Covid general thoughts

The number that we normal people can use to guide us concerning risk is not the number of deaths pr positive test. We don’t know the percentage tested, we don’t know how reliable the tests are, and we don’t know how many have had Covid 19 and are immune. 

But luckily, like you indicate with your graphs, we can know risk of death by nationality. China is a bit over 2 pr million. Right now, Italy has 6820 deaths in 60 million, 113 pr million. 

Annual flu deaths in Italy are around 340 pr million. It the numbers doble for Covid 19, we will still be way below normal flu deaths. And most of the people dying from Covid 19 would be the ones most likely to die from the flu, so if we hadn’t started testing for Corona, we might not have noticed anything at all, especially in China, but even in Italy. 

A lot of people die every day from all causes, 1700 pr day in Italy, so many die with Corona, not from Corona. Maybe all the Corona deaths would have died anyway. We really don’t know. 


We could know, though. Antibody testing (now available as fingerpick) of 100 random persons would establish the percent who have or have had Corona. 100 normal swab tests of the same group could establish current virus in the system. Maybe authorities are afraid of doing this. It could make them look really stupid if we see that over half of the population has antibodies, and possibly show that it has been around much longer than we think.

The  major disease groups in the study would almost all be using ACE inhibitors and could be dying because of that. It is estimated that up to 700 000 patients in the US die every year because of medical errors or side effects of medication, so that wouldn’t be the fist time doctors do more harm than good. 

Anyway, the big doctor organisations sign up for Catastrophic Climate Change, so they may not be the ones to trust blindly when it comes to numbers or reasoning ability. And now the cardiac organisations say patients should not change their ACE medication... 

Deaths pr million is the only sensible number. It combines risk of being contaminated withthe risk of dying from Corona when you are from a certain country. You could also search for death pr million for the age group within the country or  diagnosis group death or million e.g. ACE inhibitor users e.g. in the US

Somebody shoud do a fingerprick antibody test of at lest 100 random persons to check how many are already immune e.g. from a very mild infection. 

Do the math! Pr million inhabitants, Corona is hundred times LESS deadly than the flu in China, less than half of the risk in Italy, even counting that they double the death numbers  before it is over. And the Italians probably test all dead patients and count them if they have Corona, even if they just died WITH Corona. That makes sence to justify hard measures put in place. 

If nobody had thought of testing for Corona, we wouldn't have noticed it. Most who die from it would otherwise have died from the flu. Remember average age of death is way above life expectancy for many countries.

It is very typical that doctors are sceptical to anybody knowing better than them. They also want people to continue with their bloodpressure ACE inhibitor, even if it is very medically plausible that this medication "opens the doors "in their cells for the virus. 

Lucky Africans, many take a tablet hydroxychloroquine a week to prevent malaria and may be very protected from Corona because of it. By the way a few glasses if Tonic (without gin) pr day would be equivalent of a tablt a weel prevention

When a doctor is unwilling to try something that can prevent a patient from dying because they think it may be a placebe effect (That is the only reason to do a clinical trial) of a drug that millions take for Malaria prevention all year around, ona may wonder about his sanity. If the patient stays alive because he believes the cloroquin will save him, because of the placebo effect of the pill, all the better! Unless side effects of a drug may kill a patient who would otherwise live we have a moral obligation to try it.

"Anthony Fauci, a physician who heads the NIAID and a veteran of outbreaks going back to HIV, emphasized the need for a methodical clinical trial". Who actually needs this trial? The dying patient? Doctors who want to play God? It would be interesing if Fauci would say the same if he himself or a family member was dying from Corona.

“researchers are already using the test at Mount Sinai Hospital to determine how quickly people develop antibodies to COVID-19,”

https://nypost.com/2020/03/24/mount-sinai-researchers-develop-test-for-coronavirus-antibodies/

There seems to be a lot money in increasing the fear. Corona has a death rate of less than 2 pr million in Korea. Flu is around 300 pr million, more than 100 times more deadly. Even in Italy the normal flu is 5 times more deadly than Corona. Even with vaccination campaigns for the flu. Handling corona (common cold) viruses have not had success in the past, but with the extreme fear associated with Corona, all nations will compete to get any remedy. Great for business. But the results will probably not be fantastic. 

"Over the past few days, state pharmacy boards in Texas, Ohio, Idaho, and Nevada began restricting who can be prescribed the drugs, after reports of some doctors prescribing the drugs for themselves and their families."

When doctors start behaving like this, we may be relaively certain that the drug is useful and with acceptable side effects.

You can’t use a map unless you know where you are and know if you are going in the right direction. Before we do RANDOM testing of 100 individuals with antibody testing  (to determine who has had Corona and are immune) and 100 swabs to determine number of active cases in the population, and repeat this every day, we have no idea where we are and where we are going. If we decrease social distancing and the random test still shows more immune people and less active cases, we can continue, if not, it is back to lockdown ASAP. But we have to know. DO THE RANDOM TEST. Aren’t there any scientists out there?

