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Honored Contributor
Posts: 13,510
Registered: ‎05-23-2010

@esmerelda wrote:

@Mindy D  Death rate in the US is 4.2%...am I reading that right?


@esmerelda According to John's Hopkins' chart, yes. At least for now. The question I have is about the death certificates and autopsies. If a patient dies of a blood clot caused by COVID, and the death certificate reads pulmonary embolism secondary to infection with SARS CoV2; will this death be included in the numbers? When it comes to the rate, you really need all total cases and all deaths attributed to COVID on death certificate to be more accurate. This would come at the end of a pandemic. If this is of interest to you, you will find this glossary of epidemiology terminology invaluable. Take a look. https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwj-j7CS3MbqAhUBlKwKHSFDDRwQ...

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@Mom2Dogs wrote:

@esmerelda   We will probably never know...1 small example...car accident in my county, death certifiate read Covid as the cause.  The family made a big stink about it and the death certificate is supposed to be changed.  I have not heard if that has happened yet.  

 

A friend in Florida says a friend of her has covid, and has tested positive several times since the initial diagnosis/positive test.  Every time she is tested, and it's positive (which has been 3 times now) it is reported as a positive case....but the three positives are coming from 1 person.  Something is fishy.


How would she know that it counted as another positive case?

Honored Contributor
Posts: 13,510
Registered: ‎05-23-2010

Re: death rate please

[ Edited ]

 

 

Case-fatality rate

The case-fatality rate is the proportion of persons with a particular condition (cases) who die from that condition. It is a measure of the severity of the condition. The formula is:
Number of cause-specifc deaths among the × 10 n incident cases
Total number of incident cases
The case-fatality rate is a proportion, so the numerator is restricted to deaths among people included in the
denominator. The time periods for the numerator and the denominator do not need to be the same; the denominator could be cases of HIV/AIDS diagnosed during the calendar year 1990, and the numerator, deaths among those diagnosed with HIV in 1990, could be from 1990 to the presentThe case-fatality rate is a proportion, not a true rate. As a result, some epidemiologists prefer the term case-fatality ratio.
The concept behind the case-fatality rate and the death-to-case ratio is similar, but the formulations are different. The death-to-case ratio is simply the number of cause-specific deaths that occurred during a specified time divided by the number of new cases of that disease that occurred during the same time. The deaths included in the numerator of the death-to-case ratio are not restricted to the new cases in the denominator; in fact, for many diseases, the deaths are among persons whose onset of disease was years earlier. In contrast, in the case-fatality rate, the deaths included in

 

😷inEXAMPLE: Calculating Case-Fatality Rates
In an epidemic of hepatitis A traced to green onions from a restaurant, 555 cases were identifed. Three of the case- patients died as a result of their infections. Calculate the case-fatality rate.
Case fatality rate = (3 ⁄ 555) × 100 = 0.5%

 

@esmerelda 

Honored Contributor
Posts: 13,510
Registered: ‎05-23-2010

Re: death rate please

[ Edited ]


Death-to-case ratio

Definition of death-to-case ratio
The death-to-case ratio is the number of deaths attributed to a particular disease during a specifed time period divided by the number of new cases of that disease identifed during the same time period. The death-to-case ratio is a ratio but not necessarily a proportion, because some of the deaths that are counted in the numerator might have occurred among persons who developed disease in an earlier period, and are therefore not counted in the denominator

 


Method for calculating death-to-case ratio
Number of deaths attributed to a particular disease during specifed period
Number of new cases of the disease identifed during the specifed period
× 10 n
EXAMPLE: Calculating Death-to-Case Ratios
Between 1940 and 1949, a total of 143,497 incident cases of diphtheria were reported. During the same decade, 11,228 deaths were attributed to diphtheria. Calculate the death-to-case ratio.
Death-to-case ratio = 11,228 ⁄ 143,497 × 1 = 0.0783
or
= 11,228 ⁄ 143,497 × 100 = 7.83 per 100

 

@esmerelda 

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Posts: 24,105
Registered: ‎03-09-2010

@Bhvbum wrote:

@esmerelda wrote:


What is the death rate from this virus?  And why isn't it being reported in a manner so that I don't have to ask?  Why can't I find it at CDC or NIH?

