Does COVID-19 testing as done in NYC lead to over-reporting % death rate and under-reporting COVID-19 cases ?

Posted by freedomforall 1 month, 2 weeks ago to Ask the Gulch
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A friend lives in Manhattan NYC and his daughter-in-law is sick with symptoms
like COVID-19. They will not test her for COVID19 until she becomes sick
enough to require hospitalization.

I think that would indicate for NYC:
1) clear understatement of total cases of COVID19
2) definite overstatement of the death rate as a % of COVID19 cases
3) overstatement of the rate of serious cases as a % of COVID19 cases

Is this the way testing is being done throughout the world?

Would this ratchet up the fear factor for everyone?


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  • Posted by CaptainKirk 1 month, 2 weeks ago
    Yes, this keeps the denominator LOW, and HIDES the fact that the tests MAY BE Defective!

    In FL, we have 89% of the tests coming back NEGATIVE. And they are applying similar criteria.

    What does that mean? Sick people are not being counted as CV carriers in the denominator, unless they die of it, LOL.

    After this many weeks, one would expect at least 20% of the population being tested to be positive!

    The number is growing from 10% to 10.5% very slowly, when the number of new tests should be overwhelming the old tests.
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    • Posted by TheRealBill 1 month, 2 weeks ago
      "After this many weeks, one would expect at least 20% of the population being tested to be positive!"

      Not necessarily - that isn't how testing works. Seasonal influenza has a higher rate of infection and the positive test rate to be considered epidemic level is ~8%. Peak rates in average seasons are around the low 20s a few months into the season and the testing criteria is generally the same.

      "What does that mean? Sick people are not being counted as CV carriers in the denominator, unless they die of it, LOL."

      Wrong. You can't claim that someone who is sick right now is sick due to sars2 absent a test. Someone with fever, cough, and difficulty breathing is far more likely to have a flu than to have sars2. In fact, given what we know about the differences we should be emphasizing flu tests for people with these symptoms. Why? Narrowing the scope.

      The reason it matters is the difference in breathing issues between the two. In "standard" pneumonia and breathing issue cases the problem is blockage in the lungs. You treat that by clearing the lungs and providing anti-virals (ZPAC and steroids commonly). However, sars2 works differently. Like the malaria virus, sars2 binds to the red blood cells in a way that prevents them from absorbing oxygen. This has to be treated specifically - no amount of steroids or forced ventilation will help. This is the likely reason so many elderly and seriously ill have died due to it. Those cohorts are already at risk of O2 deprivation or have lower absorption volume to begin with.

      Treating covid-19 by trying to get more O2 into the lungs doesn't really work. In non-risk exposed people (i.e general population), testing for flu is the better first route - though perhaps ideally in combination because it lowers pressure on covid-19 stocks and also identifies likely treatment plans. However, there is a more expedient method in a clinical setting:

      0) measure blood oxygen levels
      1) administer steroids via inhalation and in more intense cases injection.
      2) measure blood oxygen levels

      If this process leads to normalized serum O2 levels the chance it is covid-19 drop dramatically. Knowing the above you can see why: of the blood is capable of taking in the oxygen when the lungs temporarily clear (that is what the steroids do) it is unlikely to be sars-cov-2 infecting the blood cells and preventing the O intake. If that sequence does not result in a high enough improvement, test for COVID-19.

      In that scenario I would expect those tests to have a much higher positive rate, likely well over 50%. You wouldn't be able to say the same for a flu test in the case of the O2 levels coming up because there are multiple physical causes for that scenario.

      The above is imperfect, but it is a damned sight better in terms of triage and diagnosis.

      As a side note: quite a bit of research into oxygenation was done in Soviet Russia decades ago - stuff you couldn't do in the west I'd add. It showed a rather high correlation, and some causation (ie. the experiments you couldn't do here) between effectiveness of oxygen intake and death in a surprising set of conditions. I would suspect that research would support the reasons covid-19 is so brutal to the elderly. To give you an idea of how extensive and surprising it was: if you're over 60 years of age, sleeping in a head-elevated bed dramatically lowers your risk of dying while sleeping - especially around 2-4am.

      It would also explain why so many can get it and it be mild enough to not even notice: those people have a "surplus" oxygen intake capacity. It would also explain why people with Asthma are at no increase in risk of serious illness to covid-19. People w/chronic Asthma actually develop more efficient and effective O2 absorption, thus are "better prepared" bioochemically.
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      • Posted by CaptainKirk 1 month, 2 weeks ago
        TRB thanks for the response. Let me clarify and ask a few questions...

