Slitherine

quote:

ORIGINAL: Kull

quote:

ORIGINAL: ITAKLinus

I use data diffused everyday at 1800 by Protezione Civile, the state's entity managing the emergency. I do not know where worldometers takes its data, but I strongly believe that the ones given by Protezione Civile are the correct ones.

I think also Kull had the same problem of worldometer giving other data for yesterday.


Given the situation, I suppose Protezione Civile's data are for sure more accurate than the ones given by anyone else.

Worldometers has the same source you do. The problem is the way Protezione Civil has been defining "new cases", which is different from the WHO standard followed by every other country in the world:

quote:

5210 new cases and 683 new deaths in Italy. 4th day in a row with daily new cases below the 6557 peak reached on March 21. Protezione Civile chief Borrelli, the person usually holding the daily press conference, is at home with a fever, while the former chief Bertolaso is now hospitalized in Milan after having tested positive to the virus

During the press conference, Protezione Civile officials were asked to clarify what the "change in active cases" ("incremento delle persone attualmente positive") really represents, after our website had raised the issue of Italian media reporting the change in active cases (a lower number) rather than the change in total cases (a higher number), incorrectly representing it as "newly infected" when, in fact, it represents the "change in active cases"

Newly infected, meaning the number of people who have tested positive to the virus in the last day, corresponds to the number Worldometer has always reported, which is the change in total cases in accordance with the international standards set by the WHO and followed by all countries. An important figure which can be compared to newly recovered, as we do in our charts.

The change in active cases (what most Italian media incorrectly label as "newly infected") is the result of the following formula: (newly infected) - (new deaths) - (new recoveries).

Sharing the goal of providing the correct interpretation of data, we are pleased to notice that a few days ago, one of the leading Italian newspapers, Corriere della Sera, began reporting the figures correctly

To repeat, "New Cases" is most definitely NOT determined by this formula: New Cases = (newly infected) - (new deaths) - (new recoveries)

quote:

ORIGINAL: Canoerebel

It's encouraging to see the "flattening of the curve" for new cases in Italy. Today's number, which isn't shown on this chart, is essentially the same as yesterday's. A good trend now.**

**assuming the reporting is accurate

quote:

ORIGINAL: ITAKLinus

quote:

ORIGINAL: Canoerebel

It's encouraging to see the "flattening of the curve" for new cases in Italy. Today's number, which isn't shown on this chart, is essentially the same as yesterday's. A good trend now.**

**assuming the reporting is accurate

The reporting is not accurate at all. It's not that they are screwing up, it's that basically they cannot test millions and millions of people.

Those who are managing the emergency in Italy are convinced the total amount of cases can, and probably is, 10 (ten!) times more.


On the other side, we can assume that by far the vast majority of the tested people are symptomatic cases (from midly to severe symptoms) and, therefore, they are a sort of proxy for the total amount of infected. A lowering in midly/severe cases, probably means a lowering of new cases in general. Still, nobody it Italy thinks that number is even remotely accurate.


Regarding the flattening of the curve. There is a major risk. So far, there have been relatively few cases in southern Italy, but we don't know whether the epidemy will start over there as well. In that case, we would have a disaster, since southern Italy is barely capable of managing the standard medical needs of the population.
We will see during the week. If nothing happens this week as well, probably we can start being optimistic regarding the south.

quote:

ORIGINAL: JohnDillworth
...Survived a terrorist bombing (1st World Trade Center), blackouts and Sandy. This is the worst by far.

quote:

ORIGINAL: Yaab

Sleeping with the Enemy

Doc: "Uhm, your curves are so nice..."
Covid: "Thank you, doc. So flattening of you".

quote:

ORIGINAL: obvert

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ORIGINAL: Cap Mandrake

The first human-derived isolate is from Dec 3, 2019

This does NOT mean the first human infection was from that date. It took some time for the infection to amplify and come to the attention of doctors in Wuhan. It takes 1 or 2 or 3 doctors talking to each other over lunch. "Man that guy could not take a joke! His O2 sat is 95% and then 8 hrs later he is dead!"

I know it sounds cynical but that's how it is....then the second guys says...."****, that sounds like SARS!" because he is a bit older and remembers SARS...and then they all leave their food on the table.

They traced case zero to Nov 17. The first case who presented in a hospital which they diagnosed retroactively. I remember distinctly as that is the day my wife returned from a trip to China. However a geneological study on the virus went back to mid-late-October for its origin.

This was some of what fed the hype of it being a military developed virus, as there was a military games in Wuhan in mid-October. Since also disproven.

quote:

ORIGINAL: obvert

quote:

ORIGINAL: ITAKLinus

quote:

ORIGINAL: Canoerebel

It's encouraging to see the "flattening of the curve" for new cases in Italy. Today's number, which isn't shown on this chart, is essentially the same as yesterday's. A good trend now.**

**assuming the reporting is accurate

The reporting is not accurate at all. It's not that they are screwing up, it's that basically they cannot test millions and millions of people.

Those who are managing the emergency in Italy are convinced the total amount of cases can, and probably is, 10 (ten!) times more.


On the other side, we can assume that by far the vast majority of the tested people are symptomatic cases (from midly to severe symptoms) and, therefore, they are a sort of proxy for the total amount of infected. A lowering in midly/severe cases, probably means a lowering of new cases in general. Still, nobody it Italy thinks that number is even remotely accurate.


Regarding the flattening of the curve. There is a major risk. So far, there have been relatively few cases in southern Italy, but we don't know whether the epidemy will start over there as well. In that case, we would have a disaster, since southern Italy is barely capable of managing the standard medical needs of the population.
We will see during the week. If nothing happens this week as well, probably we can start being optimistic regarding the south.

