National Review article:
The CDC instructs officials to report deaths as COVID-19 deaths whenever the patient has either tested positive or, despite the absence of a test, presents circumstances from which presence of the infection can be inferred “within a reasonable degree of certainty” — such that its contribution to death is “probable” or may be “presumed.” This is drawn from CDC guidance, which directs that COVID-19 be specified in death certificates whenever “COVID-19 played a role in the death.”
The goal here is not to inflate the count, it is to get the most accurate count possible in the absence of sufficient testing.
Personally, I don't think there is a motivation other than the one you mention. But, counting deaths in that way is going to lead to some "false positives" and that is accepted. It is just a disclaimer for the numbers.
Yes, but if you are suggesting that the argument that the NYC mortality rate is overstated, you also need to account for the fact that there are plenty of tested cases in NYC that have yet to be resolved. Unfortunately some of them will undoubtedly die. I’d suggest that probably more than makes up for the potential false negatives. Also, since the point of this discussion is to compare to flu mortality and not all of those cases are confirmed through tests, maybe we should be noting that their should be a disclaimer about those numbers too?
Yes, but if you are suggesting that the Argument that the NYC mortality rate is overstated, you also need to account for the fact that there are plenty of tested cases in NYC that have yet to be resolved. Unfortunately some of them will undoubtedly die. I’d suggest that probably more than makes up for the potential false negatives. Also, since the point of this discussion is to compare to flu mortality and not all of those cases are confirmed through tests, maybe we should be noting that their should be a disclaimer about those numbers too?
The hypocrisy of:
- NYC is “over-reporting cases” because they are including assumed COVID deaths despite the deceased never testing positive
- Those damn Chinese and their fake numbers! They clearly understated the threat because the data doesn’t include all the COVID deaths.
How do you think the flu deaths you guys keep trying to compare to are counted?
I think you’re referring to this study:
https://news.usc.edu/168987/antibody-testing-results-covid-19-infections-los-angeles-county/
if we take 600 as the number of deaths (from the article, not sure if timing matches up perfectly to the study), wouldn’t that imply a range of 0.14% to 0.27%? Lower than a lot of the estimates we’ve seen (I had 0.6% in my head from an earlier research article). Would be interesting to see demographic data now that this data is available, could help with design of rational going-forward policy.
First-time antibody tests are always wildly inaccurate...
Just like the coronavirus tests themselves?
On average, 123 Americans die from suicide every day. That's a tragic number. That's 44,895 suicide deaths per year.
Since Feb. 1, 43,622 Americans have died from Coronavirus. Coronavirus is winning the race.
So your point is trump was right to downplay the virus 10 weeks ago and wrong to say now that he didn't.
No. The point is shutting down the economy is not going to cause more death (by suicide) than what the coronavirus has done and will do. It's just something to say that's emotionally based, not factually, to justify a "got to open up" argument.
People need to understand that there isn't one "true" mortality rate that applies to everyone. A lot will depend on the sample that is infected.
Geography might matter too: NYC and Detroit apparently got the virus from Italy (as did most of Western Europe), rather than directly from China.
I understand that the way epidemiologists assess the true death rate is by looking at comparing the average annual total deaths with the death rate in the virus year. By that count, Italy has four times its annual number of deaths, which is indeed a lot of people dead. Here is a similar comparison for some other countries. Not definitive, but suggestive, for better or worse, that this thing really is pretty deadly:
https://www.nytimes.com/interactive/2020/04/21/world/coronavirus-missing-deaths.html
Something tells me the average death rate next year will be a lot lower....in essence COVID accelerated what would have happened over the next few years anyway.
Generally, I think so too. But, the number of people scared of the hospital now and people not coming in for procedures will likely lead to more deaths the rest of this year. If you wait to have your heart looked at when you think there might be a problem, your chances of dying go up.
This has become a serious problem: https://www.nytimes.com/2020/04/06/well/live/coronavirus-doctors-hospitals-emergency-care-heart-attack-stroke.html
kind of secondary deaths due to C19. From the NYT article: “The most concerning possible explanation is that people stay home and suffer rather than risk coming to the hospital and getting infected with coronavirus.”
