Why is the global ratio of deaths to cases going up?

[ejman]

I don't understand why the ratio of total deaths to total cases is going up over time in the numbers reported at this tracking website https://www.worldometers.info/coronavirus/#countries . It was in the range of 4% a month ago and it's over 6% now.



I would expect as more and more people are infected to have the opposite take place i.e. the rate going down over time if the true death rate is around 1% of all infected as some have mentioned. Perhaps the statisticians in this group could explain so that the math challenged (i.e. me) could understand? Thank you.

 

[stepford]

Just guessing here, but a month ago international deaths were primarily still from China while now you must include those from places where healthcare systems were overwhelmed like Italy and Spain (and NYC?). This skews the death rate higher.

When the inevitable second wave hits we will hopefully have adequate healthcare in place and something closer to a ubiquitous testing regime and the "true" death rate will become clearer.

 

[Sojourner]

I have noticed exactly the same thing recently, especially for South Korea, which is troubling. From what I've read and heard, the SK testing system is one of the best in the world, with quick, drive-through testing facilities widely available to all. And yet their CFR is currently hovering around 2.0%, while in early March it was an encouraging 0.8%. Maybe it's because people who are experiencing only mild symptoms are not as worried as they would have been a month ago and aren't going to the trouble of getting tested? IOW, maybe any and everyone in SK who had even a mild case of the sniffles was rushing out to get tested in the early days of the pandemic, whereas now people with very mild symptoms are more widely aware that they'll just be sick for a few weeks and then be OK?

 

[6miths]

The time from first symptoms to death is in the range of 14-21 days. All of the measures taken will eventually reduce the number of new cases. Meanwhile the number of deaths will continue to rise for another 2-3 weeks which will increase the CFR.

Consider that at the outset there could be a very high number of cases with mild symptomatology and no deaths (CFR=0). Over time the number of deaths heads up and the CFR starts to increase. If one then intervenes to decrease the number of cases (hopefully) the CFR will increase even more.

Also bear in mind that in some instances the CFR could be artificially high (e.g. due to testing of only very symptomatic people who are more likely to die) and sometimes artificially low (e.g. as the system gets overwhelmed and people die [especially at home or old age facilities] and don't get tested at all and thus are not included as a 'case'). All the numbers have to be taken with a fairly large piece of rock salt. But there is no doubt that this is bad.

 

[ejman]

The time from first symptoms to death is in the range of 14-21 days. All of the measures taken will eventually reduce the number of new cases. Meanwhile the number of deaths will continue to rise for another 2-3 weeks which will increase the CFR.

Consider that at the outset there could be a very high number of cases with mild symptomatology and no deaths (CFR=0). Over time the number of deaths heads up and the CFR starts to increase. If one then intervenes to decrease the number of cases (hopefully) the CFR will increase even more.

Also bear in mind that in some instances the CFR could be artificially high (e.g. due to testing of only very symptomatic people who are more likely to die) and sometimes artificially low (e.g. as the system gets overwhelmed and people die [especially at home or old age facilities] and don't get tested at all and thus are not included as a 'case'). All the numbers have to be taken with a fairly large piece of rock salt. But there is no doubt that this is bad.

Very puzzling. It will be interesting to see over time as the number of new cases goes down globally due to the lock down provisions in so many countries if the ratio deaths to total cases actually starts going down. As you said, this all has to be taken with a large piece of rock salt but its very frustrating that 4 1/2 months into this pandemic there seem to be few hard well established answers.

 

[CardsFan]

Very puzzling. It will be interesting to see over time as the number of new cases goes down globally due to the lock down provisions in so many countries if the ratio deaths to total cases actually starts going down. As you said, this all has to be taken with a large piece of rock salt but its very frustrating that 4 1/2 months into this pandemic there seem to be few hard well established answers.

I am guessing that FDR had the same frustration in April 1942.

We live in an "I want it now" information society.

 

[audreyh1]

I know that in GA, they are only testing the very sick, and in fact over 20% of those testing positive end up being hospitalized.

And even with the pretty sick folks there are probably false negatives.

 

[ExFlyBoy5]

I am guessing that FDR had the same frustration in April 1942.

We live in an "I want it now" information society.

I can't like this post ENOUGH. Like most major events like this, what we know NOW is very likely wrong or at least misunderstood. Give it a year for the experts to go over the mountains of data and evidence and we will most surely have a better understanding. Right now, we are living in a world of sound bites and a lot of information that is questionable and not vetted very well.

 

[Nemo2]

Right now, we are living in a world of sound bites and a lot of information that is questionable and not vetted very well.

When I was a kid a product came out claiming to grow hair.....my father said "If it worked, Frank Sinatra wouldn't wear a toupee".

Fortunes to be made, and how many people have worked on that problem for how many years?

 

[Mdlerth]

Americans are invulnerable to anything except Corona

Perhaps not every country is counting exactly the same way? If a patient in another nation tests positive for the virus and later dies from pneumonia, is the fatality attributed to COVID-19 or to pneumonia?

I recall reading on at least one of these threads that in the US, if a patient tests positive for CV and later dies, it will be recorded as death from COVID-19, not pneumonia or kidney failure, etc. The perceived CFR then would be heavily influenced by the large numbers continuing to come from the US.

It also appears that America is taking longer to close out cases than some other places. It probably isn't possible to know the true rate anyway, not without universal testing.

 

[Alan]

Perhaps not every country is counting exactly the same way? If a patient in another nation tests positive for the virus and later dies from pneumonia, is the fatality attributed to COVID-19 or to pneumonia?

