Corona virus, Port and the AFL. Part 2.

[MaxPowa]

That's not what's happening, but yes until after the pandemic we wont really know.
That does not negate the need for action during though.

Agreed. I'm not using this as an argument to do nothing (our reaction to the Pandemic will take a long time to understand whether it was appropriate or not as well), this is purely a thought exercise to try and understand what the true mortality impact of COVID is and how we might go about determining it more accurately as I do think how it is being reported now is crude and not truly representative.

 

[chiwigi]

You have to laugh really! The BALLS on them!

 

[pastmyprimus]

It does provide some insight into their thinking but quite rightly states the data is simply not there yet. Again I think it will take years until we work out the true mortality impact of CVOID 19.

This may sound harsh, but a COVID death for a sick/ elderly person that merely hastened their death by 6-12 months is completely different to the death of an otherwise healthy person that may have lived for years and we should be able to discern those differences from the post pandemic mortality numbers.

At the moment there appears to be an emphasis on reporting anyone that tested positive for COVID as a "COVID death" which would significantly overstate the number of Deaths due primarily to COVID and not where COVID is only a factor and particularly where it is only an incidental one.

Epidemiologists are using the excess deaths technique because of their belief that the official death numbers underestimate the true numbers and by a fair margin. That article and others like it give reasons why covid isn't recorded as the cause of death in many instances. Eg, people dying at home.

There is a genuine aim to provide more realistic estimates of covid deaths through this technqiue. It isn't perfect but people working in this field would have more faith in the excess deaths estimates than the official death numbers for covid.

 

[RussellEbertHandball]

Epidemiologists are using the excess deaths technique because of their belief that the official death numbers underestimate the true numbers and by a fair margin. That article and others like it give reasons why covid isn't recorded as the cause of death in many instances. Eg, people dying at home.

There is a genuine aim to provide more realistic estimates of covid deaths through this technqiue. It isn't perfect but people working in this field would have more faith in the excess deaths estimates than the official death numbers for covid.

Surely excess deaths in most of Oz and even Victoria will be pretty small compared to average deaths per year and what we have seen in some countries where they have lost control at various stages.

 

[pastmyprimus]

Surely excess deaths in most of Oz and even Victoria will be pretty small compared to average deaths per year and what we have seen in some countries where they have lost control at various stages.

Absolutely. We can have faith in the Aus numbers because there are so few deaths. Practically all patients who die would have had a pathology test confirming covid. Most of the aged care residents who died in Victoria died in a hospital, and they would have been tested.

Excess deaths are more accurate in countries that experience large waves/have over-run health systems. But that's in many parts of the world.

 

[Lawnchair Larry]

Did Covidsafe sink without trace?
I know the argument was that hands-on personnel were doing a good job, but it seems to me that with a mass outbreak, as in Victoria, it may have been useful.
I could see it being useful at footy matches, if it were conditional upon entry to have it on your phone. Unless, of course, it would require a supercomputer to generate the relevant associations.

 

[DaTBird187]

Did Covidsafe sink without trace?
I know the argument was that hands-on personnel were doing a good job, but it seems to me that with a mass outbreak, as in Victoria, it may have been useful.
I could see it being useful at footy matches, if it were conditional upon entry to have it on your phone. Unless, of course, it would require a supercomputer to generate the relevant associations.

I gave up using it about five months ago when this state became COVID free. Now five months later, I can stand up at a pub (but only outside and after midnight) and drink a beer.

Wooo SA Great.

 

[OneGreatClub]

Did Covidsafe sink without trace?
I know the argument was that hands-on personnel were doing a good job, but it seems to me that with a mass outbreak, as in Victoria, it may have been useful.
I could see it being useful at footy matches, if it were conditional upon entry to have it on your phone. Unless, of course, it would require a supercomputer to generate the relevant associations.

mine never seems to be operating unless I make a point of turning it on.

 

[MaxPowa]

Absolutely. We can faith in the Aus numbers because there are so few deaths. Practically all patients who die would have had a pathology test confirming covid. Most of the aged care residents who died in Victoria died in a hospital, and they would have been tested.

Excess deaths are more accurate in countries that experience large waves/have over-run health systems. But that's in many parts of the world.

Yes but over what timeframe do you look at excess deaths?

