Covid-19 pandemic

[Wouter D]

The effects on the pandemic on the Low Countries seems to have rather fallen under the radar in the UK media. The Dutch and Belgian mortality rates are significantly higher than those for France, for example, and more have died in those two countries than in the UK.

Taking a relatively low number of tests results in a relatively high mortality rate. It doesn't imply that the virus is more deadly here. But even if we compare the total number of confirmed cases with the total number of confirmed deaths, Belgium and the Netherlands are in line with France* and the UK (double logscale). The regional outlier is Germany, where we know that many more people were tested.

The RIVM has just briefed parliament again on Dutch numbers. Slide set here. The chart on slide 15 illustrates how the basic reproductive rate has dropped way below 1 in the last two weeks. This implies that the virus growth will now be sublinear, from which you can conclude that the measures taken to stop the spread of the virus are working as intended. It is important to keep those measures intact, which the government has announced to do until at least April 28.

Slides 11 and 12 show the progression of patient numbers in intensive care, which was a topic of concern within the Netherlands. Slide 11 has the old model, making an assumption on the average length of stay in IC. This assumption turned out to be too positive: people stay in IC longer than expected. Slide 12 has the updated model. The black line is the Dutch IC capacity, at 1200 beds; for the last week or so, much energy has been invested in doubling this capacity, which is expected to be achieved by the end of the week. Notice that both these slides include a pessimistic choice for R_0 in their models, while we just saw on slide 15 that R_0 is dropping.

*by the way, if you un-highlight the selected five countries, you'll notice that France almost overlaps with another country in this chart. That country is Iran. I do not believe this for even a second; reporting from Iran surely isn't accurate. This illustrates a bigger point though: since every country has their own reporting methods, their own definitions of confirmed cases and deaths, their own protocols w.r.t. who gets tested, any cross-country comparison is doomed from the start.

[Antepli Ejderha]

How much "non-fresh" food do you have? And could you survive on it until Monday?

No milk, bread, eggs, fruit or veg. However I followed jwdd27's advice and found a sainsbury's slot open up for Friday. First world problem I know but I'm relieved.

As sainsbury's pick from their shelves in the supermarket rather than from a large warehouse I know some things won't be available.

[Logan Mountstuart]

Rather unbelievably, I was stuck in a traffic jam yesterday. Stupid people need to get off the road so that I can purvey my vital hamburger supplies.

There is way too much unnecessary activity in The Netherlands, including my stupid activity. I feel much sympathy for poor old Plies, further up the thread.

As I said before, I fear for the Dutch. Already over a 1000 dead. 400 more than Germany with 1/5 the population.

This virtually voluntary lock down is not really going to do that much to stem the tide in the coming weeks as other lock downs elsewhere might well do.

Yet more proof that it's the more libertarian free economy governments that are really not coming up to scratch in a crisis.

[Nocturnal Submission]

Taking a relatively low number of tests results in a relatively high mortality rate. It doesn't imply that the virus is more deadly here. But even if we compare the total number of confirmed cases with the total number of confirmed deaths, Belgium and the Netherlands are in line with France* and the UK (double logscale). The regional outlier is Germany, where we know that many more people were tested.

The RIVM has just briefed parliament again on Dutch numbers. Slide set here. The chart on slide 15 illustrates how the basic reproductive rate has dropped way below 1 in the last two weeks. This implies that the virus growth will now be sublinear, from which you can conclude that the measures taken to stop the spread of the virus are working as intended. It is important to keep those measures intact, which the government has announced to do until at least April 28.

Slides 11 and 12 show the progression of patient numbers in intensive care, which was a topic of concern within the Netherlands. Slide 11 has the old model, making an assumption on the average length of stay in IC. This assumption turned out to be too positive: people stay in IC longer than expected. Slide 12 has the updated model. The black line is the Dutch IC capacity, at 1200 beds; for the last week or so, much energy has been invested in doubling this capacity, which is expected to be achieved by the end of the week. Notice that both these slides include a pessimistic choice for R_0 in their models, while we just saw on slide 15 that R_0 is dropping.

