COVID-19 Data & Docs

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COVID-19 Data & Docs

Postby alloneword » Tue Mar 31, 2020 12:04 pm

A thread for documentation and data related to the CORVID-19 crisis (that's probably too boring for the main thread).
...

https://www.gov.uk/guidance/high-conseq ... eases-hcid

Published 22 October 2018
Last updated 21 March 2020 — see all updates

From:
Public Health England

Contents

Status of COVID-19
Definition of HCID
Classification of HCIDs
List of high consequence infectious diseases
HCIDs in the UK
HCID risks by country
Monthly summaries of global HCID events
Infection prevention and control in healthcare settings
Specialist advice for healthcare professionals
Hospital management of confirmed HCID cases
Travel health advice for HCIDs

Status of COVID-19

As of 19 March 2020, COVID-19 is no longer considered to be a high consequence infectious diseases (HCID) in the UK.

The 4 nations public health HCID group made an interim recommendation in January 2020 to classify COVID-19 as an HCID. This was based on consideration of the UK HCID criteria about the virus and the disease with information available during the early stages of the outbreak. Now that more is known about COVID-19, the public health bodies in the UK have reviewed the most up to date information about COVID-19 against the UK HCID criteria. They have determined that several features have now changed; in particular, more information is available about mortality rates (low overall), and there is now greater clinical awareness and a specific and sensitive laboratory test, the availability of which continues to increase.

The Advisory Committee on Dangerous Pathogens (ACDP) is also of the opinion that COVID-19 should no longer be classified as an HCID.

The need to have a national, coordinated response remains, but this is being met by the government’s COVID-19 response.

Cases of COVID-19 are no longer managed by HCID treatment centres only. All healthcare workers managing possible and confirmed cases should follow the updated national infection and prevention (IPC) guidance for COVID-19, which supersedes all previous IPC guidance for COVID-19. This guidance includes instructions about different personal protective equipment (PPE) ensembles that are appropriate for different clinical scenarios.
Definition of HCID

In the UK, a high consequence infectious disease (HCID) is defined according to the following criteria:

acute infectious disease
typically has a high case-fatality rate
may not have effective prophylaxis or treatment
often difficult to recognise and detect rapidly
ability to spread in the community and within healthcare settings
requires an enhanced individual, population and system response to ensure it is managed effectively, efficiently and safely

Classification of HCIDs

HCIDs are further divided into contact and airborne groups:

contact HCIDs are usually spread by direct contact with an infected patient or infected fluids, tissues and other materials, or by indirect contact with contaminated materials and fomites

airborne HCIDs are spread by respiratory droplets or aerosol transmission, in addition to contact routes of transmission

List of high consequence infectious diseases

A list of HCIDs has been agreed by a joint Public Health England (PHE) and NHS England HCID Programme:
Contact HCID Airborne HCID
Argentine haemorrhagic fever (Junin virus) Andes virus infection (hantavirus)
Bolivian haemorrhagic fever (Machupo virus) Avian influenza A H7N9 and H5N1
Crimean Congo haemorrhagic fever (CCHF) Avian influenza A H5N6 and H7N7
Ebola virus disease (EVD) Middle East respiratory syndrome (MERS)
Lassa fever Monkeypox
Lujo virus disease Nipah virus infection
Marburg virus disease (MVD) Pneumonic plague (Yersinia pestis)
Severe fever with thrombocytopaenia syndrome (SFTS) Severe acute respiratory syndrome (SARS)*

*No cases reported since 2004, but SARS remains a notifiable disease under the International Health Regulations (2005), hence its inclusion here

**Human to human transmission has not been described to date for avian influenza A(H5N6). Human to human transmission has been described for avian influenza A(H5N1), although this was not apparent until more than 30 human cases had been reported. Both A(H5N6) and A(H5N1) often cause severe illness and fatalities. Therefore, A(H5N6) has been included in the airborne HCID list despite not meeting all of the HCID criteria.

The list of HCIDs will be kept under review and updated by PHE if new HCIDs emerge that are of relevance to the UK.
HCIDs in the UK

HCIDs, including viral haemorrhagic fevers (VHFs), are rare in the UK. When cases do occur, they tend to be sporadic and are typically associated with recent travel to an area where the infection is known to be endemic or where an outbreak is occurring. None of the HCIDs listed above are endemic in the UK, and the known animal reservoirs are not found in the UK.

As of February 2020, 2019, the UK has experience of managing confirmed cases of Lassa fever, EVD, CCHF, MERS and monkeypox. The vast majority of these patients acquired their infections overseas, but rare incidents of secondary transmission of MERS and monkeypox have occurred in the UK.
HCID risks by country

For health professionals wishing to determine the HCID risk in any particular country, an A to Z list of countries and their respective HCID risk is available.

See HCID country risks
Monthly summaries of global HCID events

PHE’s epidemic intelligence activities monitor global HCID events. These are published in a monthly summary.
Infection prevention and control in healthcare settings

Specific infection prevention and control (IPC) measures are required for suspected and confirmed HCID cases, in all healthcare settings (specialist and non-specialist).

IPC guidance appropriate for suspected and confirmed cases of Lassa fever, EVD, CCHF, MVD, Lujo virus disease, Argentinian haemorrhagic fever, Bolivian haemorrhagic fever and SFTS, is available in the ACDP guidance.