I think the 0.1% mortality rate may be low - probably more like 0.25% - but I don't think you're not wrong otherwise.
The median age of COVID deaths is about 75-80 in most states and countries - which is basically the national median age at death in "more normal times."
Please link this "study". Because that is the death rate for influenza on average. But somehow influenza isn't filling up ice rinks and mass graves with bodies in NY and Milan every year. Yearly influenza deaths don't require hospitals to rent refrigeration trucks to store bodies.
Seriously, I'm a physician, please link this study, because I haven't seen anything like it in major journals. I've seen estimate as low as %1 put out there, which is still 10x the flu, if true. The bottom line is that this datum of mortality rate can't possibly be known until there is widespread antibody testing available.
There are several studies that estimate IFR < 1% (a couple below including this USC study that is ongoing. The last link estimates 1.4% with including only symptomatic cases).
Isn’t the acuteness of the absolute number of deaths in a short period of time a combination of IFR and of speed of spread or infection rate? It’s possible for disease A and B to have a similar death rate but have more deaths from one in the same amount of time bc more people are infected.
https://news.usc.edu/168987/antibody-testing-results-covid-19-infections-los-angeles-county/
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30243-7/fulltex
https://www.nature.com/articles/s41591-020-0822-7
I've seen the kind of data from your second and third links. However, it's difficult to know the veracity of numbers coming out of China. They lie categorically to protect the esteem of the regime. I'm quite surprised about the first link, if true. Other areas aren't seeing that kind of result, they're seeing low levels of antibodies in the communities.
You're right about China's numbers. But I'd just add that you won't be able to trust the U.S. numbers, either. For one thing, the vast majority of sick people (and dead people) haven't been tested. God only knows how many people who officially died of "pneumonia," "the flu" or "lung disease" were actually killed by covid. Not to mention all the indirect deaths -- all the heart attack and stroke victims who didn't get treatment because ICUs were full. And, not least, a certain someone will almost certainly dispute any numbers recorded by WHO, the CDC, etc.
I think you have nailed it here. There are two factors at play and the IFR gets an outsized share of the attention. Would you rather a virus with a 10% mortality rate that only infects 1000 people or one with a 0.1% mortality rate that impacts one billion people. Both numbers contribute to the number of deaths, but that is the number we ultimately care about. The flu usually kills about 2000 people a year in NYC, Covid has so far killed somewhere between 9500 and a bit over 15,000 people in New York City depending upon what you think about the 4800 deaths certified as covid by the coroner that were not tested. That means anywhere from 4.5 to 7.5 times as many deaths as from the flu. And as we speak, people are still dying. Those are real and significant numbers. It is not clear how anyone can look at those numbers and say, but there is this unpeer reviewed study in California that says the IFR is close to 0.1, see this is barely more serious than the flu.
A seasonal flu could easily do that if (1) it is HIGHLY contagious, (2) it is new to the whole population, and (3) there is no known treatment plan.
As for estimates lower than 1% IFR, there are lots out there. The Stanford study. The USC study. Study of a small town in Germany. A study of a small ski resort in Italy. Spain did one of health care workers. There is also this "large scale" Dutch one from yesterday.
It is interesting because it is the only one I have seen to break things down by age (which we know is a huge factor). It shows an IFR of .1% for people under 59 and under .014 for people younger than 50. Or course, I am sure the rates look bad once you get above 80 years old. Study.
Not sure how good any of these are (especially since I need to use Google translate). But they are clearly heading in a direction under 1% overall and much, much lower for people under 65.
You're a bad influence on the world around you. Either an idiot, or maliciously lying, or maliciously ignoring and twisting data to fit your narrative. It's shameful.
I would give much to be able to give all of "you people" a lifelong brand that you have to wear around everywhere, so everyone knows just what you are.