*by the way, if you un-highlight the selected five countries, you'll notice that France almost overlaps with another country in this chart. That country is Iran. I do not believe this for even a second; reporting from Iran surely isn't accurate. This illustrates a bigger point though: since every country has their own reporting methods, their own definitions of confirmed cases and deaths, their own protocols w.r.t. who gets tested, any cross-country comparison is doomed from the start.

Thanks for that, Wouter. Very interesting.

Re. mortality rates, I was comparing deaths from the virus per head of population rather than per cases. Using the former measure, and as per the site I use, the rates for Belgium (71 deaths per 1m population) and the Netherlands (61) are higher than France (54) and the UK (26).

The Iranian figures are nonsense. They've been reporting around 125-150 deaths each day for about the last three weeks which would give them a mortality profile unlike any other nation that I've seen.

[anton pulisov]

Taking a relatively low number of tests results in a relatively high mortality rate. It doesn't imply that the virus is more deadly here. But even if we compare the total number of confirmed cases with the total number of confirmed deaths, Belgium and the Netherlands are in line with France* and the UK (double logscale). The regional outlier is Germany, where we know that many more people were tested.

The RIVM has just briefed parliament again on Dutch numbers. Slide set here. The chart on slide 15 illustrates how the basic reproductive rate has dropped way below 1 in the last two weeks. This implies that the virus growth will now be sublinear, from which you can conclude that the measures taken to stop the spread of the virus are working as intended. It is important to keep those measures intact, which the government has announced to do until at least April 28.

Slides 11 and 12 show the progression of patient numbers in intensive care, which was a topic of concern within the Netherlands. Slide 11 has the old model, making an assumption on the average length of stay in IC. This assumption turned out to be too positive: people stay in IC longer than expected. Slide 12 has the updated model. The black line is the Dutch IC capacity, at 1200 beds; for the last week or so, much energy has been invested in doubling this capacity, which is expected to be achieved by the end of the week. Notice that both these slides include a pessimistic choice for R_0 in their models, while we just saw on slide 15 that R_0 is dropping.

*by the way, if you un-highlight the selected five countries, you'll notice that France almost overlaps with another country in this chart. That country is Iran. I do not believe this for even a second; reporting from Iran surely isn't accurate. This illustrates a bigger point though: since every country has their own reporting methods, their own definitions of confirmed cases and deaths, their own protocols w.r.t. who gets tested, any cross-country comparison is doomed from the start.

If you go here and click on "per miljon invånare" (no explanation needed for what that Swedish means for a Dutch speaker) then you can see the mortality rate in time for the various countries. Unfortunately the Netherlands is currently tracking Italy. The hope is of course that the Netherlands will bend earlier than Italy did, due to Italy having the bad luck of being the first country infected in Europe, whereas the Netherlands had more prior warning.

[Wouter D]

Re. mortality rates, I was comparing deaths from the virus per head of population rather than per cases. Using the former measure, and as per the site I use, the rates for Belgium (71 deaths per 1m population) and the Netherlands (61) are higher than France (54) and the UK (26).

Ah, that makes more sense. Thanks for the clarification.

This way of measuring would lead to the linked chart. Ourworldindata adds to that the disclaimer "Limited testing and challenges in the attribution of the cause of death means that the number of confirmed deaths may not be an accurate count of the true number of deaths from COVID-19."

The wealth of data available to us right now is so rich that we can draw any conclusion we want by selecting the right chart or statistic. Doing this right is almost impossible to trained data scientists, let alone journalists. I have no idea whether I am doing the right thing here, but I am drawing hope from that R_0 chart.

[Fussbudget]

Re: using deaths to size of population ratios to compare countries:

https://twitter.com/jburnmurdoch/status/1238914490772701185

https://twitter.com/jburnmurdoch/status/1238999365030678529

[Nocturnal Submission]

Probably not an April Fools' Day joke. From the BBC:

The Malaysian government was forced to apologise after its women's ministry posted cartoons online telling wives to dress up, wear makeup and avoid nagging their husbands during the country's partial lockdown

[Wouter D]

If you go here and click on "per miljon ivånare" (no explanation needed for what that Swedish means for a Dutch speaker) then you can see the mortality rate in time for the various countries. Unfortunately the Netherlands is currently tracking Italy. The hope is of course that the Netherlands will bend earlier than Italy did, due to Italy having the bad luck of being the first country infected in Europe, whereas the Netherlands had more prior warning.