If (and this is just a theoretical example) the majority of COVID deaths are of individuals who were otherwise seriously ill and likely to die in the next 6-12 months from other conditions then if the pandemic lasts for say 18 months, while during the pandemic excess deaths would increase significantly your would expect a below average number of deaths in the first few years after the pandemic is over that would correct to an extent the excess deaths during the pandemic.

This is why I think it will take until a few years after the pandemic to see what the true number of deaths were where COVID is the primary factor.

 

[OneGreatClub]

Yes but over what timeframe do you look at excess deaths?

If (and this is just a theoretical example) the majority of COVID deaths are of individuals who were otherwise seriously ill and likely to die in the next 6-12 months from other conditions then if the pandemic lasts for say 18 months, while during the pandemic excess deaths would increase significantly your would expect a below average number of deaths in the first few years after the pandemic is over that would correct to an extent the excess deaths during the pandemic.

This is why I think it will take until a few years after the pandemic to see what the true number of deaths were where COVID is the primary factor.

That is a valid point but those extra months in a person’s life can be meaningful and important so it is all so hard to measure anyway.
My mother had cancer and the last year we had with her was very special for us, for her, for the grandchildren.
To have that time cut short would have been devastating.

 

[VineValerian]

Did Covidsafe sink without trace?
I know the argument was that hands-on personnel were doing a good job, but it seems to me that with a mass outbreak, as in Victoria, it may have been useful.
I could see it being useful at footy matches, if it were conditional upon entry to have it on your phone. Unless, of course, it would require a supercomputer to generate the relevant associations.

First tried it very early on.
Maybe the glitches hadn't been worked out of it yet cos it was bats**t useless on my two months old new mobile phone.
Turn it on and 20 minutes later check it and it's gone off.
After 3 months I gave up and uninstalled it.
Installed it again couple of months later.
Same issue.
F*****G hopeless.
Never using it ever again.

 

[MaxPowa]

That is a valid point but those extra months in a person’s life can be meaningful and important so it is all so hard to measure anyway.
My mother had cancer and the last year we had with her was very special for us, for her, for the grandchildren.
To have that time cut short would have been devastating.

I'm glad you got to have that valuable time with your mother. I know for all four of my grand parents their last 6-12 months were an utterly miserable existence where they were likely to not even be fully aware of their conditions (at least for 3 of the 4).

I'm not sure what the right answer is, but I think as a society it is worth asking ourselves whether trying to protect and extend every life no matter the cost is the right thing to do given the majority of COVID deaths appear to be in the over 70 age group and individuals in assisted care or hospital who are likely there due to other serious conditions. There has been a tremendous generational cost we have incurred in our efforts to eliminate COVID via lockdowns, and the question should be asked whether our obsession with extending life to it's maximum limit, irrespective of quality of life or burden on the rest of society, is morally right.

The average person will consume the majority of their health care costs in the last 6 months of life (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4891509/) and as chronic disease has been increasing over the last century first in the developed world and now in the developing world (https://www.aihw.gov.au/getmedia/8f7bd3d6-9e69-40c1-b7a8-40dca09a13bf/4_2-chronic-disease.pdf.aspx) it is reasonable to argue the quality of those extended lives is decreasing. So while we have focused on longer lifespans as a metric of medical success, we need to also look at the quality of life, particularly for those facing chronic illness and whose lives are arguably being artificially extended who are effectively forced to exist in a degenerated state (particularly where there is lack of self-awareness of their condition). I am sure all of us have elderly relatives in nursing homes or who have endured significant hospitalisation towards the end of their lives and questioned whether this is something they would want if they were able to make these decisions for themselves.

Why have we become so obsessed with the extension of life irrespective of any other factors? Is it a philosophical change that has occurred in society due to the significant reduction in unexpected/ sudden deaths over all (e.g. we are less experienced with death and therefore more afraid?)or is there an element of private interest? (In an increasingly privatised healthcare system the ideal patient for private hospitals, clinics and pharmaceutical companies is a chronically ill patient who is kept alive but never recovers...).

While the pandemic is still evolving and our picture of its impacts are incomplete, IF it does turn out that a significant amount of the people who have died from COVID had comorbidities and were likely to die within a relatively short time frame anyway, given the cost of our response, I wouldn't be surprised if there are serious questions asked about whether we did the right thing.