I can find the number of cases...the focus now since the number of deaths (which is also easy to find) continues to decrease. But the RATE of death from the virus in this country is elusive. 

I'd like to know...what is it and where can I see it?


There is a big reason everyone wants the number of cases, for each state or for the country, it is the leading indicator of what is to come, for PPE, testing, hospitilizations and deaths.  Lots of people take that critical number and trend, to forecast.  

 

Here is a interesting number for you:

 

The US has only 4% of the world's population but to date has 24% of the Covid19 deaths.  For the wealthiest, diverse, educated,  country, etc. that is a significant number.  


The lookback studies on Covid-19 will be very interesting. I suspect this numbers disparity will be revealed to have something to do with the number of Americans in nursing homes/rehab facilities and how those facilities function in America.

 

In parts of the world care homes, are literally just that, homes. They house a handful of elderly (sometimes just two or three) who have no one else to care for them. Here it's more of an industry. American nursing homes tend to house lots of residents all in close quarters. They also tend to function as rehab facilities for patients just released from the hospitals. If you've been in a hospital in recent years, you've likely been told it's advised for you to go to a rehab facility upon discharge.

 

When you look at the number of beds in nursing homes in the most affected states (locally NY and NJ) you find they tend to have more beds per facility than less affected states. (At least as of the 2016 numbers from the CDC which are the latest I could find.) NY facilities average 185 beds per facility, NJ averages 144 beds per facility. And those beds turn over at a pretty good clip as rehabbers come and go, and residents die and get replaced. When a virus gets loose in such a facility, especially an air-borne virus, it's not good.

 

I suspect we'll see our reliance on modern style nursing homes and rehab facilities come under scrutiny once this is all said and done. A return to smaller, more isolated facilities might be seen as a better alternative than the more warehouse-style model we're using now. Perhaps increasing reimbursement rates for smaller, more focused facilities makes more sense given the ravages we've seen in nursing homes from the flu and Covid-19.

 

Lookback studies on Covid-19 will likely be brutal for most involved. The wildly contradictory statements from health experts, the politically motivated lunacy of banning suspected/possible treatments, the insertion of Covid-19 patients into nursing homes, and much, much more will face intense scrutiny in the lookback studies. A whole lot of people are going to get roasted when the experts look back at what happened.  

Fly!!! Eagles!!! Fly!!!
Esteemed Contributor
Posts: 6,527
Registered: ‎03-10-2010

@gardenman  If lookback studies are as brutal as you think they will be, I suspect we will hear little about them and will have to seek them out to see them. 

*********************
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@SusieQ_2 wrote:

@suzyQ3 wrote:

@pitdakota wrote:

@suzyQ3 wrote:

@Puppy Lips wrote:
There is a difference between dying FROM the virus and dying WITH the virus. My nurse friend said that people who likely were doing to die anyway, due to other issues, who tested positive, are counted as dying from the virus. So I think the numbers are skewed.

@Puppy Lips, likely to die? If they were positive for the virus and died from complications, shouldn't that be counted as a Covid death, as opposed to their testing positive but falling off a ladder and dying?

 

Maybe @pitdakota can weigh in for us. :-)


++++++++++++++++++++++++++++++++++++++++++++++++++

 

@suzyQ3, ridiculous to say the least.  Anyone that dies, dies "from" something.  It is lay people termniology that someone died of old age.  Well they may be old, but their lungs either gave out & they contracted pneumonia, they had a stroke, they had kidney failure....you get the picture.  That is the cause of death.  And it is counted in the death rate reported for that county, state, etc. 

 

Fact is, someone 100 years old that is living and ticking along just fine for being a 100 that contracts covid-19 and dies, dies from covid-19.  It is literally "elementary my dear Watson".  lol

 

 

 

 

 


@pitdakota, yes, thanks. I didn't think it made sense. I wouldn't be surprised if it's a talking point in some circles.


@suzyQ3 

 

It sounds to me like you and pitdakota aren't talking about the same types of illness that Puppy Lips was talking about. I don't think she was talking about things like falling off a ladder after having tested positive for covid. I also don't think she was talking about a person who passes away with what the lay person calls old age while coincidentally also being covid positive.

