Wednesday, August 19, 2020

My notes since Feb 2020. Second wave + Novel Coronavirus outbreak, forecasting the end of the curve

Note March 3rd 2020 Dutch Minister of Healthcare Ernst Kuipers wants new lockdowns as soon as possible. Has no clue about epidemics, gompertz curves, Farr's Law etc. Excerpt from newspaper interview last Saturday:

Ultimately, says Minister Kuipers, preventing a new wave is “not just a problem of medical care, as I hear time and again”. He means: don't just look at the number of hospital beds. “Germany is a country with many more hospital beds. But they had to take similar measures at various times. If the virus grows exponentially, more beds will only buy you a few days.”
Interviewer: As a national 'bed boss' you had to arrange extra (IC) beds throughout the country for two years because the Netherlands had too few. Then, as a new minister, you are already committed to expansion first, right?
(Shakes head). “That's the last thing you should bet on. I hear people talk a lot about raising our dikes. As if the dikes were high enough, we wouldn't have to worry about anything anymore. My answer is: that won't help. You cannot increase the capacity in such a way that it no longer has to take these kinds of measures in the event of a next wave or pandemic.”

Note January 20th, 2022: Excerpt Dutch Mayors to the national cabinet: Lockdowns don't work: "This is even more pressing when the infection and hospital figures undermine the logic and reasonableness of the current strong measures. It is true that many people are infected, but they also become less quickly and less seriously ill. In neighboring countries, much less far-reaching measures are taken without very serious accidents. This removes the fear of the virus and the motivation to follow the rules."

Notes January 11th. 2022 The Netherlands still in #dommelockdown . Omicron is nature's vaccine. Employers VNO NCW and MKB demanding re-opening on Sunday. We personally are in France waiting it out. NOS news still has not reported on South Dakota never going into lockdown or Florida opening up a year and a half ago.... 

Notes December 31st 2021 . 
The Netherlands in pre-emptive Omicron South Africa variant lockdown. Demonstration on January 2nd 2022 Museumplein forbidden... Robin Fransman passed away last week of/with Covid19. Traffics jams to Belgium which is more open. In the USA internal migration to free open states. Montana, South Dakota, Florida. 

Omicron seems to be a game-changer, a nasal cold instead of something that effects the lungs. Evaluation is starting in many places. I am discussing with someone in Dutch state media why they haven't spoken with leaders of areas not in lockdown, interesting groupthink and tribal processes. The main diseases: obesity, sloth, social media addiction, and mental viruses, remain. 

Endemic okt 30th
For The Netherlands pop. 18m ENDEMIC could mean: 
5 500 infections per day, more  in winter. 
1 900 deaths, 5 per day. More in winter.

Based on UK guesstimate:

Notes October 22, 2021 Coronapass in The Netherlands the unvaccinated from 13 and older being turned into scapegoats. The Dutch health authority RIVM being goaded into lockdowns by the press and "Red Team" (independant SAGE). All measures lifted in many other countries including scandanavia. Starting Vlam op de Dam until emergency law is lifted here. 

"Based on antibody testing of blood donors, 98.0% of the adult population now have antibodies to COVID-19 from either infection or vaccination compared to 18.7% that have antibodies from infection alone."

Effectiveness against hospitalisation: Greater waning appears to occur among those in clinical risk groups. (Booster for the elderly seems to make sense. Opportunity cost that they are not being done in The Netherlands.) Effectiveness against mortality: Relatively limited waning of protection against mortality is seen over a period of at least 5 months.

In individuals aged greater than 30, the rate of a positive COVID-19 test is higher in vaccinated individuals compared to unvaccinated. This is likely to be due to a variety of reasons, including differences in the population of vaccinated and unvaccinated people as well as differences in testing patterns. The rate of hospitalisation within 28 days of a positive COVID-19 test increases with age, and is substantially greater in unvaccinated individuals compared to vaccinated individuals. 

Page 17

This is strange. 
September 2021 role of obesity in excess death?
Map1: Morbid obesity deaths 2016

Map 2: Excess death during Covid pandemic

Note August 18th: It is called sterilizing immunity when it stops infection. 

Note August 11th 2021: Vaccination passports in France, UK, Germany based (I believe) on a misunderstanding of PERMANENT and TEMPORARY vaccination. Covid19 is a coronavirus that you can get more than once, unlike measles. There will be no eradiction or "herd immunity" with COVID19 only endemicity. 
Case Fatality Rate in The Netherlands with Delta (India) variant currently around 0,15%. 