 

[Holden Hillbilly]

 

[RussellEbertHandball]

Yesterday morning I copied the worldometers site just after 12.01am GMT of their covid stats and have seperated Australia into Victoria and Rest of Oz and these compared 3 figures for Oz against different countries by continent.

I have sorted by deaths and looked at total deaths for countries around 1,000 like Oz and around 80-100 like Oz without Victoria.

When I took the snapshot of cases Oz was ranked # 80 by total cases and #61 by total deaths.
NZ with 1,871 cases was ranked # 159 by total cases, and 25 deaths is ranked #161 by total deaths

20,000 total cases gets you ranked around 89th, 10,000 cases 106th, 5,000 129th, 2,000 157th and 1,000 165th.
1,000 total deaths ranked 56th, 500 76th, 200 100th, 100 118th, and 50 144th

The # column is the ranking number for a country in its continent. The active cases for Oz is different to https://covidlive.com.au/ site because of the way NSW stops counting cases as active after 4 weeks and the feds count them as still active for a longer time. Even the Covid live site has NSW as 3,140 recovered cases but has 40 active cases out of 4,310 total cases.

it would be good to find out exactly what Taiwan have done to almost have no impact on their population. I cant find quarter by quarter real gdp data for Taiwan but year on year real gdp growth their quarterly results are;

Q1 2019 1.71%
Q2 2019 2.40%
Q3 2019 2.99%
Q4 2019 3.38%
Q1 2020 1.59%
Q2 2020 (0.58)%

 

[raptalia]

The incidence of local cases in NSW today was 11 while in Victoria it was 7.

The open borders with NSW will look pretty shaky if that continues.

 

[Interstater]

A sobering picture

 

[pastmyprimus]

Yes but over what timeframe do you look at excess deaths?

If (and this is just a theoretical example) the majority of COVID deaths are of individuals who were otherwise seriously ill and likely to die in the next 6-12 months from other conditions then if the pandemic lasts for say 18 months, while during the pandemic excess deaths would increase significantly your would expect a below average number of deaths in the first few years after the pandemic is over that would correct to an extent the excess deaths during the pandemic.

This is why I think it will take until a few years after the pandemic to see what the true number of deaths were where COVID is the primary factor.

One way to consider this is the life expectancy of people who die prematurely from covid. A 95 year old in Aus is expected to live another 3.5 years, an 85 year old another 7.5 years, a 65 year an extra 22.5 more years and a 45 year 40 more years (data from the Australian Institute of Health and Welfare). That spreads deaths over many years not just one or two.

Covid deaths are concentrated amongst the elderly in Aus but the at risk groups in addition to the elderly are:

- people with weakened immune systems
- people with one or more chronic medical conditions (eg, diabetes, high blood pressure, cancer and heart disease
- Aboriginal people

Significant numbers in younger age groups fall into the above categories. Our lockdown strategy here has avoided significant number of deaths in all 'at risk' groups. I live in Victoria and now feel the restrictions should be lifted more quickly. Community transmission cases are in the low single digits, and we have much better systems to deal with outbreaks.

But you can see what what happens when restrictions are lifted too quickly. Spain, France and even the UK are experiencing significant second waves. Their hospital systems are under stress and contract tracing systems are failing. A stressed hospital system is associated with high levels of avoidable mortality and morbidity due to fear and the inability to access to health care.

 

[Forzaport]

Here's another way to look at excess deaths.

Looking at Victoria, roughly 80% of covid-deaths were from individuals in aged care. The average length of stay in aged care until death is 32 months (AIHW, 2017-18). Assuming the aged care deaths were residents that on average were not all new residents, the life-expectancy lost is in the months, not years. Here's where it gets funky, flu related deaths in 2020 tanked due to covid restrictions. It's probably a safe bet that the population at greatest risk of flu-related death is aged care residents (flu becomes pneumonia "old man's friend"). What this means is that while one group of aged care residents had their lives shortened by covid, another group of aged care residents had their lives extended.

