Cycling UK Forum

there are statistics about the corona virus pandemic here

https://corona.help/

You can see the figures broken down by country.

You can see that, on the face of it, the mortality rate (deaths/total infected) varies from about 1% to about 10% with country, even between countries with ostensibly similar levels of heath care and comparable outcomes in many areas of public health/disease.

My question is this; does anyone know if this discrepancy is likely to be 'real' or is it an anomaly created by the way statistics are collected?

I can think of a few ways the stats can become misleading;

For example, there may be many more cases of corona virus infection that go unreported in countries which (say) have implemented self-isolation ahead of the outbreak in that country; only the sick who get very sick might end up being 'counted'.

In countries where testing is more commonplace, those who show mild symptoms or are entirely asymptomatic are more likely to be included in the total infected.

In some countries it is possible that those who die as a result of a secondary infection of some kind may (accidentally or deliberately) not be counted amongst those who are victims of this disease.

Currently the UK mortality rate is about 8.5%, which is pretty high. Countries such as Turkey have a mortality rate about 2%. The USA, Germany and Switzerland all show low mortality rates. Can we really be about eight times more likely to die in this country?

Brucey wrote:In countries where testing is more commonplace, those who show mild symptoms or are entirely asymptomatic are more likely to be included in the total infected.

I'm pretty sure the differences are down to the numbers tested and when those tests takes place. I haven't cross referenced them but the testing data is available
https://ourworldindata.org/covid-testing

Just a glance at that shows the UK testing numbers are very low. People are not being tested till they're ill enough to require hospitalisation.

Brucey wrote:there are statistics about the corona virus pandemic here

https://corona.help/

You can see the figures broken down by country.

You can see that, on the face of it, the mortality rate (deaths/total infected) varies from about 1% to about 10% with country, even between countries with ostensibly similar levels of heath care and comparable outcomes in many areas of public health/disease.

My question is this; does anyone know if this discrepancy is likely to be 'real' or is it an anomaly created by the way statistics are collected?
.....

The number of cases depend on your testing regime. It would seem a fair number of infections are asymptomatic or minor symptoms. e.g. in the UK we are (I believe) only testing those suspected of C-19 who are admitted to hospital so likely a lot of cases are not being detected nor counted so two effects 1. Our number of cases will be much lower than reality and 2. those cases we are counting are the worst cases (because they are admitted o hospital) so outlook much worse than the average.

Whereas e.g. S. Korea instituted a massive public testing scheme so their number of cases would include the asymptomatic and minor cases they would have detected.

And when looking at death rates you need to question what you are actually looking for e.g. looking for deaths caused by the virus or deaths caused because somebody with a severe infection could not be put on a ventilator because their health service did not have the facilities (and they might have recovered were a ventilator/better care available). The "state" of a health service will also have an impact of the death rates from infections.

Ian

Dr John Lee (a retired pathologist) has explored this quite extensively in the Spectator. He says that reporting rules have now been (alarmingly) changed and that someone (AIUI) who dies with coronavirus will now be recorded as having died of coronavirus i.e. covid19 was the cause of death. The WHO didn't generally like this (prior to the outbreak) as it means that serious conditions (e.g. lung cancer) are under-reported while final illnesses like pneumonia are over-recorded. It does mean of course that covid19 cases are picked up but it also means that we never really know why someone died. This is especially true of "outlier" cases of young people and health workers having died of the coronavirus.

So the UK's death rate might be much higher simply because of the way we are recording cause of death. The same may be true of Italy. These figures are balanced perhaps by under-recording at home or in nursing homes but not to the same degree.

I think that in the UK, deaths from CV in the community as opposed to in a hospital lag several days behind.

Trends should measure properly if the data collection methodology is consistent.

A further ascpect on the statistics is you need to be very careful when looking at UK statistics as, as seems too common, we are somewhat "all over the place" with our stats. e.g.

https://www.theguardian.com/world/2020/apr/02/coronavirus-took-hold-in-uk-earlier-than-thought-data-reveals wrote:On Thursday, 561 deaths were reported, but only 84 took place in the 24 hours to 5pm on 1 April.
...
Earlier this week the number of deaths reported on one day was less than half the total number of deaths that occurred in the reporting period the day before.
...
On 30 March, 159 deaths were reported by NHS England. The true number of deaths on that day has since been revised up to 401.

Ian

+1 to the above.

And here is the link to Prof John Lee's article (I think there is another article as well):

https://www.spectator.co.uk/article/how ... 19-deaths-

horizon wrote:Dr John Lee (a retired pathologist) has explored this quite extensively in the Spectator. He says that reporting rules have now been (alarmingly) changed and that someone (AIUI) who dies with coronavirus will now be recorded as having died of coronavirus i.e. covid19 was the cause of death. The WHO didn't generally like this (prior to the outbreak) as it means that serious conditions (e.g. lung cancer) are under-reported while final illnesses like pneumonia are over-recorded. It does mean of course that covid19 cases are picked up but it also means that we never really know why someone died. This is especially true of "outlier" cases of young people and health workers having died of the coronavirus.

So the UK's death rate might be much higher simply because of the way we are recording cause of death. The same may be true of Italy. These figures are balanced perhaps by under-recording at home or in nursing homes but not to the same degree.

A proportion of people dying with Covid 19 will also have underlying complex health problems. I suspect that if we did a retrospective anlysis at the end of the out break, and also in the following 12 months, we will see a reduction in the number of people recorded as having died because of; Cancer, Heart Disease, Dementia, etc.

There’s a delay collecting the death statistics:
https://www.theguardian.com/world/2020/ ... SApp_Other
The figure we are all watching is likely to be an under-report, which is skewing the curve

Do we need to add into the mix the reliability (or otherwise) of the tests used?