        They are running VERY Few tests. The ones they do require REAL symptoms and a FEAR of CV. And only 11% testing positive seems "right" to you?
        11% of SICK people, generally going to the Hospital (since doctors are not ordering these tests, and they still can't do quick ones, etc)... [stating my assumptions].

        So if Barely 11% of the sick population have been exposed. What percentage of the healthy have been exposed? Knowing that Asymptomatic Spreaders are the biggest risk? Is that 1%?

        And we ASSUME 60 Million in america get the flu every year. So, that's like 17% of our population is assumed to get the flu.
        How do we project this out? Because flu is NOT novel it burns out at 17% but this will go until we have 40%? Which implies:
        A) It is killing about 10 times the number of people as the flu is
        B) About 3 times as many people will get it, than the flu, so we are up to 30 times our annual flu season deaths

        I don't think we will hit close to numbers like that... It looks like the worse is starting to move behind us. We have a couple of treatments that are pretty much 90% and a better idea of the method of attack. So my PREDICTION is that it feels like we have this under control, and we can start getting back to work. The next wave will be smaller, and we know how to triage it.

        I like your triage/analytics on how they respond to steroids... I did note Inflammation (IL-6 being high has a 20 fold increase risk of death), is not surprising. Faster inflammation build up in the lungs, I would assume, and POTENTIALLY an oxygen issue..

        Thanks again!
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  • Posted by term2 1 month, 2 weeks ago
    what would interest me is the liklihood that I would interact with a person who could infect me IF I went out . If the chances were 1 in 10,000, I would probably go out. If its 1 out of 5, I am staying home.
    This is the data that is meaningful to me.
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    • Posted by 1 month, 2 weeks ago
      I agree, term. That is the data that should be collected and publicized. For some reason (power?) we are being kept in the dark and not allowed our right to make our own rational decisions. The elite know better what is good for us.
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      • Posted by term2 1 month, 2 weeks ago
        Its pretty clear that since it is my life that is danger, I should take the responsibility for it, and make the decisions for myself.
        Living in Las Vegas, the state government pretty much closed down the economy here. Things are going to go south pretty fast here as stopping the flow of tourism trickles down very fast to most of the 2 million residents that live here.
        Fortunately for my small company, we sell online and to many states in the USA as well as other countries, and are still (at least) getting orders.
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    • Posted by TheRealBill 1 month, 2 weeks ago
      I'd suggest looking at state data. For example in my zip code we have over 10k souls, but only 5 confirmed cases. Neighboring zip codes are similar Seasonal influenza is more contagious and more prevalent by over an order of magnitude.

      Unless, of course, you are in NYC. ;)
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      • Posted by TheRealBill 1 month, 2 weeks ago
        I just wanted to come back and provide some more perspective on the numbers above. Looking at the data for NYC - where generally speaking your risk is highest:

        The Bronx: 1,273 cases per 100,000 people.
        Staten Island: 1,255 cases per 100,000 people
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      • Posted by term2 1 month, 2 weeks ago
        I find it kind of fitting that NYC is the most leftist of the cities with the worst politicians, and it has the highest incidence of kung flu infestation. I cant help but think there is some connection there
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        • Posted by TheRealBill 1 month ago
          Sort of, but not likely the way we would normally think of it. Population density is almost certainly a driving factor, but ISTR that early one the mayor was encouraging people to not buy into the "xenophobic fear mongering" and go party in Chinatown, do ... whatever we'd call the opposite of distancing, and so on.

          But there is a strong correlation between population density and authoritarianism among the populace, with plausible theories on causation.
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  • Posted by Lucky 1 month, 2 weeks ago
    Yes.

    The excuse would be not enough test kits. It is hard to get proper data but I understand that some countries manage to do widespread testing, eg. Germany, Singapore.

    China is doing the opposite, clearly for political not medical reasons.
    Comment on a Chinese blog-
    When I see a rumor condemned, I know it is true.
    Comment now taken down.

    UK, big problems. Not enough test kits. On top of that a rigid 35h per week by the operators, etc.
    Some EU countries have found that Chinese test kits are grossly inadequate.