Now what about the remaining 20% of deaths in Victoria? As I understand it, these individuals had some form of co-morbidity which most likely took the form of a chronic disease. What does a chronic disease do to life expectancy? We do have some amazing pharmaceuticals that have extended lifespans. I don't have the link but the average expected lifespan post onset of a chronic disease is about 19 years with modern medicine from memory with the onset of chronic disease occurring in the early 60s age range (this data was from a study comparing centenarians to everyone else - centenarians on average don't suffer from chronic diseases until very late in life). Of the remaining 20% of Victorian deaths, how old were they at the time of their covid-related deaths? The point is while these individuals have had their lives shortened it's probably not as a severe loss in years because they shouldn't be compared to healthy individuals.

By far the biggest impact of years of life expectancy lost will be in the population of people that put off their breast, bowel, prostate exams, didn't go to their GP to get that sore spot checked, victims of domestic violence and crime and those that take their own lives (a statistic that has sadly spiked during the pandemic). It's not hard to guess which groups of people will be disproportionately affected by these flow-on impacts of covid in Australia.

The unfortunate reality is that there is no palatable decision available to navigate the pandemic. The path that leads to the most years of lifespan saved has probably shifted now to focus on those under 65. It doesn't mean that the elderly and those at high risk are ignored but it does mean that more sophisticated strategies should be used moving forward (consistent with recent statements from WHO officials).

My 2 cents.

 

[TheFVK]

..

The unfortunate reality is that there is no palatable decision available to navigate the pandemic. The path that leads to the most years of lifespan saved has probably shifted now to focus on those under 65. It doesn't mean that the elderly and those at high risk are ignored but it does mean that more sophisticated strategies should be used moving forward (consistent with recent statements from WHO officials).

My 2 cents.

Nice post and your one sentence there says it all.

It irks me to hear people wailing at politicians for making poor choices in handling the pandemic, when simply there are no decisions that don't have horrible consequences for at least some members of our society.

There is no single KPI that we can use to tell us how we are doing, and every individual KPI has its own nuances as you've just demonstrated. We will be picking up the pieces either way.

 

[AM]

Oh boy, the NYT softly dipping it's toes into the water... What if Sweden was right after all?

Vilified Early Over Lax Virus Strategy, Sweden Seems to Have Scourge Controlled (Published 2020)

After having weathered high death rates when it resisted a lockdown in the spring, Sweden now has one of Europe’s lowest rates of daily new cases. Whether that is an aberration remains to be seen.

www.nytimes.com

"Today, all of the European countries are more or less following the Swedish model, combined with the testing, tracing and quarantine procedures the Germans have introduced, but none will admit it. Instead, they made a caricature out of the Swedish strategy. Almost everyone has called it inhumane and a failure.”

Unsubscribe, unsubscribe!!

Hmm!

The Swedish COVID-19 Response Is a Disaster. It Shouldn’t Be A Model for the Rest of the World

Sweden's unique approach to the pandemic has drawn interest from other countries. But the data are clear: it's largely been a failure.

time.com

 

[OneGreatClub]

Here's another way to look at excess deaths.

Looking at Victoria, roughly 80% of covid-deaths were from individuals in aged care. The average length of stay in aged care until death is 32 months (AIHW, 2017-18). Assuming the aged care deaths were residents that on average were not all new residents, the life-expectancy lost is in the months, not years. Here's where it gets funky, flu related deaths in 2020 tanked due to covid restrictions. It's probably a safe bet that the population at greatest risk of flu-related death is aged care residents (flu becomes pneumonia "old man's friend"). What this means is that while one group of aged care residents had their lives shortened by covid, another group of aged care residents had their lives extended.

Now what about the remaining 20% of deaths in Victoria? As I understand it, these individuals had some form of co-morbidity which most likely took the form of a chronic disease. What does a chronic disease do to life expectancy? We do have some amazing pharmaceuticals that have extended lifespans. I don't have the link but the average expected lifespan post onset of a chronic disease is about 19 years with modern medicine from memory with the onset of chronic disease occurring in the early 60s age range (this data was from a study comparing centenarians to everyone else - centenarians on average don't suffer from chronic diseases until very late in life). Of the remaining 20% of Victorian deaths, how old were they at the time of their covid-related deaths? The point is while these individuals have had their lives shortened it's probably not as a severe loss in years because they shouldn't be compared to healthy individuals.