The studies I've seen from Wuhan and the Diamond Princess showed around 15-20% asymptomatic case estimates.

If we look at mortality today (7,503), rate it at 0.5% (low estimate based on high testing and low mortality rate of South Korea), and then calculate total cases, we might see that as an indication of where Italy was about 10-14 days ago for "real" cases. That gives me 1,500,600. I think that's about 2.46% of the Italian population, but if you take Northern Italy's three most affected provinces, it's about 7.89% of their population.

Knowing case numbers continued to grow over the past 14 days it's conceivable, using this kind of model, that 10-15% of the Northern Italian population has been infected.

quote:

ORIGINAL: ITAKLinus

quote:

ORIGINAL: obvert

quote:

ORIGINAL: ITAKLinus

quote:

ORIGINAL: Canoerebel

It's encouraging to see the "flattening of the curve" for new cases in Italy. Today's number, which isn't shown on this chart, is essentially the same as yesterday's. A good trend now.**

**assuming the reporting is accurate

The reporting is not accurate at all. It's not that they are screwing up, it's that basically they cannot test millions and millions of people.

Those who are managing the emergency in Italy are convinced the total amount of cases can, and probably is, 10 (ten!) times more.


On the other side, we can assume that by far the vast majority of the tested people are symptomatic cases (from midly to severe symptoms) and, therefore, they are a sort of proxy for the total amount of infected. A lowering in midly/severe cases, probably means a lowering of new cases in general. Still, nobody it Italy thinks that number is even remotely accurate.


Regarding the flattening of the curve. There is a major risk. So far, there have been relatively few cases in southern Italy, but we don't know whether the epidemy will start over there as well. In that case, we would have a disaster, since southern Italy is barely capable of managing the standard medical needs of the population.
We will see during the week. If nothing happens this week as well, probably we can start being optimistic regarding the south.

The studies I've seen from Wuhan and the Diamond Princess showed around 15-20% asymptomatic case estimates.

If we look at mortality today (7,503), rate it at 0.5% (low estimate based on high testing and low mortality rate of South Korea), and then calculate total cases, we might see that as an indication of where Italy was about 10-14 days ago for "real" cases. That gives me 1,500,600. I think that's about 2.46% of the Italian population, but if you take Northern Italy's three most affected provinces, it's about 7.89% of their population.

Knowing case numbers continued to grow over the past 14 days it's conceivable, using this kind of model, that 10-15% of the Northern Italian population has been infected.

Even if you take a very low estimate of 500.000 it still means that in northern Italy we have half a million infected people. On the other side, it also explains the relatively high mortality rate experienced by Italy (and probably same goes with Spain).

I do believe that we are in the range of 500k-1M for northern Italy only.

quote:

ORIGINAL: Cap Mandrake

We moved all 12 pediatricians in the group to one building and moved all the adult docs out to prevent the kids from giving it to the vulnerable seniors. We screen everyone by telehealth. If we can establish a probable dx over the phone or video-link we send their Rx electronically. If they have respiratory or GI sx we send them to the "sick building" where one poor bastard works 3 days in row and burns his/her clothes at night. Whoever has to see the newborns in the hospital does that for a whole week and takes night call and nothing else. We still have to bring in the 2 month to 2 year olds for vaccines or we will have another epidemic.

Telehealth is not quite ready technologically. You need good bandwith on both ends and the caller has to have a good phone or laptop. We use ZOOM, which is good software but patients have a hard time following the instructions and it takes a lot of staff time. Patient phone call volume is massive (at least 10x baseline). We haven't solved that yet. The web-based patient messaging secure health information system is working well but it technologically intimidating for most parents.

Small problems compared to Spain and Italy and New York

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ORIGINAL: MakeeLearn

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ORIGINAL: JohnDillworth
...Survived a terrorist bombing (1st World Trade Center), blackouts and Sandy. This is the worst by far.

In what ways?

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ORIGINAL: Cap Mandrake

The Covid 19 genotype maps to bat and pangolin hybridization of the species-specific Cornavirus viral genome.

Somebody in Wuhan thought it was a good idea to eat one of these.

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ORIGINAL: Chickenboy

I guess that's my point. Little is known about typical 'clearance' of the virus relative to production of detectable antibodies. Is it possible that someone that is seropositive has a titer that is insufficient to protect against future challenges? Yes. Is it possible that someone that thinks they're antibody negative has only started with the disease and therefore hasn't had time to produce a detectable serologic response (this takes several days)? Yes. Is it possible that someone that is antibody positive could be shedding virus? Yes.

*Maybe* paired samples-RT-PCR and simultaneous antibody screening could provide a more useful picture. Antibody positive and simultaneous virus negative is a greater margin of safety IMO.

We run into this from time to time with animal disease outbreaks. Serosurveillance is nice for planned, routine screens of a population for diseases that one should not find antibody (or to quality check vaccination strategies when a titer *is* expected). But there is an inherent delay between the introduction of a pathogen (e.g., avian influenza) and production of detectable antibodies. Depending on the test and the disease, this could be 48-96 hours or more.

Performing antibody serosurveillance as a quasi-realtime diagnostic tool in a rapidly evolving disease outbreak is usually selecting the wrong tool for the task. Unless there was considerable (2+ days) delay in getting antigen testing results back, there are better choices.

Rapid antigen (read: virus) detection kits can be used as a proxy for virus isolation or PCR in a pinch. But antibody detection tests require too many assumptions about temporal exposure to be proactive in a timely fashion, IMO.

Lots of folks / companies trying to dump test kits or treatments or cures on a panicked public. I question the rationale of this antibody detection implementation without deeper thought about whether some better choices may exist.