    To avoid the fear/panic factor there has to be an adequate and responsive health system. The market would get somewhat close, else you need a really competent government and public service - Germany, Singapore?
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    • Posted by 1 month, 2 weeks ago
      That is one explanation.
      The other alternative when one has less tests than needed is what NZ is doing. They include probable COVID19 cases in their total even though they have not been tested.
      But they do report the number as unconfirmed cases.
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      • Posted by TheRealBill 1 month, 2 weeks ago
        Johns Hopkins, which most places seem to use, admits in the fine print that their data counts "presumed cases" as "confirmed cases" and that there "may be" duplication of cases because they combine actual data with media reports.

        But, it is in the fine print. -.-

        The problem at this point isn't that we don't have enough tests. It is that the results and what that means are being ignored by the press, and there is no perspective.
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    • Posted by term2 1 month, 2 weeks ago
      Not surprised if chinese test kits are inadequate and dont report all the positives. Since they started this whole pandemic, they would wan to minimize it
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  • Posted by TheRealBill 1 month, 2 weeks ago
    Ok, this is a tricky question to answer as there are many factors at play here.


    First lets consider the two main strategies for testing and the differences between the strategies themselves. First up: testing sick people who may have it. This is the strategy currently being used in most places. Fundamentally you want to minimize the testing and reduce the scope to people who are sick. The reasons for this are 1) to identify an infection for precise treatment 2) to identify and control spread. Within this strategy and conditions you can be doing this because of supply, need for data, or because you need or have specific quarantine and/or treatment.

    In the second main testing strategy you test to minimize the broader risk by testing those who are at the highest risk of spreading it. You would prioritize first responders, transport drivers, frequent travelers, and people that you encounter often such as grocery store clerks and home delivery people. Here you are testing not to identify who has the virus, but who does not have it so they can continue operating.

    Because of the fundamentally different purposes behind those strategies what the results mean are likewise different. In the former case not having a high positive rate means, primarily, one or ore of the following:

    1) The infection rates are not as high as you think
    2) Something is wrong w/the test (timing, type, accuracy, etc.)
    3) The severity of the infection is lower than expected

    In the second strategy, a lack of results is kind of what you want to have as that lets you keep the locomotive running, so to speak. However, a low positive rate could mean either of the first two above as well as "testing the wrong cohort". FInally, depending on the local frequency a low rate could be explained by repeatedly testing the same people - which you would have to do. Now as to how testing is being (mis)used today for covid-19/SARS-CoV-2 and what the rate of positives might mean in that context.

    First, we are generally going with the first presented strategy. In this scenario we've see then assumption of a massive crackdown on movement and a general not giving a shit about the infrastructure and people's economy. This rules out the second strategy entirely. So, given that, lets look at the "whys" of our current low rate, after getting some perspective by using data on something we simply accept: seasonal influenza.

    If you took the reaction to covid19 and applied it to the same data on the beginning of flu season we would be doing this crap every winter. Presently we're sitting at around 12-14k deaths in ~3 months attributed to covid19 in the U.S.. The flu season started in the first full week of October (week 40 of the year), and had killed more by this point in its progression, but more critically for this context had infected far more. This trend has, of course, continued and the seasonal flu has killed, a minimum of more than 2x the amount of covid19 with some estimates up n the 5x range. The infection numbers for the seasonal flu are over 30m so far (estimated). Compare that to the relatively small numbers for covid19: 12-14-k dead and under half a million infected.

    Quick sidenote on that last sentence: Most people seem to be relying on the Johns Hopkins site for their counts. However, those counts are inflated. As they note in the fine print frame: "Confirmed cases include presumptive positive cases." and further that it is based on a combination of state resources and news reports which also means multiple countings of the same cases. This will also be different from the CDC results which generally exclude non-lab validated cases and go from state and provider reporting. Personally I consider this an abuse of people's trust and wildly irresponsible. If we treated seasonal influenza the same way the death toll would be about ten times higher for it. That would mean that at this stage in the flue season we'd have been looking at death reports due to flu of around quarter million in the U.S. - almost three times higher than the global count for covid-19.

    Anyway, now that we have the perspective, what is the positive test rate for covid/sars2? It varies widely. In NYC, for example, the rate is around 28-30%. In Texas it is around 7-8%. As such there is no proper broad answer. NYC also has 1/3rd of the total deaths. You don't need a multivariate analysis to see that a key factor in NYC vs Texas (and/or Texas cities) is population density which then means a lack of social distance. It has been widely reported on for decades about how NYers don't really have personal space but those of us out west - even in CA - retain some sense of keeping distance. But I digress a bit. Anyway, the positive test rate for the flu has been higher than for covid19.