Thanks for the alternative source! I have a bit of an issue with the choice of x-axis here.

Google Translating the given explanation results in "The curve begins on the day when the country had 8 deaths, a number that is arbitrarily chosen but that marks a point when it "started to move". The reason why we choose deaths instead of the number that tested positive is that different countries have very different testing strategies, for example. means that the number of cases may be much higher in some countries only because that they are testing more."
Two things about that:
- choosing the fixed number 8 irrespective of population size and density seems arbitrary at best
- taking into account that different countries have different testing strategies is commendable. Resolving this by taking deaths instead is a bit of an own goal, since different countries will also have different death attribution strategies.

[anton pulisov]

Yeah I wonder if how taking different numbers of death as starting point would affect it. Would be cool if they could allow the user to specify that.

Belgium on the same curve as Spain according to that website as well...

[Lurgee]

I am worried about India, partly for humanitarian reasons (the number of likely victims) and selfish (the likelihood of Covid-19 becoming endemic, mutating frequently and causing ongoing global outbreaks in the future.)

[Guy Profumo]

One for Kuntz Korner

GP surgery send "fuck off and die quickly" letters to elderly and patients suffering life-limiting conditions.



https://www.bbc.co.uk/news/uk-wales-52117814

[anton pulisov]

I am worried about India, partly for humanitarian reasons (the number of likely victims) and selfish (the likelihood of Covid-19 becoming endemic, mutating frequently and causing ongoing global outbreaks in the future.)

Regarding your selfish reasons. Apparently this virus doesn't mutate very much, so any vaccine should be long lasting. And historically, viruses tend to mutate to less dangerous forms anyway. It's not in the interest of the virus to kill off its hosts. It is as powerful as it is now because it evolved for the strong immune systems of bats. As it adjusts to the human population it should weaken. Many of the common cold viruses that have been circulating through human populations for centuries are corona viruses. Who knows, maybe those were also more deadly when they first jumped into humans.

[Antepli Ejderha]

https://www.gov.uk/guidance/coronavi...-30-march-2020

MOT advice for the UK

[Vicarious Thrillseeker]

No milk, bread, eggs, fruit or veg. However I followed jwdd27's advice and found a sainsbury's slot open up for Friday. First world problem I know but I'm relieved.

As sainsbury's pick from their shelves in the supermarket rather than from a large warehouse I know some things won't be available.

If it's any use, AE, Jack Monroe's 'Tin Can Cook' is available on Kindle/Amazon for 99p today. She's brilliant with tins/dried foodstuffs. She's also got a really easy home bread recipe.

[Glass Half Empty]

One for Kuntz Korner

GP surgery send "fuck off and die quickly" letters to elderly and patients suffering life-limiting conditions.



https://www.bbc.co.uk/news/uk-wales-52117814

Ok, a bit unsubtle and this looks a bit bleak in written form but is, in reality, dealing with exactly the dilemma A&E doctors will be confronted with numerous times over in the next few weeks. Harsh for 'normal' times certainly but these times aren't normal.

[Janik]

That is the prioritisation that is going on up and down the country, just laid out in black-and-white. It's... honest. Brutally so. Medical staff do try and sugar-coat such messages normally...

Apparently this virus doesn't mutate very much, so any vaccine should be long lasting. And historically, viruses tend to mutate to less dangerous forms anyway. It's not in the interest of the virus to kill off its hosts. It is as powerful as it is now because it evolved for the strong immune systems of bats. As it adjusts to the human population it should weaken. Many of the common cold viruses that have been circulating through human populations for centuries are corona viruses. Who knows, maybe those were also more deadly when they first jumped into humans.

Absolutely on the second part - Spanish 'flu (aka H1N1) is still out there. It just doesn't kill like it did in the first waves. And yes with a caveat to the first part - vaccines, when they come, should be effective for years ahead. However the time that they will protect one person will be limited - the antibodies that attack coronoviruses seem to be lost after 12-18 months. Hence the 12 month 'booster' shots (basically a re-immunisation) for Influenza, which is pretty similar. A mixture of a vaccination programme, the evolutionary pressure on the virus to lower it's virulence and, yes, herd immunity are the eventual exit route to all this.