By far the biggest impact of years of life expectancy lost will be in the population of people that put off their breast, bowel, prostate exams, didn't go to their GP to get that sore spot checked, victims of domestic violence and crime and those that take their own lives (a statistic that has sadly spiked during the pandemic). It's not hard to guess which groups of people will be disproportionately affected by these flow-on impacts of covid in Australia.

The unfortunate reality is that there is no palatable decision available to navigate the pandemic. The path that leads to the most years of lifespan saved has probably shifted now to focus on those under 65. It doesn't mean that the elderly and those at high risk are ignored but it does mean that more sophisticated strategies should be used moving forward (consistent with recent statements from WHO officials).

My 2 cents.

But also to be considered is the long term morbidity of covid infection even in the young.
Death is only part of the equation.
In hindsight, many month or years into the future, we will start to understand whether we over estimated or under estimated covid19 ‘s effects on all aspects of life and society and what we could have done differently.
At the moment we are in the middle of the storm.

 

[raptalia]

The infection rate in the UK continues to rise. There were over 19,000 new infections in the UK yesterday. Unfortunately with Keir Starmer calling for a lock down it is probably the last thing Boris will do.

Clearly many MPs on both sides of UK politics are putting their seats in Parliament before slowing the spread of COVID.

Labour calls for 'circuit breaker' lockdown as UK's daily death toll rises

Starmer made the call in a televised press conference, as the Commons approved Prime Minister Boris Johnson's three-tier lockdown system unveiled on Monday.

www.smh.com.au

It is not just the UK where COVID is on the rise, across Europe there were over 134,000 new infections yesterday. In Russia where Putin's wonder vaccine is being used they had over 14,000 recorded cases. That is if you can trust the figures out of Russia.

Apart from New Zealand I doubt that we will be seeing international travel any day soon.

COVID Live Update: 240,767,464 Cases and 4,903,550 Deaths from the Coronavirus - Worldometer

Live statistics and coronavirus news tracking the number of confirmed cases, recovered patients, tests, and death toll due to the COVID-19 coronavirus from Wuhan, China. Coronavirus counter with new cases, deaths, and number of tests per 1 Million population. Historical data and info. Daily...

www.worldometers.info

 

[pastmyprimus]

Six new cases and no deaths are the latest figures for Vic. Two days in a row of new cases in single digits (5 yesterday), and that's with reasonably good testing volumes

 

[Interstater]

The age distribution of mortality from novel coronavirus disease (COVID-19) suggests no large difference of susceptibility by age - Scientific Reports

Among Italy, Spain, and Japan, the age distributions of COVID-19 mortality show only small variation even though the number of deaths per country shows large variation. To understand the determinant for this situation, we constructed a mathematical model describing the transmission dynamics and...

www.nature.com

In my opinion the Swedes did it half right.
They depended on social distancing and trusted their people, but they didn't do enough to isolate the elderly and vulnerable.

IMO the long term solution is:
a) lower the pension age to 60
b) be better at preventing transmission between the general community vs anyone over 60 or vulnerable
c) trust your people and social distance, but get on with business

Look at Adelaide for instance, yes we have had closed borders and still have overseas and Victorian quarantines but apart from that we are doing c).
As we lower Jobkeeper and JobSeeker, I think we also need to lower the pension age to 60 to compensate for rewarding companies for providing incentives for hiring those under 35.

Ask yourself, what benefit does it provide to have people 60-67 with no job and no income?
Of course continue to have the income and asset tests on the pension.

My earlier opinion was to just lock everything down until we know what is going on.

Now I want to see firm action in supporting the young to get work while providing those over 60 with financial support if needed.

Governments are now gambling that they can keep their people locked down until there is a vaccine.
Should we do this or should we assume there wont be one and evolve into a more productive society?

 

[raptalia]

The total of local cases in NSW today is 6 making 17 over two days. NSW is still short of Morrison's definition of a metro hotspot and it would take 13 more local cases in the metro area tomorrow for Sydney to be defined as a hot spot under the Federal Government criteria.

From the National Cabinet site-

• The Commonwealth trigger for consideration of a COVID-19 hotspot in a metropolitan area is the rolling 3 day average (average over 3 days) is 10 locally acquired cases per day. This equates to over 30 cases in 3 consecutive days.

It is worth noting that the above is the Federal Cabinet's definition and that individual States and Territories are not obliged to abide by this definition.