Germany extending "epidemic emergency" , UK had Freedom Day and cases fell whilst modellers predicted a spike. 

Evaluation of guesstimate (dotted line) I made on August 19th 2020 for the second wave in the Netherlands, excess deaths were 12 000 significantly higher than the 5 000 I thought. The guesstimate was much better than The Institute for Health Metrics and Evaluation (IHME) at the University of Washington estimate which became much too high after August: 
Today August 19 I penciled my guesstimate of the second wave of Covid19 for The Netherlands.  My guesstimate AJB: Ansgar John Brenninkmeijer. 5 000 excess deaths, population adjusted based on Swedens 2020/2021 scenario of 3 000 deaths. Curve shape should be Gompertz but isn't. Data at the moment isn't conducive for making an estimate because the number of Covid 19 mortalities is so low. I am curious whether we will see the result of the 2020 heatwave on Thursday the 19th in weekly update.

The Netherlands Total Nr of Deaths per week
Update November 7th: Police staat, not allowed to meet more than 1 other person on the street... Excess deaths week 22-28 oktober 2020 3448-2951 = five hundred excess deaths in The Netherlands in one week. 
Update October 16 Partial Lockdown2 in The Netherlands starts for 4 weeks. Scientific community split between Great Barrington Declaration (go to endemic) versus John Snow "herd immunity" is a fallacy. 
Update August 27 Record heatwave very visible: As expected. Three to four hundred more deaths than usual in the summer. 

A "government" plan published at the end of June:  predicts 1/2 the number of Intensive Care beds needed at the peak for Covid care 650 versus 1 378 beds in the spring of 2020. 

Conventional Coronavirus in Sweden over the years

Add Source: 

Coronaviruses are seasonal in northern Europe. Asknow nobody knows how many people die of old age every year in combination with rhinovirusses or conventional coronavirusses. What we do know is that in general 200 to 300 more people die everyweek in the winter and this winter the authorities will keep track of COVID19 deaths which will probably increase. The best-case scenario (IHME) is deaths measured but bottom line no statistically relevant excess deaths. Track here:

In the winter, a lot more people get sick and die every day in The Netherlands. SARS-COV-2 which causes has been killing about 1 person a day during the summer, so it would be perfectly normal if 5 people per day, 35 per week died of it during the winter. (Based on acute respiratory complaints increasing fivefold between week 33 and December/January/February). 
plaatje niet beschikbaar

It might be higher, it might be lower depending on #groepsimmuniteit #herdimmunity there isn't 1 threshold or immunity "tipping point" it seems to be more of a spectrum. 
Dutch Government explanation: 

Note September 28th 2020: "Diederik Gommers of the Dutch Association for Intensive Care expects that 400 to 700 covid patients will be in intensive care in two weeks. (Check: October 14th 2020)"

Update September 24th: No increased deaths up to September 16th. In fact 124 deaths lower than the upper line. In the week up to September 22nd 33 corona deaths were reported in the Netherlands. So the report next week should be normal. The week after that up to the 29th guesstimate: 112 deaths so around the upper line.

Note: Exponential "forecast" for the end of October: 

Level 2:
Replying to
Analyse van 22/09 Opnieuw een stijging van het groeipercentage en dat is geen goed nieuws. De verdubbelingstijd is nu iets meer dan 10 dagen. Dat betekent 8x zoveel besmettingen over een maand bij gelijkblijvende groei. Ofwel bijna 20.000 per dag eind oktober.

Note September 1st: 

Note: 31st of August: Tweet Prof. Francois Balloux: "The reduction in #COVID19 mortality has multiple explanations: Improved treatment; younger demographic infected; possible 'mortality displacement'; likely role of 'infectious dose' (sometimes incorrectly referred to as "viral load"). And the virus' virulence didn't significantly change."

First wave:

The Netherlands Retrospect: RIVM terugblik "In the winter of (2017/2018), mortality was increased for 15 weeks (weeks 51 2017 to 14 2018). The increased mortality rate coincided with the flu epidemic that occurred from week 50 2017 through week 15 2018. The mortality rate during the 18-week flu epidemic was estimated at 9,444 (8,885 for the entire winter period from weeks 40 to 20). This was the highest mortality rate ever measured since the start of the monitoring in 2009. The mortality mainly affected people aged 75 years and older, but there were also several weeks in which the mortality was increased in people between 55-64 years and 65- 74 years.
A brief resurgence of the flu epidemic in weeks 10 and 11 2020 overlapped with the first 2 weeks of the COVID-19 epidemic. The mortality rate in weeks 10 to 19 of the COVID-19 epidemic was 9,768, of which 213 were in the first 2 weeks.