[Patrick Thistle]

Wow. Up from 69 deaths to 98 deaths in Wales today.

274 new cases have tested positive for Novel Coronavirus (COVID-19) in Wales, bringing the total number of confirmed cases to 1,837, although the true number of cases is likely to be higher.
“29 further deaths have been reported to us of people who had tested positive for Novel Coronavirus (COVID-19), taking the number of deaths in Wales to 98.

[Glass Half Empty]

563 UK deaths last 24 hours, all hospital or hospital plus some catch-up? don't know.

[anton pulisov]

That is the prioritisation that is going on up and down the country, just laid out in black-and-white. It's... honest. Brutally so. And medical stuff do try and sugar=coat such messages normally.


Absolutely on the second part - Spanish 'flu (aka H1N1) is still out there. It just doesn't kill like it did in the first waves. And yes with a caveat to the first part - vaccines, when they come, should be effective for years ahead. However the time that they will protect one person will be limited - the antibodies that attack coronoviruses seem to be lost after 12-18 months. Hence the 12 month 'booster' shots (basically a re-immunisation) for Influenza, which is pretty similar. A mixture of a vaccination programme, the evolutionary pressure on the virus to lower it's virulence and, yes, herd immunity are the eventual exit route to all this.

I remember reading about survivors of SARS (another coronavirus) still having antibodies five years later. But can't find it at the moment. The immune system seems to remember for longer if the virus was nasty, and forget quicker in the case of something mild like the common cold.

[ursus arctos]

Grauniad says the 563 are all hospital deaths

[Glass Half Empty]

Regarding your selfish reasons. Apparently this virus doesn't mutate very much, so any vaccine should be long lasting. And historically, viruses tend to mutate to less dangerous forms anyway. It's not in the interest of the virus to kill off its hosts. It is as powerful as it is now because it evolved for the strong immune systems of bats. As it adjusts to the human population it should weaken. Many of the common cold viruses that have been circulating through human populations for centuries are corona viruses. Who knows, maybe those were also more deadly when they first jumped into humans.

The statistics for H1N1, Spanish Flu, seem to both back this up and run a bit counter to this. It came in 3 peaks, the first wave was the mildest, it then came back and the second wave was by far the worst it then came back a third time in the space of 2 years. Did it mutate between waves 1 and 2? unclear. It might have done or the devastation of wave 2 could have been down to the particular circumstances of the end of the war, medical resources completely overstretched, returning soldiers, large numbers of wounded soldiers, apparently, those who had suffered gas attacks virtually all died if they caught it, victory celebrations etc. The death toll was horrendous though, estimated 50 million died and 1/3rd of the global population eventually infected, disproportionately young adults killed, approx 4 times more killed than in the whole of WW1. The basic strain though is still around today but clearly less virulent.

[Wouter D]

Taking a relatively low number of tests results in a relatively high mortality rate. It doesn't imply that the virus is more deadly here. But even if we compare the total number of confirmed cases with the total number of confirmed deaths, Belgium and the Netherlands are in line with France* and the UK (double logscale). The regional outlier is Germany, where we know that many more people were tested.

The chart on slide 15 illustrates how the basic reproductive rate has dropped way below 1 in the last two weeks. This implies that the virus growth will now be sublinear, from which you can conclude that the measures taken to stop the spread of the virus are working as intended. It is important to keep those measures intact, which the government has announced to do until at least April 28.

Sorry to keep banging on about Dutch numbers; this just happens to be the day when the local scientists dropped a whole load of knowledge about the situation over here. It turns out that the reproductive rate, R_0, was around 3 at Carnaval (end of February), but has dropped to 0.3 now (link in Dutch). There are also significantly fewer deaths and hospitalizations today than there were yesterday. The tide seems to be turning (provided that the measures taken, stay in place).

[anton pulisov]

Sudden increase in Sweden today. 59 deaths today. Population wise, that's equivalent to 354 in Italy. Head epidemiologist in Sweden says everything is grand.

[ursus arctos]

Those are striking figures, Wouter.

I'm wondering if a key variable is the degree of compliance with restrictions. If the population takes what is legislated very seriously, the measures may not need to be as Draconian as those where compliance is more hit and miss.