Testing 3300 town Italy

His team carried out 3300 coronavirus swabs on the entire population of one of the initial 11 lockdown towns in northern Italy, Vo Euganeo, the only one in the Veneto region.

No one else decided to test every single member of the lockdown community. The results immediately showed that 3 percent of all those tested were positive. 

[RETRACTED][Potential False-Positive Rate Among the 'Asymptomatic Infected Individuals' in Close Contacts of COVID-19 Patients] 

[Article in Chinese] 

G H Zhuang  1 , M W Shen, L X Zeng, B B Mi, F Y Chen, W J Liu, L L Pei, X Qi, C Li 

Affiliations 

• PMID: 32133832 

• DOI: 10.3760/cma.j.cn112338-20200221-00144 

Abstract

in English , Chinese 

Objective: As the prevention and control of COVID-19continues to advance, the active nucleic acid test screening in the close contacts of the patients has been carrying out in many parts of China. However, the false-positive rate of positive results in the screening has not been reported up to now. But to clearify the false-positive rate during screening is important in COVID-19 control and prevention. Methods: Point values and reasonable ranges of the indicators which impact the false-positive rate of positive results were estimated based on the information available to us at present. The false-positive rate of positive results in the active screening was deduced, and univariate and multivariate-probabilistic sensitivity analyses were performed to understand the robustness of the findings. Results: When the infection rate of the close contacts and the sensitivity and specificity of reported results were taken as the point estimates, the positive predictive value of the active screening was only 19.67%, in contrast, the false-positive rate of positive results was 80.33%. The multivariate-probabilistic sensitivity analysis results supported the base-case findings, with a 75% probability for the false-positive rate of positive results over 47%. Conclusions: In the close contacts of COVID-19 patients, nearly half or even more of the 'asymptomatic infected individuals' reported in the active nucleic acid test screening might be false positives. 

Keywords: COVID-19; Close contacts; False-positive; Nucleic acid test; Screening. 

deCode has published the results of a total of 5 490 tests. Those have yielded 47 positive results (0.86%) indicating that the prevelance (sic) of the virus is modest among the general population,” the Government of Iceland reports. “A total of 409 cases have been identified in Iceland since the first case on February 28th. One person with COVID-19 has died. Six individuals with COVID-19 are hospitalized, one in intensive care.”

https://cleantechnica.com/2020/03/21/iceland-is-doing-science-50-of-people-with-covid-19-not-showing-symptoms-50-have-very-moderate-cold-symptoms/

reports that deCODE Genetics has tested samples from roughly 1,000 Icelanders in the general population, i.e., people who are not currently in home quarantine. Registration for these screenings is done online. Of these people, only nine have tested positive for novel coronavirus—or 0.899%.

Even with this small sample size, deCODE Genetics CEO Kári Stefánsson is optimistic.

“I calculate that the spread [of the virus] in the general population is even lower,” he told reporters. “Because I believe it’s likely that those who have reason to believe they may haveVísir contracted or come in contact with the virus are more likely to come to us.”

Iceland, for example, which, because of its tiny population, is able to test Icelandic citizens at random, is finding that about 50% of all people who test positive for Coronavirus have no symptoms at all:

Importantly, approximately half of the people who tested positive for COVID-19 are non-symptomatic, according to Gudnason as reported by BuzzFeed. The other half is mostly showing “very moderate cold-like symptoms.”

Some 5,000 volunteers who did not have any symptoms stepped forward to join the study – 48 of whom actually tested positive.

In one recent study, a group of 101 elderly nursing-home patients watched a video that showed attempted CPR, as well as less aggressive treatment. They were then given a choice of life-prolonging care, limited curative efforts with comfort care, or just comfort care. Eight out of 10 opted for comfort care. Among those who heard only verbal descriptions, just 57% wanted comfort care, while most of the rest wanted life-prolonging or limited treatment.

https://money.com/cutting-the-high-cost-of-end-of-life-care/

Could it be that the medication load older patients live with may be part of the reason they die from Corona?

But Prof Ricciardi added that Italy’s death rate may also appear high because of how doctors record fatalities. 

“The way in which we code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus.

“On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity - many had two or three,” he says. 

https://www.telegraph.co.uk/global-health/science-and-disease/have-many-coronavirus-patients-died-But Prof Ricciardi added that Italy’s death rate may also appear high because of how doctors record fatalities. 

“The way in which we code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus.

“On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity - many had two or three,” he says. 

https://www.telegraph.co.uk/global-health/science-and-disease/have-many-coronavirus-patients-died-italy/

As soon as possible we need to test a representative random sample of the population to see how many already have antibodies and are immune. These could be on the frontlines without getting sick and without infecting others. I am sure many brave souls would volunteer to be tested and be first immune responders.