IPC guidance for MERS, avian influenza, Nipah virus infection, monkeypox and pneumonic plague, can be found in the relevant PHE guidance listed below.
Links to relevant PHE guidance for healthcare professionals

avian influenza

MERS

monkeypox

Nipah virus infection

plague

VHF, including Ebola

Specialist advice for healthcare professionals

The Imported Fever Service (IFS) provides 24-hour, 7-days a week telephone access to expert clinical and microbiological advice. Hospital doctors across the UK can contact the IFS after discussion with the local microbiology, virology or infectious disease consultant.
Hospital management of confirmed HCID cases

Once an HCID has been confirmed by appropriate laboratory testing, cases in England should be transferred rapidly to a designated HCID Treatment Centre. Occasionally, highly probable cases may be moved to an HCID Treatment Centre before laboratory results are available.
Contact HCIDs

There are 2 principal Contact HCID Treatment Centres in England:

the Royal Free London High Level Isolation Unit (HLIU)

the Newcastle Royal Victoria Infirmary HLIU.

Further support for managing confirmed contact HCID cases is provided by the Royal Liverpool Hospital and the Royal Hallamshire Hospital, Sheffield.
Airborne HCIDs

There are 4 interim Airborne HCID Treatment Centres in England. Adult and paediatric services are provided by 6 NHS Trusts:

Guy’s and St Thomas’ NHS Foundation Trust (adult and paediatric services)
Royal Free London NHS Foundation Trust, with a paediatric service provided by Imperial College Healthcare NHS Foundation Trust
Royal Liverpool and Broadgreen University Hospitals NHS Trust, with a paediatric service provided by Alder Hey Children’s NHS Foundation Trust
Newcastle upon Tyne Hospitals NHS Foundation Trust (adult and paediatric services)

Case transfer arrangements

Hospital clinicians seeking to transfer confirmed HCID cases, or discuss the transfer of highly probable HCID cases, should contact the NHS England EPRR Duty Officer. It is expected that each case will have been discussed with the Imported Fever Service before discussing transfer.
Travel health advice for HCIDs

The National Travel Health Network and Centre (NaTHNaC) provides travel health information about a number of HCIDs, for healthcare professionals and travellers. Advice can be accessed via the Travel Health Pro website.
Published 22 October 2018
Last updated 21 March 2020 + show all updates


alloneword » Tue Mar 31, 2020 9:11 am wrote: (perhaps illnesses classified as HCIDs require treatment in specialist 'HCID' designated hospitals?), we probably won't know for a while.


Here is the protocol for managing suspected/confirmed Covid-19 positive patients in England, dated 27th Feb - therefore it applied when Covid-19 was still considered a HCID:

https://www.england.nhs.uk/wp-content/u ... y-v2.3.pdf

(From https://www.england.nhs.uk/publication/ ... t-pathway/ )

The cover letter states that it 'is a live document which, will provide a single point of reference for the NHS and will be updated as the situation develops' - although it doesn't appear to have been. Throughout the protocol Covid-19 cases are referred to and discussed as being HCID cases.
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Re: COVID-19 Data & Docs

Postby alloneword » Tue Mar 31, 2020 2:21 pm

UK ONS mortality stats: https://www.ons.gov.uk/peoplepopulation ... ndandwales
and report: https://www.gov.uk/government/statistic ... 19-to-2020
UK C-19 stats (cumulative): https://www.gov.uk/guidance/coronavirus ... r-of-cases
UK annual 'flu reports: https://www.gov.uk/government/statistic ... lu-reports
Historical 'flu study (Scotland): https://www.pnas.org/content/116/52/271 ... gures-data

EuroMOMO (European Monitoring of Excess Mortality for Public Health Action) website: https://www.euromomo.eu/index.html

Icelandic stats: https://www.covid.is/data

US 'flu stats: https://www.cdc.gov/flu/weekly/weeklyar ... Data11.csv
US Covid-19 stats: https://covidtracking.com/api/

Testing:
Capek (German): https://coronadaten.wordpress.com/ (G.Translate)

alloneword » Sat Mar 28, 2020 9:24 pm wrote:
Image

UK similar at ~14%, apparently Germany 6 - 7% (machine translation)...

...does it look like there are an insanely high number of non-Covid19 ILI cases occurring?




Papers:

International Journal of Antimicrobial Agents - SARS-CoV-2: fear versus data (19 March 2020): https://swprs.org/open-letter-from-prof ... la-merkel/
Fundamental principles of epidemic spread highlight the immediate need for large-scale serological surveys to assess the stage of the SARS-CoV-2 epidemic (AKA 'The Oxford Study'): https://www.medrxiv.org/content/10.1101 ... 20042291v1
Coronavirus disease 2019: the harms of exaggerated information and non‐evidence‐based measures: https://onlinelibrary.wiley.com/doi/abs ... /eci.13222

Imperial College Reports: https://www.imperial.ac.uk/mrc-global-i ... /covid-19/

Report 9 (That 16th March report): https://www.imperial.ac.uk/media/imperi ... 3-2020.pdf

Perhaps our most significant conclusion is that mitigation is unlikely to be feasible without emergency surge capacity limits of the UK and US healthcare systems being exceeded many times over. In the most effective mitigation strategy examined, which leads to a single, relatively short epidemic (case isolation, household quarantine and social distancing of the elderly), the surge limits for both general ward and ICU beds would be exceeded by at least 8-fold under the more optimistic scenario for critical care requirements that we examined. In addition, even if all patients were able to be treated, we predict there would still be in the order of 250,000 deaths in GB, and 1.1-1.2 million in the US.
(pg. 16 para 3 - my emph.)


Origins:

https://harvardtothebighouse.com/2020/0 ... 2019-ncov/


Other resources:

https://swprs.org/a-swiss-doctor-on-covid-19/
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Re: COVID-19 Data & Docs

Postby alloneword » Tue Mar 31, 2020 3:19 pm

Legal:

Coronavirus Act 2020
2020 CHAPTER 7

An Act to make provision in connection with coronavirus; and for connected purposes.