Cracks me up how people's reaction to that study is "the mortality rate is lower than we thought," when the real take away is this thing spreads way faster and easier than we thought. We already have more confirmed deaths in less than 3 months than the flu killed the whole year last year (using extrapolation to estimate), with the trend looking like that number will at least double. Who knows what the actual number of deaths is if we use the modeling method we use for flu, probably a lot higher. All while most of the country has been all but shut down.
What it means is that the peak using a more moderate social distancing approach might not be nearly the disaster that a lot of the models predicted (this already appears to be true).
If IFR and hospitalization rates are much lower than previously thought, we can likely handle outbreaks without shutting down society so long as we take certain precautions (limits on large events, better hygiene, mask-wearing, reduced indoor capacities, etc.).
Except we already know what that looks like, hospitals on the verge of being overwhelmed. We already have so many examples of how this thing actually behaves in the real world, from the US and around the world, without having to resort to guessing by massive extrapolation of preliminary data.
That study has been torn to shreds by experts
This is funny, but Ohio is the right answer.
You left out an important detail: a lot of Florida counties (including Miami-Dade) locked down very early. By the time the governor announced it for the entire state, it only affected a handful of remaining counties. Overall the two states largely did the same thing, it's just that in one (California) the order came from the governor and in the other (Florida) it came from the county executives.
The same thing happened in California. Localities had locked down prior to the state wide order.
BTW - It seems that you are implying that this may be overkill for rural areas.
So why do you speak of "two different approaches" again? They differed mainly on form, not function.
The major difference was in speed and scope of action. How hard, fast and deep they shut down.
They were similar in that local areas did their own thing first. They were similar in the number of confirmed cases around the same time. They were similar in having big events that many people traveled there for in late January/early Feb (Super Bowl, Kobe, awards, etc.). They are similar in climate (somewhat).
So, maybe the Florida way is all you need?
Have you paid off all that damage at TreeTops that you and your frat bros caused yet?
Well done. Insert Orson Wells clapping gif.
This is all I could really find on the matter:
Miami issues 'Safer at Home' on March 26th. https://miami.cbslocal.com/2020/03/26/miami-dade-issues-shelter-in-place-order/
State of Florida issues statewide lockdown on April 1. https://www.npr.org/sections/coronavirus-live-updates/2020/04/01/825383186/florida-governor-orders-statewide-lockdown
6 days?
His post is a farce, but it seems reasonable because a large portion of the board has bought into the idea that a full scale lock down is the only way out of this situation. When information flies in the face of that, the story changes:
"Oh actually Florida handled this early and well on the county level. No, ignore all those articles from experts claiming it will be a disaster zone by the middle of April"
"Oh Sweden's medical system isn't collapsing (the entire point of flattening the curve) and they haven't destroyed their economy, potentially setting back a generation for decades to come? Uh, look over there while I move the goal posts. Okay now look back! See the number of deaths? Sweden is doing terribly!"
Yeah okay.
Every expert alive was predicting that Florida was going to be the next disaster zone due to their situation in March (spring break, lack of statewide lock down). The counties shut down from March 19th through the statewide order.
Very early would be the counties in California that shut down well before the 19th.
But please, let's keep rewriting history.
Edit: A quick google search reveals how laughable this post is:
Article after article from late March and early June predicting Florida as the "next hot spot"
A timeline of county closures in Florida:
Most taking place between March 24th and the 1st of April
Here's MGoBlog discussing Florida:
https://mgoblog.com/mgoboard/near-realtime-covid19-predictive-data
Conclusion: Florida is fucked.
But now? Oh actually Florida took a super strict approach to the pandemic, that's why they look to be doing okay.
Exactly. NYC is a complete outlier at this point but doomers keep pointing back to it. I remember an article in the NYT several weeks ago predicting Greenville, SC as the next hot spot because satellite tracking proved that none of us were staying home. From first hand accounts, I can tell you this is true - its' still pretty easy here to get into traffic jams. And we have 12 deaths in Greenville County from this spring flu season.
Any doomers want to explain the article in the WaPo this morning saying that scientists have now proven the virus was freely circulating on the west coast in January? Why weren't they digging mass trenches? I don't get it.