It may be that some of the earlier countries affected used tests that were not fully tested, as it were. I have in mind the briefing session the other day where it was revealed that one of the tests gave inaccurate results in 75% of cases - was this test used en mass anywhere?

Vitara wrote:

horizon wrote:Dr John Lee (a retired pathologist) has explored this quite extensively in the Spectator. He says that reporting rules have now been (alarmingly) changed and that someone (AIUI) who dies with coronavirus will now be recorded as having died of coronavirus i.e. covid19 was the cause of death. The WHO didn't generally like this (prior to the outbreak) as it means that serious conditions (e.g. lung cancer) are under-reported while final illnesses like pneumonia are over-recorded. It does mean of course that covid19 cases are picked up but it also means that we never really know why someone died. This is especially true of "outlier" cases of young people and health workers having died of the coronavirus.

So the UK's death rate might be much higher simply because of the way we are recording cause of death. The same may be true of Italy. These figures are balanced perhaps by under-recording at home or in nursing homes but not to the same degree.

A proportion of people dying with Covid 19 will also have underlying complex health problems. I suspect that if we did a retrospective anlysis at the end of the out break, and also in the following 12 months, we will see a reduction in the number of people recorded as having died because of; Cancer, Heart Disease, Dementia, etc.

Very true. I know of one person (in early 70s) who without any infection and for the last couple of years who has massively compromised lung function to the point where she can't leave the house or anything (ambulance called several times and GPs attended home). I suspect if she caught any infection impacting ENT she'd need a ventilator.

It must be difficult (even before C-19) to establish "cause of death" e.g. for a dementia patient. I suspect most dementia sufferers don't actually die of dementia but from complications related to dementia but also more common in some elderly (e.g. falls, infections, etc.). So does somebody die of "dementia" or from a fall or pneumonia, etc. And if such a patient catches C-19 would it be accurate to count it as a C-19 death or dementia, etc.?

Ian

Psamathe wrote:

Vitara wrote:

horizon wrote:Dr John Lee (a retired pathologist) has explored this quite extensively in the Spectator. He says that reporting rules have now been (alarmingly) changed and that someone (AIUI) who dies with coronavirus will now be recorded as having died of coronavirus i.e. covid19 was the cause of death. The WHO didn't generally like this (prior to the outbreak) as it means that serious conditions (e.g. lung cancer) are under-reported while final illnesses like pneumonia are over-recorded. It does mean of course that covid19 cases are picked up but it also means that we never really know why someone died. This is especially true of "outlier" cases of young people and health workers having died of the coronavirus.

So the UK's death rate might be much higher simply because of the way we are recording cause of death. The same may be true of Italy. These figures are balanced perhaps by under-recording at home or in nursing homes but not to the same degree.

A proportion of people dying with Covid 19 will also have underlying complex health problems. I suspect that if we did a retrospective anlysis at the end of the out break, and also in the following 12 months, we will see a reduction in the number of people recorded as having died because of; Cancer, Heart Disease, Dementia, etc.

Very true. I know of one person (in early 70s) who without any infection and for the last couple of years who has massively compromised lung function to the point where she can't leave the house or anything (ambulance called several times and GPs attended home). I suspect if she caught any infection impacting ENT she'd need a ventilator.

It must be difficult (even before C-19) to establish "cause of death" e.g. for a dementia patient. I suspect most dementia sufferers don't actually die of dementia but from complications related to dementia but also more common in some elderly (e.g. falls, infections, etc.). So does somebody die of "dementia" or from a fall or pneumonia, etc. And if such a patient catches C-19 would it be accurate to count it as a C-19 death or dementia, etc.?

Ian

Sry few patients are coming into hospital with heart attacks or strokes at the moment interestingly. Hospital I was working at on Friday is usually very busy with heart attack patients, they are meant to be covering for many other hospitals now who are only taking Covid patients. After my case I asked if they were getting many acute coronary cases, “bugger all” was the response.

Your neighbour above in her 70’s with massively compromised lung disease wouldn’t have been ventilated before this outbreak if presenting to hospital and certainly wouldn’t now.

Psamathe wrote:...And when looking at death rates you need to question what you are actually looking for e.g. looking for deaths caused by the virus or deaths caused because somebody with a severe infection could not be put on a ventilator because their health service did not have the facilities (and they might have recovered were a ventilator/better care available). The "state" of a health service will also have an impact of the death rates from infections.

Ian

That is not the case in the UK ..... yet.

Syd wrote:

Psamathe wrote:...And when looking at death rates you need to question what you are actually looking for e.g. looking for deaths caused by the virus or deaths caused because somebody with a severe infection could not be put on a ventilator because their health service did not have the facilities (and they might have recovered were a ventilator/better care available). The "state" of a health service will also have an impact of the death rates from infections.

Ian

That is not the case in the UK ..... yet.

I was talking about/responding to comparing death rates between different countries. My comment was not about the UK and (according to reports) that has happened in some other countries and will likely impact their number of deaths.

Ian

Psamathe wrote:

Syd wrote:

Psamathe wrote:...And when looking at death rates you need to question what you are actually looking for e.g. looking for deaths caused by the virus or deaths caused because somebody with a severe infection could not be put on a ventilator because their health service did not have the facilities (and they might have recovered were a ventilator/better care available). The "state" of a health service will also have an impact of the death rates from infections.

Ian

That is not the case in the UK ..... yet.

I was talking about/responding to comparing death rates between different countries. My comment was not about the UK and (according to reports) that has happened in some other countries and will likely impact their number of deaths.

Ian

And as that is not the case in the UK yet it skews figures.