[25th March 2020]

Be it enacted by the Queen’s most Excellent Majesty, by and with the advice and consent of the Lords Spiritual and Temporal, and Commons, in this present Parliament assembled, and by the authority of the same, as follows:—


http://www.legislation.gov.uk/ukpga/2020/7/enacted

(I was going to include the full text within 'spoiler' tags, but at 139149 words, it's about 8x bigger than the forum software allows - so see attached txt file, which I had to zip!)

Coronavirus Act 2020.txt.zip
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Re: COVID-19 Data & Docs

Postby alloneword » Tue Mar 31, 2020 6:16 pm

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Re: COVID-19 Data & Docs

Postby alloneword » Wed Apr 01, 2020 6:32 am

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Re: COVID-19 Data & Docs

Postby alloneword » Wed Apr 01, 2020 7:59 am

South Korea datasets: https://www.kaggle.com/kimjihoo/coronavirusdataset (need to create 'kaggle' account to download) - 'time.csv' contains testing data.
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Re: COVID-19 Data & Docs

Postby alloneword » Wed Apr 01, 2020 8:58 am

UK ONS 'all cause' mortality datasets now include a separate row for 'Deaths where COVID-19 was mentioned on the death certificate (ICD-10 U07.1 and U07.2)'

https://www.ons.gov.uk/file?uri=%2fpeop ... 22020.xlsx

This will actually make comparison easier. Thanks, ONS.
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Re: COVID-19 Data & Docs

Postby alloneword » Wed Apr 01, 2020 10:38 am

alloneword » Wed Apr 01, 2020 11:59 am wrote:South Korea datasets: https://www.kaggle.com/kimjihoo/coronavirusdataset (need to create 'kaggle' account to download) - 'time.csv' contains testing data.


This was unexpected:

South Korea Testing.png


(Doesn't show the first 4 tests).

Will do other countries (that testing data is available for) later.
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Re: COVID-19 Data & Docs

Postby alloneword » Wed Apr 01, 2020 11:06 am

Long, boring, but essential viewing:

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Re: COVID-19 Data & Docs

Postby alloneword » Wed Apr 01, 2020 12:13 pm

Couple of subtle changes in UK stats publishing: No longer (since yesterday) giving a figure for 'negative test results' and deaths are now qualified with 'of those hospitalised'.
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Re: COVID-19 Data & Docs

Postby alloneword » Wed Apr 01, 2020 12:35 pm

UK data (or rather, a visualisation): https://covid19-uk.co.uk/

Shame he's not sharing the raw data, tho.
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Re: COVID-19 Data & Docs

Postby alloneword » Wed Apr 01, 2020 4:14 pm

Dumped in full, as paywalled:

How to understand – and report – figures for ‘Covid deaths’
29 March 2020, 3:07pm

Every day, now, we are seeing figures for ‘Covid deaths’. These numbers are often expressed on graphs showing an exponential rise. But care must be taken when reading (and reporting) these figures. Given the extraordinary response to the emergence of this virus, it’s vital to have a clear-eyed view of its progress and what the figures mean. The world of disease reporting has its own dynamics, ones that are worth understanding. How accurate, or comparable, are these figures comparing Covid-19 deaths in various countries?

We often see a ratio expressed: deaths, as a proportion of cases. The figure is taken as a sign of how lethal Covid-19 is, but the ratios vary wildly. In the US, 1.8 per cent (2,191 deaths in 124,686 confirmed cases), Italy 10.8 per cent, Spain 8.2 per cent, Germany 0.8 per cent, France 6.1 per cent, UK 6.0 per cent. A fifteen-fold difference in death rate for the same disease seems odd amongst such similar countries: all developed, all with good healthcare systems. All tackling the same disease.

You might think it would be easy to calculate death rates. Death is a stark and easy-to-measure end point. In my working life (I’m a retired pathology professor) I usually come across studies that express it comparably and as a ratio: the number of deaths in a given period of time in an area, divided by that area’s population. For example, 10 deaths per 1,000 population per year. So just three numbers:

The population who have contracted the disease
The number dying of disease
The relevant time period

The trouble is that in the Covid-19 crisis each one of these numbers is unclear.


1. Why the figures for Covid-19 infections are a vast underestimate


Say there was a disease that always caused a large purple spot to appear in the middle of your forehead after two days – it would be easy to measure. Any doctor could diagnose this, and national figures would be reliable. Now, consider a disease that causes a variable raised temperature and cough over a period of 5 to 14 days, as well as variable respiratory symptoms ranging from hardly anything to severe respiratory compromise. There will be a range of symptoms and signs in patients affected by this disease; widely overlapping with similar effects caused by many other infectious diseases. Is it Covid-19, seasonal flu, a cold – or something else? It will be impossible to tell by clinical examination.

The only way to identify people who definitely have the disease will be by using a lab test that is both specific for the disease (detects this disease only, and not similar diseases) and sensitive for the disease (picks up a large proportion of people with this disease, whether severe or mild). Developing accurate, reliable, validated tests is difficult and takes time. At the moment, we have to take it on trust that the tests in use are measuring what we think they are.

So far in this pandemic, test kits have mainly been reserved for hospitalised patients with significant symptoms. Few tests have been carried out in patients with mild symptoms. This means that the number of positive tests will be far lower than the number of people who have had the disease. Sir Patrick Vallance, the government’s chief scientific adviser, has been trying to stress this. He suggested that the real figure for the number of cases could be 10 to 20 times higher than the official figure. If he’s right, the headline death rate due to this virus (all derived from lab tests) will be 10 to 20 times lower than it appears to be from the published figures. The more the number of untested cases goes up, the lower the true death rate.


2. Why Covid-19 deaths are a substantial over-estimate

Next, what about the deaths? Many UK health spokespersons have been careful to repeatedly say that the numbers quoted in the UK indicate death with the virus, not death due to the virus – this matters. When giving evidence in parliament a few days ago, Prof. Neil Ferguson of Imperial College London said that he now expects fewer than 20,000 Covid-19 deaths in the UK but, importantly, two-thirds of these people would have died anyway. In other words, he suggests that the crude figure for ‘Covid deaths’ is three times higher than the number who have actually been killed by Covid-19. (Even the two-thirds figure is an estimate – it would not surprise me if the real proportion is higher.)

This nuance is crucial ­– not just in understanding the disease, but for understanding the burden it might place on the health service in coming days. Unfortunately nuance tends to be lost in the numbers quoted from the database being used to track Covid-19: the Johns Hopkins Coronavirus Resource Center. It has compiled a huge database, with Covid-19 data from all over the world, updated daily – and its figures are used, world over, to track the virus. This data is not standardised and so probably not comparable, yet this important caveat is seldom expressed by the (many) graphs we see. It risks exaggerating the quality of data that we have.

The distinction between dying ‘with’ Covid-19 and dying ‘due to’ Covid-19 is not just splitting hairs. Consider some examples: an 87-year-old woman with dementia in a nursing home; a 79-year-old man with metastatic bladder cancer; a 29-year-old man with leukaemia treated with chemotherapy; a 46-year-old woman with motor neurone disease for 2 years. All develop chest infections and die. All test positive for Covid-19. Yet all were vulnerable to death by chest infection from any infective cause (including the flu). Covid-19 might have been the final straw, but it has not caused their deaths. Consider two more cases: a 75-year-old man with mild heart failure and bronchitis; a 35-year-old woman who was previously fit and well with no known medical conditions. Both contract a chest infection and die, and both test positive for Covid-19. In the first case it is not entirely clear what weight to place on the pre-existing conditions versus the viral infection – to make this judgement would require an expert clinician to examine the case notes. The final case would reasonably be attributed to death caused by Covid-19, assuming it was true that there were no underlying conditions.

It should be noted that there is no international standard method for attributing or recording causes of death. Also, normally, most respiratory deaths never have a specific infective cause recorded, whereas at the moment one can expect all positive Covid-19 results associated with a death to be recorded. Again, this is not splitting hairs. Imagine a population where more and more of us have already had Covid-19, and where every ill and dying patient is tested for the virus. The deaths apparently due to Covid-19, the Covid trajectory, will approach the overall death rate. It would appear that all deaths were caused by Covid-19 – would this be true? No. The severity of the epidemic would be indicated by how many extra deaths (above normal) there were overall.


3. Covid-19 and a time period

Finally, what about the time period? In a fast-moving scenario such as the Covid-19 crisis, the daily figures present just a snapshot. If people take quite a long time to die of a disease, it will take a while to judge the real death rate and initial figures will be an underestimate. But if people die quite quickly of the disease, the figures will be nearer the true rate. It is probable that there is a slight lag – those dying today might have been seriously ill for some days. But as time goes by this will become less important as a steady state is reached.

Let me finish with a couple of examples. Colleagues in Germany feel sure that their numbers are nearer the truth than most, because they had plenty of testing capacity ready when the pandemic struck. Currently the death rate is 0.8 per cent in Germany. If we assume that about one third of the recorded deaths are due to Covid-19 and that they have managed to test a third of all cases in the country who actually have the disease (a generous assumption), then the death rate for Covid-19 would be 0.08 per cent. That might go up slightly, as a result of death lag. If we assume at present that this effect might be 25 per cent (which seems generous), that would give an overall, and probably upper limit, of death rate of 0.1 per cent, which is similar to seasonal flu.

Let’s look at the UK numbers. As of 9 a.m. on Saturday there were 1,019 deaths and 17,089 confirmed cases – a death rate of 6.0 per cent. If one third of the deaths are caused by Covid-19 and the number of cases is underestimated by a factor of say 15, the death rate would be 0.13 per cent and the number of deaths due to Covid-19 would be 340. This number should be placed in perspective with the number of deaths we would normally expect in the first 28 days of March – roughly 46,000.

The number of recorded deaths will increase in the coming days, but so will the population affected by the disease – in all probability much faster than the increase in deaths. Because we are looking so closely at the presence of Covid-19 in those who die – as I look at in more detail in my article in the current issue of The Spectator – the fraction of those who die with Covid-19 (but not of it) in a population where the incidence is increasing, is likely to increase even more. So the measured increase in numbers of deaths is not necessarily a cause for alarm, unless it demonstrates excess deaths – 340 deaths out of 46,000 shows we are not near this at present. We have prepared for the worst, but it has not yet happened. The widespread testing of NHS staff recently announced may help provide a clearer indication of how far the disease has already spread within the population.

The UK and other governments have no control over how their data is reported, but they can minimise the potential for misinterpretation by making absolutely clear what its figures are, and what they are not. After this episode is over, there is a clear need for an internationally coordinated update of how deaths are attributed and recorded, to enable us to better understand what is happening more clearly, when we need to.

John Lee is a recently retired professor of pathology and a former NHS consultant pathologist.
Written byDr John Lee


https://www.spectator.co.uk/article/how ... 19-deaths-
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Re: COVID-19 Data & Docs

Postby alloneword » Wed Apr 01, 2020 4:16 pm

And his previous article:

How deadly is the coronavirus? It’s still far from clear
There is room for different interpretations of the data
From magazine issue: 28 March 2020

In announcing the most far-reaching restrictions on personal freedom in the history of our nation, Boris Johnson resolutely followed the scientific advice that he had been given. The advisers to the government seem calm and collected, with a solid consensus among them. In the face of a new viral threat, with numbers of cases surging daily, I’m not sure that any prime minister would have acted very differently.

But I’d like to raise some perspectives that have hardly been aired in the past weeks, and which point to an interpretation of the figures rather different from that which the government is acting on. I’m a recently-retired Professor of Pathology and NHS consultant pathologist, and have spent most of my adult life in healthcare and science – fields which, all too often, are characterised by doubt rather than certainty. There is room for different interpretations of the current data. If some of these other interpretations are correct, or at least nearer to the truth, then conclusions about the actions required will change correspondingly.

The simplest way to judge whether we have an exceptionally lethal disease is to look at the death rates. Are more people dying than we would expect to die anyway in a given week or month? Statistically, we would expect about 51,000 to die in Britain this month. At the time of writing, 422 deaths are linked to Covid-19 — so 0.8 per cent of that expected total. On a global basis, we’d expect 14 million to die over the first three months of the year. The world’s 18,944 coronavirus deaths represent 0.14 per cent of that total. These figures might shoot up but they are, right now, lower than other infectious diseases that we live with (such as flu). Not figures that would, in and of themselves, cause drastic global reactions.

Initial reported figures from China and Italy suggested a death rate of 5 per cent to 15 per cent, similar to Spanish flu. Given that cases were increasing exponentially, this raised the prospect of death rates that no healthcare system in the world would be able to cope with. The need to avoid this scenario is the justification for measures being implemented: the Spanish flu is believed to have infected about one in four of the world’s population between 1918 and 1920, or roughly 500 million people with 50 million deaths. We developed pandemic emergency plans, ready to snap into action in case this happened again.

At the time of writing, the UK’s 422 deaths and 8,077 known cases give an apparent death rate of 5 per cent. This is often cited as a cause for concern, contrasted with the mortality rate of seasonal flu, which is estimated at about 0.1 per cent. But we ought to look very carefully at the data. Are these figures really comparable?

Most of the UK testing has been in hospitals, where there is a high concentration of patients susceptible to the effects of any infection. As anyone who has worked with sick people will know, any testing regime that is based only in hospitals will over-estimate the virulence of an infection. Also, we’re only dealing with those Covid-19 cases that have made people sick enough or worried enough to get tested. There will be many more unaware that they have the virus, with either no symptoms, or mild ones.

That’s why, when Britain had 590 diagnosed cases, Sir Patrick Vallance, the government’s chief scientific adviser, suggested that the real figure was probably between 5,000 and 10,000 cases, ten to 20 times higher. If he’s right, the headline death rate due to this virus is likely to be ten to 20 times lower, say 0.25 per cent to 0.5 per cent. That puts the Covid-19 mortality rate in the range associated with infections like flu.

But there’s another, potentially even more serious problem: the way that deaths are recorded. If someone dies of a respiratory infection in the UK, the specific cause of the infection is not usually recorded, unless the illness is a rare ‘notifiable disease’. So the vast majority of respiratory deaths in the UK are recorded as bronchopneumonia, pneumonia, old age or a similar designation. We don’t really test for flu, or other seasonal infections. If the patient has, say, cancer, motor neurone disease or another serious disease, this will be recorded as the cause of death, even if the final illness was a respiratory infection. This means UK certifications normally under-record deaths due to respiratory infections.

Now look at what has happened since the emergence of Covid-19. The list of notifiable diseases has been updated. This list — as well as containing smallpox (which has been extinct for many years) and conditions such as anthrax, brucellosis, plague and rabies (which most UK doctors will never see in their entire careers) — has now been amended to include Covid-19. But not flu. That means every positive test for Covid-19 must be notified, in a way that it just would not be for flu or most other infections.

In the current climate, anyone with a positive test for Covid-19 will certainly be known to clinical staff looking after them: if any of these patients dies, staff will have to record the Covid-19 designation on the death certificate — contrary to usual practice for most infections of this kind. There is a big difference between Covid-19 causing death, and Covid-19 being found in someone who died of other causes. Making Covid-19 notifiable might give the appearance of it causing increasing numbers of deaths, whether this is true or not. It might appear far more of a killer than flu, simply because of the way deaths are recorded.

If we take drastic measures to reduce the incidence of Covid-19, it follows that the deaths will also go down. We risk being convinced that we have averted something that was never really going to be as severe as we feared. This unusual way of reporting Covid-19 deaths explains the clear finding that most of its victims have underlying conditions — and would normally be susceptible to other seasonal viruses, which are virtually never recorded as a specific cause of death.

Let us also consider the Covid-19 graphs, showing an exponential rise in cases — and deaths. They can look alarming. But if we tracked flu or other seasonal viruses in the same way, we would also see an exponential increase. We would also see some countries behind others, and striking fatality rates. The United States Centers for Disease Control, for example, publishes weekly estimates of flu cases. The latest figures show that since September, flu has infected 38 million Americans, hospitalised 390,000 and killed 23,000. This does not cause public alarm because flu is familiar.

The data on Covid-19 differs wildly from country to country. Look at the figures for Italy and Germany. At the time of writing, Italy has 69,176 recorded cases and 6,820 deaths, a rate of 9.9 per cent. Germany has 32,986 cases and 157 deaths, a rate of 0.5 per cent. Do we think that the strain of virus is so different in these nearby countries as to virtually represent different diseases? Or that the populations are so different in their susceptibility to the virus that the death rate can vary more than twentyfold? If not, we ought to suspect systematic error, that the Covid-19 data we are seeing from different countries is not directly comparable.

Look at other rates: Spain 7.1 per cent, US 1.3 per cent, Switzerland 1.3 per cent, France 4.3 per cent, South Korea 1.3 per cent, Iran 7.8 per cent. We may very well be comparing apples with oranges. Recording cases where there was a positive test for the virus is a very different thing to recording the virus as the main cause of death.

Early evidence from Iceland, a country with a very strong organisation for wide testing within the population, suggests that as many as 50 per cent of infections are almost completely asymptomatic. Most of the rest are relatively minor. In fact, Iceland’s figures, 648 cases and two attributed deaths, give a death rate of 0.3 per cent. As population testing becomes more widespread elsewhere in the world, we will find a greater and greater proportion of cases where infections have already occurred and caused only mild effects. In fact, as time goes on, this will become generally truer too, because most infections tend to decrease in virulence as an epidemic progresses.

One pretty clear indicator is death. If a new infection is causing many extra people to die (as opposed to an infection present in people who would have died anyway) then it will cause an increase in the overall death rate. But we have yet to see any statistical evidence for excess deaths, in any part of the world.

Covid-19 can clearly cause serious respiratory tract compromise in some patients, especially those with chest issues, and in smokers. The elderly are probably more at risk, as they are for infections of any kind. The average age of those dying in Italy is 78.5 years, with almost nine in ten fatalities among the over-70s. The life expectancy in Italy — that is, the number of years you can expect to live to from birth, all things being equal — is 82.5 years. But all things are not equal when a new seasonal virus goes around.

It certainly seems reasonable, now, that a degree of social distancing should be maintained for a while, especially for the elderly and the immune-suppressed. But when drastic measures are introduced, they should be based on clear evidence. In the case of Covid-19, the evidence is not clear. The UK’s lockdown has been informed by modelling of what might happen. More needs to be known about these models. Do they correct for age, pre-existing conditions, changing virulence, the effects of death certification and other factors? Tweak any of these assumptions and the outcome (and predicted death toll) can change radically.

Much of the response to Covid-19 seems explained by the fact that we are watching this virus in a way that no virus has been watched before. The scenes from the Italian hospitals have been shocking, and make for grim television. But television is not science.

Clearly, the various lockdowns will slow the spread of Covid-19 so there will be fewer cases. When we relax the measures, there will be more cases again. But this need not be a reason to keep the lockdown: the spread of cases is only something to fear if we are dealing with an unusually lethal virus. That’s why the way we record data will be hugely important. Unless we tighten criteria for recording death due only to the virus (as opposed to it being present in those who died from other conditions), the official figures may show a lot more deaths apparently caused by the virus than is actually the case. What then? How do we measure the health consequences of taking people’s lives, jobs, leisure and purpose away from them to protect them from an anticipated threat? Which causes least harm?

The moral debate is not lives vs money. It is lives vs lives. It will take months, perhaps years, if ever, before we can assess the wider implications of what we are doing. The damage to children’s education, the excess suicides, the increase in mental health problems, the taking away of resources from other health problems that we were dealing with effectively. Those who need medical help now but won’t seek it, or might not be offered it. And what about the effects on food production and global commerce, that will have unquantifiable consequences for people of all ages, perhaps especially in developing economies?

Governments everywhere say they are responding to the science. The policies in the UK are not the government’s fault. They are trying to act responsibly based on the scientific advice given. But governments must remember that rushed science is almost always bad science. We have decided on policies of extraordinary magnitude without concrete evidence of excess harm already occurring, and without proper scrutiny of the science used to justify them.

In the next few days and weeks, we must continue to look critically and dispassionately at the Covid-19 evidence as it comes in. Above all else, we must keep an open mind — and look for what is, not for what we fear might be.

John Lee is a recently retired professor of pathology and a former NHS consultant pathologist.


https://www.spectator.co.uk/article/The ... s-we-think
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Re: COVID-19 Data & Docs

Postby Grizzly » Wed Apr 01, 2020 7:52 pm

ADBLOCK WARNING
Palantir, The $20 Billion, Peter Thiel-Backed Big Data Giant, Is Providing Coronavirus Monitoring To The CDC
https://www.forbes.com/sites/thomasbrewster/2020/03/31/palantir-the-20-billion-peter-thiel-backed-big-data-giant-is-providing-a-coronavirus-monitoring-tool-to-the-cdc/#1cea851f1595

If Palantir didn't know by December that there was a worldwide pandemic on the horizon, I'm the goddamn tooth fairy.


Wuhan Coronavirus, Jeffrey Epstein, and Harvard University?
http://stateofthenation.co/?p=6743

Wuhan Coronavirus, Jeffrey Epstein and Harvard University
Posted on February 8, 2020 by State of the Nation
WUHAN AND HARVARD… AND JEFFREY

by Joseph P. Farrell

I’m constantly amazed at the information that people email to me, but this one is a whopper doozie spotted by V.S. I’ve already blogged about the arrest of Dr. Charles Lieber of Harvard, and about this strange tie to the Wuhan University of Technology. But there’s more lurking in the background of that Harvard connection than meets the eye, and I just have to share this one:

Wuhan Coronavirus, Jeffrey Epstein, and Harvard University

tldr: Epstein gave exorbitant amounts of money, at least $9 million (pledged $30 million) to researchers funded by DoD, DARPA, IARPA, and NIH at Harvard University with the expertise and technology to genetically engineer and improve bacteria and viruses. One of Harvard’s most prominent scientists who received $18 million from DoD and NIH was arrested and charged for operating a secret lab in Wuhan China just hours ago – This researcher was given over $1.5 million dollars to do so, in secret, by Chinese institutions. Meanwhile, the area where the new coronavirus emerged (Wuhan) recently opened a biosafety level 4 lab (the only one in China, a country with 1.4 billion people) where researchers were actually studying and experimenting with the genetics of coronaviruses over the past few years before the emergence of this new strain. Whether these things are linked or not remains to be see, but each of these independent statements are in fact true.

In a way this post contains two distinct conspiracy theories, that I suspect may be linked together, hence my post.

A few years ago, I attended a private government research conference where Dr. George Church, Professor of Genetics at Harvard Medical School and Professor of Health Sciences and Technology at Harvard and MIT, was describing how his lab systematically altered the genome of a bacterial cell using synthetic biology and genetic engineering to make cells resistant to viruses. There was some brief discussion of how these techniques could be used for the opposite purpose (to engineer viruses to improve them or make them less recognizable by the host, thus delaying the immune response). Immediately following Dr. Church’s presentation, other researchers and myself had a discussion about how frightening these technological capabilities were. Over the years, this concern has always remained in the back of my mind and I’ve discussed it with others that didn’t attend the talk on various occasions. It is worth noting that a lot of George Church’s recent research also involves the study and engineering of viruses. Most recently in his career, Dr. Church has been funded by DARPA and IARPA, with the most recently funded grant titled, ‘Functional Genomic and Computational Assessment of Threats’ (by IARPA).

http://arep.med.harvard.edu/gmc/gc_grants.html

The description of this grant solicitation, if you search for it, starts with:

“The biological sciences have experienced extraordinary growth over the past decade. Technological advances in DNA synthesis, sequencing, large gene construction, and data analysis are expanding biological research and the bioeconomy, and are likely to enable revolutionary advances in medicine, agriculture, and materials. At the same time, these advances have intensified security concerns around the accidental or deliberate misuse of biotechnologies. One special concern regards DNA synthesis technologies that can be used to create novel organisms.”

Hence, Dr. Church is obviously involved in the area of applying advanced techniques (lab based and computational) to engineer organisms to make them resistant to viruses (and potentially vice-versa, to engineer viruses), and is involved in the efforts to combat the risks involved.

Interestingly enough, Dr. Church was one of the scientists most involved with Jeffrey Epstein. He received funding from Epstein for the purposes of ‘cutting edge science & education’ from 2005 to 2007 (the funding was apparently unrestricted). Epstein was convicted of soliciting an underage prostitute in 2008. Following his conviction, Dr. Church and Epstein continued to meet. According to an NBC report, “he had six phone calls and meetings with Epstein in 2014, as shown in Church’s online calendar (he has posted one every year since 1999). Sample entry: “Jun 21, 2014 Lunch w/ Jeffrey Epstein, 12-1:30, Martin Nowak’s Institute.” (Nowak, a Harvard biologist/mathematician, is also a Brockman client and Edge participant.) He also met with Epstein “several times” each year since, Church said.”

These meetings were often between Church, Epstein, and Church’s colleague Dr. Martin Nowak, Harvard Professor of Biology and Mathematics and Director of the Program for Evolutionary Dynamics. At the get-togethers with Nowak, Church said, “Epstein seemed interested in the science of life’s origins and mathematically modeling the evolution of viruses”. Epstein had also previously given a whopping $6.5 million dollars in research money to Dr. Nowak’s lab at Harvard in 2003. Apparently, Epstein had actually pledged a total of $30 million dollars (which is an incredible amount of money for a university professor to receive for research; large government funded grants usually top out at $2-3 million over several years) to Dr. Nowak’s program. I was not able to find additional information on what these talks in 2014 and beyond ultimately led to, or if more money was pledged to or received by these prominent scientific figures. Another thing to add is that Nowak also has a record of studying and writing about viruses, such as his first book publication in 2000 titled, Virus Dynamics: Mathematical Principles of Immunology and Virology.

Jumping to a slightly different topic of discussion. There are other two other posts that stood out to me in this sub.

https://www.reddit.com/r/conspiracy/com ... oronovirus
_bioweapon_conspiracy_indepth/

This post describes a few things. First, Wuhan, China, the 7th most populated city in a country with 1.4 billion has a biosafety level 4 (BSL-4) laboratory that was recently established in 2015. It is apparently one out of 70 or so in the entire world (number was given by OP of the post linked above; my own search only turned up 52), and it is the only BLS-4 lab in the ENTIRE country of China. For those unfamiliar with what BLS-4 refers to, they are labs involving the study of the greatest biological threats and have the highest level of biosafety precautions. It is the sort of lab where researchers would attempt to study and perhaps modify something like a coronavirus. As the other redditor pointed out (and is also outlined in other r/conspiracy posts), there are lead scientists, such as Xing-Ye Ge, that study coronaviruses based out of Wuhan. These studies are often carried out by a team of 5-20 researchers, usually across institutions.

https://www.semanticscholar.org/author/ ... =influence

If you look up the Wuhan scientists research profile, you’ll be able to find that this individual and his fellow researchers also publish studies on adenoviruses in bats (similar to Dr. Church’s own virus-focused work on adeno-associated viruses, which are similar to adenoviruses and have similar applications; there is considerable overlap here). Further searching indicates that adenoviruses and adeno-associated viruses hold potential to serve as a vaccine for coronaviruses, and there are several studies on this. Dr. Church’s own work is related to this, as he studies adeno-associated viruses mostly in the context of delivering it as a sort of gene therapy for diseases. To be fair, however, these topics are outside my own area of expertise.

Now on to another recent reddit post:

https://www.reddit.com/r/conspiracy/com ... st_charles
_lieber_taken_into/

In the last 24 hours, a colleague of Dr. Church and Dr. Nowak, Dr. Charles Lieber, Professor and Chair of the Department of Chemistry and Chemical Biology at Harvard University, was arrested and criminally charged over a contract he made with a foreign university. Where? In Wuhan, China. As a side note, it’s worth pointing out to those unaware that all three of these people are some of the highest-ranking academic officials at Harvard and are revolutionary scientists in their respective fields. They would not at all be considered just minor or just moderately important figures at Harvard.