In the UK daily briefings, when the COVID death toll charts are put up alongside those reported from other countries we are told that these are all deaths in hospital where a positive test for COVID has been received. The UK also records deaths from outside of hospitals which includes the best guess by doctors as to cause of death since those deaths have most likely not had a COVID test performed. The Office for National Statistics publishes that data which is useful in that one can look at overall deaths and see the % that is attributed to COVID.

https://www.ons.gov.uk/peoplepopula...glandandwalesprovisional/weekending3april2020

A death can be registered with both COVID-19 and Influenza and Pneumonia mentioned on the death certificate. Because pneumonia may be a consequence of COVID-19, deaths where both were mentioned have been counted only in the COVID-19 category.

Just to clarify, I believe the death toll figures countries publish are those deaths confirmed as COVID and I would expect those totals to be understated a little as they do not include deaths that have been confirmed with a test.

 

[VanWinkle]

Interesting article from a good source indicates the death rate is vastly overstated.

https://earlyretirementnow.com/2020/04/14/covid19-some-empirical-observations-reasons-for-optimism/

 

[Lewis Clark]

We live in an "I want it now" information society.

This philosophy applies to much more than information. The concept of delayed gratification is not widely practiced in this country.

 

[Texas Proud]

Was watching the news and they said that NY death increased 4200 today... it was reported that they started to count people who they think died of the virus who were not tested as positive...


SOOO, lets add deaths to the number but not overall people who have the virus... kinda skews the ratio....


Another (but cannot find the article) was that one hospital tested all the maternity patients and that IIRC 29 tested positive for the virus but showed no symptoms... they normally would not have been tested but were for some reason..


Bottom line, we are woefully short of the actual data on the virus and have no idea how deadly it really is....

 

[skipro33]

I heard on the radio a few days back, that here, in the USA, if a person dies who has COVID-19, then they are counted as died FROM COVID-19 and that may just not be true.

That has been expanded; Today I heard on the radio, if someone dies and it is suspected they had COVID-19, without any testing but with symptoms, then they are counted as died from COVID-19 regardless of actual cause of death.

Either or both of these could rack up a higher death toll.

(Radio KFBK 93.1FM Sacramento, CA The premiere news radio station for the capital of California)

 

[Texas Proud]

Skip... someone talked about this on the TV once...


The explanation is that it was the Covid that killed them... even if they had an underlying condition there is no way to know if that person would have died without Covid or not...



IOW, Copid was the cause of the death even if there were other contribution factors...

 

[skipro33]

Skip... someone talked about this on the TV once...

The explanation is that it was the Covid that killed them... even if they had an underlying condition there is no way to know if that person would have died without Covid or not...

IOW, Copid was the cause of the death even if there were other contribution factors...

But they are now counting deaths as COVID caused even if the victim was never tested for COVID, just had the symptoms. They could have died from anything and it wouldn't matter as long as they showed symptoms of COVID. This is a fundamental change with how counting was done prior.

 

[RobbieB]

Yeah, the gunshot wounds slowed him down but the covid killed him.

 

[cathy63]

NYC seems to have undercounted its death toll by more than enough to make up for any locales that are overcounting.
https://www.nytimes.com/interactive/2020/04/10/upshot/coronavirus-deaths-new-york-city.html

 

[skipro33]

Has there been any comparison of current deaths to past deaths for the same time period? Comparing this year to previous years would be interesting.

 

[cathy63]

Has there been any comparison of current deaths to past deaths for the same time period? Comparing this year to previous years would be interesting.

That's pretty much what the chart in #19 is, but it's only for NYC. I haven't seen that info for anywhere else.

 

[Aus_E_Expat]

I am bunkered down in Australia now after our government telling all Australians to return.
It is not the most exciting place to be but it seems to be the safest from the link
https://www.worldometers.info/coronavirus/#countries

It does make me wonder why the infection rate and death rate in Australia is so much lower (death rate 2 per million). The testing rate is very high in Australia so I think the figures are accurate.

I went and had my seasonal flu shot today as directed by government.

While I do not like following government directions, sometimes they are for the greater good.

 

[6miths]

NYC seems to have undercounted its death toll by more than enough to make up for any locales that are overcounting.
https://www.nytimes.com/interactive/2020/04/10/upshot/coronavirus-deaths-new-york-city.html

Now that is a striking graphic! I'm thinking that that meets both statistical and clinical significance. Thanks for posting.

 

[misanman]

Total Michigan Deaths Down in March

I think this was referenced elsewhere, but overall deaths in Michigan were down substantially in March - 5929 versus the average over the last few years of 8542.

http://https://www.detroitnews.com/story/news/local/michigan/2020/04/11/michigan-death-down-in-march-despite-coronavirus/5120360002/

 

[gwraigty]

Yeah, the gunshot wounds slowed him down but the covid killed him.

In a Ohio task force video I watched yesterday, a doctor was asked if it was true that they now have to count deaths as coronavirus deaths even if it wasn't conclusive that coronavirus was the actual cause of death. The doctor said yes and related a recent true story of one of his patients who was involved in a head on collision at 65 MPH. The patient was rushed to the ER and died 3 hours later. The hospital staff actually tested the patient for coronavirus, which the doctor thought was ridiculous. He didn't yet know the results, but if they come back positive, he would now be legally required to list the cause of death as coronavirus.

Some Ohio legislators are taking issue with the new method of counting presumed positive cases in the numbers, both the living and the dead. They're now allowed to assume someone with symptoms has the coronavirus without confirmation via testing. I realize there is a dramatic shortage of testing, but this seems wrong. It's been suggested by some Ohio legislators that they're trying to inflate Ohio's numbers because of the growing unrest and angry protests over the lock downs.