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Some rough math here, with some assumptions about how many cases are being missed now:

Back at April peak we were catching ~25% of cases we are now. We have good comparison data now on this by comparing cases vs hospitalizations in states like PA/MI/NJ. Takes 4x as many cases now to get same number of hospitalizations. Means with with today's testing you would have had 40k cases a day in NY! It is assumed we are currently catching 25% of actual transmission now. and have been since about July.

If you average out case load between April and early July (~3 Million cases were confirmed in this time period). you went from 16x to 4x ratio of real infections vs tested for mean of 10x.  So say (3Mx10 = 30 M real infections). From July until 16 days ago (to account for death report lag) you had 7Mx4=28M real infections. 250k/58M =~0.43% IFR.

Obvious some error bars but would imply close to 800k deaths without a vaccine with a slow burn to herd immunity. (330M*0.6*0.004) ~800k. If we are lucky the vaccine will prevent maybe 450k of those.

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Just now, dan11295 said:

Some rough math here, with some assumptions about how many cases are being missed now:

Back at April peak we were catching ~25% of cases we are now. We have good comparison data now on this by comparing cases vs hospitalizations in states like PA/MI/NJ. Takes 4x as many cases now to get same number of hospitalizations. Means with with today's testing you would have had 40k cases a day in NY! It is assumed we are currently catching 25% of actual transmission now. and have been since about July.

If you average out case load between April and early July (~3 Million cases were confirmed in this time period). you went from 16x to 4x ratio of real infections vs tested for mean of 10x.  So say (3Mx10 = 30 M real infections). From July until 16 days ago (to account for death report lag) you had 7Mx4=28M real infections. 250k/58M =~0.43% IFR.

Obvious some error bars but would imply close to 800k deaths without a vaccine with a slow burn to herd immunity. (330M*0.6*0.004) ~800k. If we are lucky the vaccine will prevent maybe 450k of those.

The population being infected does not represent a perfect slice of the US population. The implied IFR lowers since older folks are protecting themselves more than younger folks. You can see this reflected in the age stratified CDC commercial lab survey. 

https://covid.cdc.gov/covid-data-tracker/#national-lab

I know the CDC IFR estimates from March/April is slightly over 1% when adjusted for population distribution and afaik we have not cut the disease IFR by better treatments in excess of 60 percent. 

The UK hospitalization data is better than the US because its more nationalized. The in-hospital death rate there appears about 45% lower than the first wave. 

16x early on is too high imo. The antibody data from that time averaged more like 12x. 

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1 hour ago, dan11295 said:

Some rough math here, with some assumptions about how many cases are being missed now:

Back at April peak we were catching ~25% of cases we are now. We have good comparison data now on this by comparing cases vs hospitalizations in states like PA/MI/NJ. Takes 4x as many cases now to get same number of hospitalizations. Means with with today's testing you would have had 40k cases a day in NY! It is assumed we are currently catching 25% of actual transmission now. and have been since about July.

If you average out case load between April and early July (~3 Million cases were confirmed in this time period). you went from 16x to 4x ratio of real infections vs tested for mean of 10x.  So say (3Mx10 = 30 M real infections). From July until 16 days ago (to account for death report lag) you had 7Mx4=28M real infections. 250k/58M =~0.43% IFR.

Obvious some error bars but would imply close to 800k deaths without a vaccine with a slow burn to herd immunity. (330M*0.6*0.004) ~800k. If we are lucky the vaccine will prevent maybe 450k of those.

This site which previously modeled out to the future has launched a new project trying to model backwards to answer the question you are looking into above.

https://covid19-projections.com/

Their best estimate is 48M total infections but a range from 32M to 73M

Some pretty impressive/sad maps showing how widespread it has become in many of the midwest states while other states that put in measures to contain the thing - Hawaii, NH, VT, ME, CA, WA, OR have fared much better.

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1 hour ago, mattb65 said:

This site which previously modeled out to the future has launched a new project trying to model backwards to answer the question you are looking into above.

https://covid19-projections.com/

Their best estimate is 48M total infections but a range from 32M to 73M

Some pretty impressive/sad maps showing how widespread it has become in many of the midwest states while other states that put in measures to contain the thing - Hawaii, NH, VT, ME, CA, WA, OR have fared much better.

The per capita numbers in the Dakotas are so bad. Both now in top 10 per capita deaths, only behind the the northeast and LA/MS.The pure numbers are low so people tend to gloss over them sometimes.

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Even when the missing state reports are added tomorrow, today will be about the same as last Sunday. Nationally positivity rates have stabilized and have begun to fall. Trends are suggesting a peak is occurring in the numbers overall, and hospitalizations should peak early next week.. Peak is occurring a bit quicker than I expected, tbh. Obviously, stuff like Thanksgiving gatherings could at least temporarily stop any declines. Some states will still be rising in cases, and the next few weeks will have some ugly numbers. But I think there is a good chance overall numbers are on the decline as we go through December through a combination of partial herd immunity is some hard hit upper Midwest states and more aggressive restrictions in some others.

Future spike could also flare up during the winter depending on other events like Christmas, etc.