Anders Tegnell Sweden "What is the world basing their decisions on?" "there is the report (model) from Imperial ...that isn't even peer-reviewed." 

Last update: Thursday May 7th. Today is #rokjesdag The first wave is now recent history. It was fascinating, but the daily dose of death is depressing. Makes me think of a story I heard that a woman writing about genocide (in China?) killed herself. 

Conclusion May 7th 2020: My prediction was just a bit too low, but much more accurate than most, certainly compared to a certain college. The predictability of some things never ceases to amaze me. The laws of large numbers, etc. My respect for both Donald Trump and Elon Musk has grown and it was wonderful to compare notes with via Twitter. The memeshere like any technology is a double-edged sword.

Holland is on a "routekaart" based on the European Union "roadmap" which is not connected to reality and is stuck in a bureaucratic quagmire ;) A pain, but not the end of the world.

Guesstimate on March 19th 6 000 TOTAL* deaths in NL from the virus
Netherlands: Decline in April? 
Estimate of total weekly deaths, pencilled in. 

FORECAST March 19th, 2020
The forecast above, measurement below.

RIVM summary: "In the week from 23 to 29 April 2020, total mortality in the Netherlands was strongly increased (mortality reported within 2 weeks - around 97% reported). A total of 3,580 deaths have been reported, usually we expect between 2,609 and 2,913 deaths at this time of year. That's between 667 and 971 more deaths than we would expect. This is around 1.5 times the daily reported mortality from laboratory-confirmed COVID-19 in the same week (533). Mortality was slightly increased in the 35-44 and 55-64 age groups, increased in the 45-54 and 65-74 age groups, and greatly increased in the 75 and older age group. Mortality was increased in the combined regions of Zeeland / North Brabant / Limburg, Overijssel / Flevoland / Gelderland, and Utrecht / North Holland / South Holland. Mortality was not increased in the Groningen / Friesland / Drenthe region."

On Tuesday you can expect a higher number because on Monday data from the weekend is collected and sent to the

DateMeasuredGuesstimateGrowth RateGrowth
13-Mar10Declining by100%
14-Mar121% per day20%
1 May489356362.0%

because the 6 000 is spread over 4 weeks the peak shouldn't be much higher than in the influenza season of 2017-208 below: Maybe 3000 (normal line) + 2800 COVID19 = 5800? + 2200 = 5200? (adjusted April 2nd). (April 3rd 6 000 per week is more probable). No longer an epidemic in the Netherlands.

Italy Deaths 

DATE : DEATHS (cumul.): GROWTH %

March 19th Guess 3,5k 18% Measured 3,4k
March 20th Guess   4k 17%  Measured 4,0k
March 21st Guess 4,8k 16%  Measured 4,8k (as expected)
March 22nd Guess 5,6k 15% Measured 5,5k 
March 23rd Guess 6,5k 14%. Measured 6,1k
March 24th Guess 7,4k 13%  Measured 6,8k 12%
March 25th Guess 8,3k 12%  Measured 7,5k 10%

Adjusted Guess downwards on 25/3

March 26th Guess 8,4k 11%  Measured 8,2k   9%
March 27th Guess 9,3k 10%  Measured 9,1k   11%
March 28th Guess 10,3k 9%  Measured 10,0k 10%
March 29th Guess 11,2k 8%  Measured 10,8k   8%
March 30th Guess 12k 7%     Measured 11,6k   7%
March 31st Guess 12,9k 6%.  Measured 12,4k   7%
April 1st     Guess  13,7k 5%  Measured 13,2k   6%
April 2nd   Guess 14k 4%      Measured 13,9k  5% 
April 3rd    Guess 14,9k 3%   Measured 14,7k  6%
April 4th    Guess 15,4k 2%   Measured 15,4k  5%
April 5th    Guess 15,7k 1%   Measured 15,9  3%
April 6th    Guess 16k  0%     Measured 16,5  4%

Adjusted upwards again 6/4

April 7th    Guess 17k 3%      Measured 17,1k 3,7% 
April 8th    Guess 17,5k 3%   Measured 17,7k 3,2%
April 9th    Guess 17,9k  2%  Measured 18,3k 3,4%
April 10th  Guess 18,2k 2%   Measured 18,8k 3,1%
April 11th  Guess 18,4k 1%   Measured 19,5k 3,3%
April 12th  Guess 18,6k 1%   Measured 19,9k 2,2%  
April 13th  Guess 19k             Measured 20,5k 3%
April 14th  Guess 19k             Measured 21k 2,9%
April 15th  Guess 19k             Measured 21,6k 2,9%
April 16                                   Measured 22,2  2,7%
April 18th                                Measured 23,2k 2%
May 6th                                   Measured 30k    1%

Track total deaths here: 

Guess March 23 Less than 16k deaths? Guesstimate March 19th less than 20k deaths in Italy.