 

It sounded to me like she was talking about serious terminal illnesses from which the person has no chance of recovery such as advanced cancer, HIV, the last stages of Alzheimer's, heart failure...all things that are enough to claim a life on their own and were predicted to do so. Then, when the person is tested and the results for covid are positive that's what is listed as the cause of death.

 

Now, don't get me wrong, I'm not saying that's what happens. I have no idea. But I do think that's the point Puppy Lips was making. 


__________________________________________________________

 

@SusieQ_2, I totally understand what you are saying.  Problem is since we have not had a federal approach to managing this pandemic there are no federal requirements for reporting.  The CDC has only been allowed to release guidelines to serve as guidance but without federal management, the guidance isn't mandated to be followed by the states. So some states might report a covid-19 death with one set of criteria while another state uses another set of criteria.   

 

That can be frustrating for epidemiologists since they really want as accurate of a picture as possible to determine burden of disease.  

 

A few major metro areas in some areas have mandated that medical examiners review all records for those patients that die at home or die within several hours of arriving at a hospital when they have tested positive for coronavirus.  The medical examiner is in charge to conduct family interviews and review all medical records to get a picture of what the person was experiencing preceding the death.  If there are symptoms that align with clinical presentation of covid they determine the cause of death as covid.  I know that the Chicago area is one area that is doing this.

 

At any rate, from my personal standpoint I really don't think deaths in those with terminal cancer or end stage Alzheimer's are significantly impacting the number of deaths for covid-19.

 

Individuals with those situations are most probably a do not resuscitate status and are in some type of hospice setting.  Highly unlikely those that are end stage are being aggressively tested for covid.  Nor would they be candidates to send to the hospital due to the terminal condition along with the DNR status.  So I fall on the side that it is highly unlikely that those that might fall through the cracks and be tested for whatever reason then die at home are in a number great enough to cause a false impact on overall total numbers of deaths.

 

Even if that were true, it would probably be offset by the number of deaths that were under reported.  We now know that there were a number of deaths in the early phases of the pandemic of at home deaths related to heart attacks and stroke in New York, California, New Orleans, and Michigan that very well could have been caused by covid-19.  At the time, they didn't quite have the clinical picture that covid-19 could cause heart attacks and strokes.  So those deaths were classified as heart attack or stroke.

 

One thing that is evolving is since older individuals in long term care are at such high risk of dying and since restrictions have been put in place in most facilities across the country, we are now seeing fewer outbreaks in long term care facilities.  Especially compared to the early stages of the pandemic.

 

But now young people are out there taking risks and are ending up in the hospital critically ill.  Subsequently, we now have higher numbers of younger individuals dying in areas with high transmission rates.  Young people have always been a part of the hospital covid patient population, but people tended to discount the impact since the greatest risk for death is the older population.

 

A hospital representative in Texas has gone public with the case of a young individual that attended a covid party because they thought it was a hoax, contracted the disease and tragically died as a result.  This along with areas in Texas needing refrigerated trucks because local morgues cannot handle all the deceased individuals.  And now there are areas in both Texas and Florida needing to set up field hospitals as we are now around 6 months into this pandemic.  That speaks to the problem of high transmission rates with serious disease burden that is overwhelming local hospital ability to care for all the patients.

 

But in the end, the data is the data and officials and medical individuals can only look at the data we have and evaluate for trends to see how things are moving. But that is the point, they look at trends of what is happening in the data in a certain geographical area.  So in a  county  that is reporting  numbers going up, it signals a problem.  If the numbers go down, it signals a move in a better direction of containing the virus and subsequent hospitalizations, and ultimately number of deaths.  All the while with a big message that this virus should be taken seriously.  And that applies to those that are both young and old. 

 

 


* Freedom has a taste the protected will never know *
Respected Contributor
Posts: 3,970
Registered: ‎03-16-2010

Waving to @Drythe!  Good to see you my friend!  I remember talking previously about your son's work with ECMO. 

 

And I know that you understand that sometimes we just have to shake our heads and move on  to do what we know to do since it doesn't change what the virus is or what it does.

 

I have worked with this stuff for more than 16 years so I should know at least a wee bit about it.  As it is with you as well.  When you work with these types of situations, you understand it altogether too well. 


* Freedom has a taste the protected will never know *