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58 minutes ago, dan11295 said:

Even when the missing state reports are added tomorrow, today will be about the same as last Sunday. Nationally positivity rates have stabilized and have begun to fall. Trends are suggesting a peak is occurring in the numbers overall, and hospitalizations should peak early next week.. Peak is occurring a bit quicker than I expected, tbh. Obviously, stuff like Thanksgiving gatherings could at least temporarily stop any declines. Some states will still be rising in cases, and the next few weeks will have some ugly numbers. But I think there is a good chance overall numbers are on the decline as we go through December through a combination of partial herd immunity is some hard hit upper Midwest states and more aggressive restrictions in some others.

Future spike could also flare up during the winter depending on other events like Christmas, etc.

Wouldn't it be a godsend if we peak sometime soon.  Have to wait and see.  Even if so, I think we may be on a horrendous plateau with this thing due to getting "held up" by the holiday gatherings and, unlike spring, there are several months of more favorable transmission conditions (cold, dry weather) left to get through.

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8 hours ago, Hoosier said:

Wouldn't it be a godsend if we peak sometime soon.  Have to wait and see.  Even if so, I think we may be on a horrendous plateau with this thing due to getting "held up" by the holiday gatherings and, unlike spring, there are several months of more favorable transmission conditions (cold, dry weather) left to get through.

Some of the data this week (I know The holiday will mess up the reporting some) might tell us if the abnormal warm spell was a factor in reducing transmission. Am looking at states like Iowa in particular, where their 7-day average dropped starting November 16 with no meaningful restrictions put in place to affect numbers. That is about 13 days after the warm up started, which is about the time lag for infection>symptoms>tested>results. If their numbers stabilize or rise this week along with some other states in the area, it would be strong evidence of that. If they continue to fall then other factors are at work.

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15 hours ago, mattb65 said:

This site which previously modeled out to the future has launched a new project trying to model backwards to answer the question you are looking into above.

https://covid19-projections.com/

Their best estimate is 48M total infections but a range from 32M to 73M

Some pretty impressive/sad maps showing how widespread it has become in many of the midwest states while other states that put in measures to contain the thing - Hawaii, NH, VT, ME, CA, WA, OR have fared much better.

Nice. This estimates look much more reasonable imo than his previous model estimates. His previous model had the summer wave like double the size of the spring wave which just didn't seem reasonable and wasn't consistent with the CDC antibody studies. I still might peg the summer wave a bit smaller than he does. I'm not sure equal size makes sense. 

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Don't know how many people here saw this, but about a week ago there was a study from UT Southwestern that showed that 85% of hospitalized Covid-19 patients under the age of 50 in the US are either overweight or obese...

 

https://medicalxpress.com/news/2020-11-overweight-obese-younger-people-greater.html

 

For awhile the CDC has been talking about how much worse Covid-19 is for overweight individuals, but this study shows that it's especially important for younger folks. The protective effect of being young is completely lost if you're overweight or obese. It's VERY important to get this message out there. Changing to a healthier diet and exercising a lot can mean the difference between being a mild case or ending up in the hospital and at risk of death.

 

We know the United States has a terrible obesity epidemic. A staggering three quarters of Americans are either overweight or obese. This is a big reason why the pandemic has been much worse in the United States than most other countries. The other big reason, of course, is our idiot President encouraging his followers to not take the virus seriously and not wear masks.

 

But back to the overweight/obesity issue. Imagine how many less hospitalizations and deaths we'd have if the majority of people kept their weight down down through exercise and better diet. We know this virus preys upon overweight people. I think so many health experts in this country have been doing a bad job getting the message out there that HEALTH (diet and exercise to achieve normal weight and reduce underlying health conditions like hypertension, heart disease and diabetes) is absolutely critical in fighting back against this pandemic. Of course mask wearing and social distancing is critical, but I feel that getting into good shape to reduce the chance of having a severe problem if you catch the virus is just as important. Very important to get this message out there.

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29 minutes ago, South Shore Slop said:

If 75% of the population is overweight, then if all things were equal, 75% of hospitalizations would consist of overweight patients. So that 85% figure isn't that much of an outlier...

The exact number for the US population being overweight is 72%. If you look at this study, 85% of hospitalized people under 50 were overweight compared to 54% of people over age 70. The number is much lower for older people because many older people have underlying health conditions that put them at higher risk, despite what their weight is. So the point of the study is that the protective benefit of being younger is lost if you're overweight or obese. But of course people can reduce their chance of having a severe problem with Covid even as they get older through an exercise program, which reduces underlying health conditions like hypertension and heart disease. The statistics are overwhelming in showing that most people that die from the virus have underlying health conditions, so eating healthy and exercising is critical to reduce the risk.

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1 minute ago, winterwx21 said:

The exact number for the US population being overweight is 72%. If you look at this study, 85% of hospitalized people under 50 were overweight compared to 54% of people over age 70. The number is much lower for older people because many older people have underlying health conditions that put them at higher risk, despite what their weight is. So the point of the study is that the protective benefit of being younger is lost if you're overweight or obese. But of course people can reduce their chance of having a severe problem with Covid even as they get older through an exercise program, which reduces underlying health conditions like hypertension and heart disease. The statistics are overwhelming in showing that most people that die from the virus have underlying health conditions, so eating healthy and exercising is critical to reduce the risk.

:clap:

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