Update April 29: Total measured COVID deaths in Italy (and the UK) are higher than my guesstimate. In the Netherlands, the guesstimate has been remarkably accurate. It falls between the daily measurement and weekly measurement (RIVM Sterftecijfers). The decline of deaths is slower than expected. The government seems to be backtracking on earlier statements of stopping the lockdown because the Outbreak Management Tea, no longer "believes" in Groepsimmuniteit. The acid test is what happens when IC bed use for COVID 19 in NL falls below 700 around Bevrijdingsdag next week... 

Update April 7th. People are canceling activities in July and August as well as the end of May here in the Netherlands. Few people are infected in the north of Holland it seems, but there doesn't seem to be much "serological" or antibody testing taking place. It is not even clear to me whether it is possible. Good news: flattening the curve works. Bad news: little evidence yet of herd immunity anywhere on Earth?? After Easter Austria and some other countries are easing lockdown. Lockdown of countries like Pakistan where very few people seem to be sick seems ridiculous because they will probably need a second wave lockdown again. Boris Johnson currently in intensive care... 

Update April 3rd. "Dunkelziffer" = officially unknown number of certain [negative effects] events. 
The official number of deaths caused by COVID19 is lower than my forecast, but the actual number of people who have died in The Netherlands is higher than my guesstimate. 

Update March 19th: tracking curves and forecast for Italy and The Netherlands

Worldwide Panic: Euro 2020 has been canceled and pretty much everything else. Also Berkshire Hathaway meeting in May has been cancelled. People buying guns in the US. And unexpectedly this has become the TOILET PAPER PANIC. Heaven knows why... 

The good news is that it seems the spread in China was stopped by immunity as much as drastic government measures. So Italy (and then the rest of the world) should do fine even without tracing every case. 

Italy showing the same trend as Wuhan / China earlier: "The 1% drop in the rate of growth of total registered cases per day: 63%, 37%, 27%, 50%, 20%, 23%, 23%, 25%, 24%, 11%, 23%, 21%, 17%, 20%, 17%, 13%, 13%

Update March 13th. Now classes as a global pandemic. Containment no longer a goal, except in China where cases have dropped from 60k to 12k today. Worldwide reported number of people under treatment has jumped up to 59k from a previous dip to 39k. 

Public life has stopped in much of Europe until  March 30th Flights to US stopped for Europeans and Chinese. A palpable sense of panic also in stock markets.

Update March 9th it no longer looks like this Novel Coronavirus will be contained. Measures taken in the rest of the world have been much less vigorous than in China.

I believe the estimates I made on February 4th were wrong.

 Although active cases in China have dropped from 60k in China to less than 20k in that country today, worldwide cases are increasing again. At the beginning of March they dropped to 39k and are now up to 44k with the majority outside China. My estimate of 4k deaths (between 2k and 8k) and 200k sick now seems (much) too low.
Notes "herd immunity" is something that seems to be underestimated. "WorldWar Z it is not" Elon Musk, but the  Novel Coronavirus and reactions to it is a shock to the system.

Update February 27th active cases worldwide dropped to 46 551 yesterday.

February 26th number of sick worldwide yesterday dropped to 48 186. (81 004 - 32 818) This drop is not being widely reported or registered as far as I can tell. The numbers being reported does not include the number of people who have recovered.

24 februari number of sick worldwide decreasing quickly: Feb 23rd 79 554 minus 2 628 deaths minus 25 235 recovered is 51 691 sick.

Update Feb 19th. Spread a bit slower than I thought:

February 4th 2020:the percentage of growth is slowing. I guess the total infected will peak around 100k and not higher than 200k. Deaths between 2k and 8k. Peak in less than 4 weeks. (China)


Manuel said...

Thanks for the detail info!

Martin Spanjaard said...

Hi, do you have information about the incidence rate per age cohort, or something like that? And about the health state of patients in the intensive care before they ware hospitalized?


Martin Spanjaard

Ansgar John Brenninkmeijer said...

No I don't.

SYSCheck said...

These numbers might give additional statistics: