Posted on 03/21/2020 12:24:30 PM PDT by Kaslin
The lack of data is not necessary. It is a matter of prioritizing data collection, being willing to share data, and then doing the right kind of analytical modelling.
Only a week ago, President Trump announced a ban on European flights to reduce the spread of coronavirus. In the seven days that followed, the media have been reporting garden-variety statistics and decision-making based on infographics rather than reliable and nationally representative data. It is time for accurate, unbiased data to redo the math.
So, what data has been reported in the past seven days and what do we know? Heres a short overview:
The first three bullets can be summarized by the words reported/confirmed. In the last seven days, weve seen a snowball of news messages pop up reporting things like 200 new cases, total 1,900 cases, and two more die of coronavirus.
We also see popups like State x could have 16 more infections than officially reported, Coronavirus death rate still uncertain as mild cases go unreported, Limited data on coronavirus may be skewing assumptions, and Country x may be underreporting coronavirus numbers.
Yet how does the number of cases compare to current influenza cases, for example? We dont know. Are numbers adjusted for population to make comparisons easier and meaningful? The media simply reports new cases without context and warns the public to stay home to stop the spread of the virus.
We do have data, to some extent, from China and Italy. Yet there are many questions about the accuracy of the data from China, particularly given the Chinese governments initial denial of the illness. Yet data from China has been provided and was swiftly reported in academic journals.
Papers that normally take months to be carefully vetted, accepted, and published are now being published with remarkable speed. Less than a year ago, BMC Public Health published an article concluding that because there are several methods used to calculate the key measures, comparisons between studies and countries is difficult. Yet statisticians are still doing the precise comparisons warned against because in the COVID-19 era, everything is permitted because the baseline understanding of the disease is so limited.
In Italy, it appears that the crisis (for now) is localized in the Northern Italy, mostly in the Lombardy region. Why? Why arent patients being transferred to other regions? Are other regions in Italy also in crisis?
There have been explanations as for why Lombardy has been hit harder than other regions, but these have not been the focus of reporting. In Italy, the media reports heartrending stories about providers forced to condemn patients to die because of a lack of intensive care beds, but little else beyond raw numbers of cases and deaths.
Its this image of people dying that drives decisions. Northern Italys hospital meltdown is shocking and upsetting, but should not necessarily be alarming for the rest of the world. Northern Italy has been hit hard, but the rest of Italy is largely waiting at home like the rest of us.
The curve that went viral last week is based on an idea, not data. The idea is simple and intuitive: Washing your hands or staying home if youre sick can slow down new cases of illness, so the finite resources of our health-care system can handle a more steady flow of sick patients rather than a sudden deluge. So we do it.
Then suddenly we find ourselves at home following news reports about stocks tumbled nearly 13 percent on Monday, the downturn now set to be deeper than the financial crisis, and This Is How the Coronavirus Will Destroy the Economy. Simultaneously, the media sends videos of overwhelmed hospitals in Italy into our family rooms, creating a multiplier effect for the Stay homeit could save lives movement, which leaves us thinking we are doing the right thing.
Simulation Modeling
The New York Times reports that in the United States and United Kingdom, national quarantine decisions were strongly influenced by a report from Imperial College that simulated the possible courses of the pandemic and the impact on each countrys health-care system. The simulation was done based using the best available datafrom Italy and Chinabut it was necessary to make many assumptions because there are so many unknowns.
We counted approximately 20 such assumptions that have yet to be proven.The key unknown factors were:
This modelling exercise assumes the rates from China and Italy a) reported accurately and b) applicable to the United States. But it is unknown how country specific factors like population density, use of public transportation, waste treatment, smoking rates, population age distribution, and others affect the applicability of the data to the United States.
Even if reported accurately, the rates from Italy and China will not precisely reflect what will happen in the United States. But are they close enough that our current decisions based on that data are correct?
That is an empirical question that can and should be quickly answered. Indeed, recent evidence from Germany suggests key model inputs may not be applicable in Germany, as Germany has lower death rate than other countries. Does the virus behave differently in Germany? No, more likely the denominator of the death rates is different since Germany has been testing more aggressively.
So, what data do we need in the next seven days? If the past seven and more days were the “do the math” era, the next seven and more days should be about “redo the math.” Is it possible? Yes, it is. Epidemiology, statistics, health economics are all based on data. With the right data we can make better decisions.
Better data would give us:
This does not require massive country-wide testing, as Germany did. In the United States we could either quickly draw new samples from across the nation or use one of the many large representative samples of the population covered in ongoing surveys like the Current Population Survey (CPS) or the Medical Expenditure Panel Survey.
It should be possible to use these standing panels and do COVID-19 testing with representative samples of the population. Researchers can stratify or oversample in metropolitan areas or specific region if needed.
The Centers for Disease Control and Prevention could do tests with representative samples and repeat it every three days in the coming weeks. The relatively small number of tests diverted to gather data wouldnt meaningfully detract from ongoing treatment. Given the trillion-dollar relief package proposed in Congress, it is reasonable to spend some tax dollars on testing and gather valuable data.
With better data, it will be easy to redo the math accurately. We could draw curves based on actual data, calculate incidence rates on actual data, and most of all it would be data drawn from a representative sample of the U.S. population.
Therefore, we could better analyze risk factors and individual characteristics based on people who live in our country and use our health-care system. If we are smart enough to use the same methodology in different countries and compare notes across the world, we may actually get to a place where better decision-making is possible, and quickly. European countries have equivalents of the Centers for Disease Control, and most of them have ongoing surveys with nationally representative samples.
The lack of data is not necessary. It is a matter of prioritizing data collection, being willing to share data, and then doing the right kind of analytical modelling. Finally, we need the media to report based on data rather than the narrative.
Without data youre just another person with an opinion. These are the words of W. Edwards Deming, who helped develop the sampling techniques still used by the U.S. Department of the Census and the Bureau of Labor Statistics.
His words emphasize the kind of damage that societal naiveté and opinions can do. It is time for statisticians, health economists, data scientists, epidemiologists, and other scientists to unite and say “It’s time for better data so we can redo the math.”
Yikes .. how'd ya like to have to sign that everytime you wrote a check, etc ?!
Those that took the SARS vaccine of 2004 should be in a state of very high risk. Those that didn’t are fine. The 2 Billion dollar vaccine company Chiron Corporation was forced out of business over this particular failed vaccine.
Article is right. When someone sees ants in their house, it is silly to make much of the number seen. One needs to investigate to find out how many there really are.
Ha, ha, I always think about the current fad for having hyphenated last names. What will those look like after several generations? Will people have 6 or more last names stuck together with hyphens?
Good luck with that .. cuz it's the Trump Virus, doncha know ?!
” Given the trillion-dollar relief package proposed in Congress, it is reasonable to spend some tax dollars on testing and gather valuable data.”
Well, duh.... but we are not doing it.
Here’s the thing. Flatten the curve does not mean decrease the number of cases.
It means prolong the epidemic and space it out.
It is meant to not overwhelm hospitals not lower number of cases that will occur over the course of the epidemic.
“It is meant to not overwhelm hospitals not lower number of cases that will occur over the course of the epidemic.”
Every time I say or post that, I get negative reactions. But that’s what this is. We aren’t going to “beat covid-19”. We are trying to keep from having people die in hospital parking lots because they can’t get it.
Just like the flu, or colds, it’s going around, and many of us will be infected, sooner or later.
SERIOUSLY, TOO LATE
“We arent going to beat covid-19
Perhaps not in the sense we will have a vaccine, but that will come by next year. However there is an excellent chance we can stop it in its tracks with Chloroquine and/or Hydroxychloroquine which can if it acts with the Chinese Virus as it has with other corona viruses will stop it from replicating and by doing so halt the spread.
Tests of these drugs is going on in NYC at this time and the results should be announced by the end of next week. It has already been used to treat infected individuals with very good results.
When we permit the Democrats and their media sheep to call the tune bad, panic driven, decisions will abound. We already know that they can’t do math and that given more information will whip up more of a false narrative.
Trump has out progressived them with his suggestion of real money handouts. Now he can make them dance to his tune or look like they hate starving Americans. He can draw this one out as long as he likes and make them the bad guys. Get the popcorn!
The CDC has just been stealing our money for decades. Worthless.
Lets see 19000 cases of an Rnaught 2-3 virus each person infecting 2 people at least without the mitigation efforts seen until starting a week ago we should see between 48 to 71000 thousand cases in about a week though how many will be tested we won’t know. If we see our Er’s superslammed abruptly with people in severe respiratory distress or high fever and dehydration where we didn’t see it last week, at a time when we know regular flu rates are diminishing, and these folks are COVID positive, then the data gathered from testing finds a new clarity and the initial noise fog can be cut thru.
Check this out:
Coronavirus: The Hammer and the Dance
https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56
Yes...it’s like shining a flashlight suspecting to find roaches in your kitchen floor and yup you see cockroaches and maybe a few ants....You then spread insecticide and when you check again the next night, you hope you’ll see fewer roaches over a few days but you can’t know for sure for a while as you see an increase of numbers until the rest of the eggs in hiding have hatched and then you hope you’ll start seeing measurable declines in roaches....if you never see a decline but a sharp increase that still increases the insecticide was worthless. That is where we are at with COVID testing and virus spread mitigation...we are seeing a bunch of covid....but will there be an abrupt rise with no end in sight in which case we’ll have to try even more unpalatable measures? Or will there be a bump then a period of equilibrium of positive cases to resolved cases and finally the numbers dive towards 0%? We shall have to see.
“When someone sees ants in their house, it is silly to make much of the number seen.”
Well, America saw ants in their house and proceed to burn it down.
maybe FR needs a rolling covid-19 news thread?
Yes because we know how well the government responds to facts and figures.
Our leader always make stupid decisions. The quality of data has no affect on them.
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