According to the Justice Department: “Lieber, 60, lied about his contact with the Chinese program known as the Thousand Talents Plan, which the U.S. has previously flagged as a serious intelligence concern. He also is accused of lying about about a lucrative contract he signed with China’s Wuhan University of Technology.”

Apparently, amongst other things, Lieber established a secret research lab at the Wuhan university and was given $1.5 million dollars by the Chinese (in addition to salary and living expenses) to do so. Meanwhile “Lieber was also the principal investigator on at least six U.S. Defense Department research grants, with a cumulative value of more than $8 million, according to the affidavit. It also says he was the principal investigator on more than $10 million in grants funded by the National Institutes of Health.” So, Dept. of Defense… NIH…

For those that are unfamiliar with academia, you may be wondering “how often does a leading, well-funded academic scientist from the most prestigious university in the country set up a secret lab with a foreign government?” This probably never happens, and it is extraordinarily – and I mean extraordinarily – odd and suspicious. Researchers are sometimes solicited by foreign governments and will leak or share info, but set up another lab somewhere else under the radar? Maybe a minor scientist would, but a major one? I’ve never heard of such a thing. Some other redditor mentioned that Lieber’s research seems to be mostly focused on nanotechnology rather than bioweapons research, and this is true. However, he has been involved in previous research to use nanotechnology to detect small viral particles in humans. Most oddly though, if you try to search Charles Lieber’s Google Scholar page (basically a page where you can find all scientific articles and books authored by a researcher), his page just went dark. It shows up in the Google search results, but says ‘No information available for this page’. I kid you not, his Google Scholar page went down as I was writing this post. When you try to click on it, it strangely links you to the Google Scholar page of some completely different person.

In my mind, these are a series of very strange coincidences that seem to be interconnected. As the redditor of the first link I posted put it, what are the odds that the new coronavirus that is now making world news just so happened to come out of the same place that the Chinese just set up their first BLS-4 lab a few years ago that also just so happens to be a place where researchers are studying coronaviruses? What are the odds that, again, just in the last several hours, one of the most prominent scientists at Harvard was arrested for setting up a secret lab in Wuhan, China? Also, why was Jeffrey Epstein giving heaps and heaps of money to researchers at Harvard studying synthetic biology and genetic engineering, who had the means to systematically alter cells or viruses – people receiving money from secret defense agencies such as DARPA and IARPA – and stated himself he was interested in modeling the evolution of viruses.

We need to look into these things further. Even if the Epstein-Church-Nowak part of the conspiracy doesn’t link to the Lieber-Wuhan Coronavirus portion, these two segments stand well on their own and I feel that despite having more of a background in nanotech instead of bioweapons, Liebers arrest for secret lab in Wuhan while the coronavirus problem continues to explode is just too much of a coincidence. Why would someone getting $10 million plus from U.S. funding agencies go through the hassle of setting up a secret lab in another country and risk his entire life’s work for less money. What was he doing there exactly? I eagerly wait for more details to come out.

edit: One more thing, it keeps getting better. Another Redditor made this post: https://www.reddit.com/r/conspiracy/com ... titute_of_
virology_an_ad_posted_2_months/ It’s unclear who all is involved (such as Lieber or others), but this seems to be shaping up to be one of the better conspiracies I’ve seen on this board in a while.

There you have it. So it’s important to review what this article is saying: Dr. Lieber worked at the same university as Drs Church and Nowak, both known associates of Jeffrey Epstein and recipients of his largesse. Given the nature of their work, it strains credibility to assume that Lieber was unaware of their work or they of his. They are, after all, all faculty members working in more or less the same broad discipline. As they article makes clear, all were working in aspects of modifying biology and doing genetic engineering, all areas of obvious biowarfare implications. All of this raises some intriguing high octane speculations and questions:

1) Why would professors, who are recipients of government funds for research, also take private funding in the millions from Epstein? Did they need it? And was Epstein in fact laundering money for other interests in sponsoring this research? And does that mean that their are private interests trying to obtain a biowarfare capability? Their taking of Epstein money on an individual basis was quite probably entirely innocent. But it’s the overall pattern of a Harvard connection that I find highly odd.

2) Do these questions in their turn indicate that all of China is being turned into a biowarfare, economic warfare, and social engineering experiment?

In respect to these questions, the article itself asks a highly pertinent question regarding Dr. Lieber toward the end of the piece:

Why would someone (Lieber) getting $10 million plus from the U.S. funding agencies go through the hassle of setting up a secret lab in another country and risk his entire life’s work for less money. What was he doing there exactly?

Indeed, and for whom was he really doing it? China? Harvard? Some private international interest?

Like the author of the article, I eagerly await for more details to come out. In the connection to the idea of some private international interest however, I’m reminded of a detail that occurred prior to 9/11, when Russian economist Dr. Tatiana Koryagina mentioned in Pravda, prior to the events of 9/11, that the US would shortly be attacked on its own soil by a private group with assets in the trillions of dollars. Recently, Harvard took its funding entirely black, and I have to wonder, in the light of this article, if it is one of the crucial “fronts” or “nodes” for some sort of private network. Would it be involved in such activities as a massive social engineering experiment?

Well, as I detailed with co-author Gary Lawrence in our book Rotten to the (Common) Core, another Harvard chemist – indeed, a former president of the institution – comes to mind: Dr. James Conant Bryant, and with him, the answer to that question is a resounding yes.

See you on the flip side…

___
https://gizadeathstar.com/2020/02/wuhan ... d-jeffrey/
“The more we do to you, the less you seem to believe we are doing it.”

― Joseph mengele
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Re: COVID-19 Data & Docs

Postby alloneword » Thu Apr 02, 2020 6:07 am

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