    The reasons for the low positive testing rate include:
    1) The actual rate of infection is lower than the PPs (press/politicians) claim
    2) Relatedly: the criteria for transmission are smaller than reported
    3) The chance of getting sars2 vs the flu are much higher

    When you look at lab confirmed cases outside of the outliers such as NYC and King County, WA nursing homes, the vast majority of cases are people who traveled to certain regions and the people they live with at home. In TX, for example (I use TX because that is where I am and thus track the closest) almost 3/4ths of test-confirmed cases are from travel and their household. This is due to the means of transmission requiring close contact and the low rate of reproduction. Despite media's breathless fear merchandizing, a covid19 case will infect, on average, 1.4 other people. This is lower than for the seasonal flu (which also has a range, so using the median of each range here) which is in the 2+ range. Thus compared to the flu covid/sars2 has a lower infection rate AND a lower exposure rate.

    Now keep in mind that the "models" the media used when they were ready to fear monger (remember, the first downplayed it and toed the China line on it) said we should have 10-20m cases in the U.S. by now and have 1-2 million deaths, already assumed drastic shutdowns and quarantine. This means you can't claim that we avoided it because of those actions. That is how wrong they have been. What they really did was to take a 1% (which they claimed was low) mortality rate, then assumed infection levels of the flu. It took me a bit to hammer that out; the week a given article/report came out showed a "projected' infection level that aligns with that week's current estimated flu infection level. Yet the actual data was saying it would not spread the same.

    This bears emphasizing: The infection rate of covid19, with no vaccine, is more than an order of magnitude lower than the same for seasonal flu which has a vaccine with a 40-65% prevention rate.

    Let that sink in.

    What I'd recommend for people who have "symptoms like COVID-19" is to ask for flu test. It is far more likely to be flu, and there are likely no additional restrictions on flu testing. In terms of risk, the flu is still worse.

    The testing strategy is a valid one, and we've used basically the same for influenza for years. The problem is the reporting, or lack thereof, of the testing and what the results mean. In TX we test based on three official "symptoms": difficulty breathing, fever, and runny nose. However, we've also identified that a runny nose is uncommon in positive tests. We've done more flu testing and those results are clearly showing flu is more prevalent than previous data indicated.
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  • Posted by $ Dobrien 1 month, 2 weeks ago
    Doctors in Minnesota are told to list Covid19 as cause of death regardless of cause.
    https://mobile.twitter.com/chrisbergP...
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    • Posted by TheRealBill 1 month, 2 weeks ago
      Ehh, yes and no. Most of that is standard practice, and the linked doc gives examples of where COVID19 should not be listed despite presence. The CDC doc linked in the tweet states:

      "If COVID–19 played a role in the death, this condition should be specified on the death certificate. In many cases, it is likely that it will be the UCOD, as it can lead to various life threatening conditions, such as pneumonia and acute respiratory distress syndrome (ARDS). In these cases, COVID–19 should be reported on the lowest line used in Part I with the other conditions to which it gave rise listed on the lines above it. "

      The problem here isn't including it on the "lowest line". The problems are 1) accepting a doctor saying they think they may have had it, and 2) how the press and data mongers will misuse it. The first is obvious as to why that is wrong. For the second what we will see is that if COVID-19 is listed anywhere, regardless of "possible/probable/lab-confirmed" it will be counted by the media as definite and COVID19 as the sole cause.

      CDC doc: https://www.cdc.gov/nchs/data/nvss/vs...

      HOWEVER, MN is poorly summarizing the CDC document in it's 2-pager ( https://www.health.state.mn.us/people... ) in a way that can lead to poor reporting.

      What they SHOULD be doing is having them tested for the flu as well. And proper "data scientist" (I really dislike that term) would tell you that due to the overlap of symptoms and causes, you must test for the more likely causal conditions.
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  • Posted by $ Dobrien 1 month, 2 weeks ago
    The deepstate Dr Birx talks about US reporting in this eye opening video . The gentleman who produces it is a Christian ex marine. Most gulchers will not get past that. To bad , because it is very clearly shown the connections of WHO and the CDC and Gates , Clinton Foundations, Soros and other deep state pigs. https://youtu.be/k4CiNy-vXLs
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  • Posted by Stormi 1 month, 2 weeks ago
    Deaths as of today COVID19, 14,781, deaths during H1Nq, 17,000/ Perspective.Someone in halth care told me the testing is 90-95% negative across the country. I am more interested in the antibody test, which would put some people at ease, and help the most sick with donations.
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