Apples to oranges. Can not compare Italy with Germany.
Germans are willingly being tested, there process, order, proactive testing. In Italy everyone is 1) quarantined for the past 2 weeks and 2) didn’t even give a crap about this prior to the quarantine.
Italy is triaging, out of hospital space, vastly over estimating numbers, and probably using models with some accuracy to report their numbers. Unless someone can PROVE this otherwise.
Their death rate is what it is due to a very elderly population, with 2 or more co-morbidities, in understaffed and overwhelmed hospitals full of chaos, and infection.
Roche’s Cobas 8800 can do roughly ~4100 tests per day and this is a massive full-room setup.
Many other RT-PCR capable machines exist out there (800 is the total number in Europe cumulative) but this assumes an efficient point-of test > courier > lab > results process which many countries simply lack.
However, this assumes the current surge deaths are 100% SARS-Cov2 confirmed infections.
They aren’t. At least not 100%
Assumption can be made “atypical, bad flu season” but safer bet is on “newly discovered virus out of China that did x and y and z damage over there.”
While both theories are just that, theories. There is no empirical data which PROVES x-cases and y-surge is directly related to a confirmed SARS-Cov2 pathogen confirmed by RT-PCR and antibody test.
The Italian data is wrong period. Why or how is another debate.
Italians are most likely counting most if not all deaths as SARS-Cov2 deaths.
1) A large amount of the elderly are going to hospitals because of pre-existing conditions that might be flaring up or presenting as they normally do. They enter the clinic > get complications > get marked down as dying from SARS-Cov2. And/or they acquire hospital acquired pneumonia (HAP).
2) I’ve read the ISS report cover to cover and yes, nearly ALL deaths are due to 1) age greater than 70, 2) 75% showing 2 (two) or more per-existing conditions with a staggering 99% showing 1 (one) or more pre-existing conditions. Let’s not forget the above comment (HAP or other hospital acquired infections from SARS-Cov2, Influenza, whatever).
3) Seeing a death count YOY would be beneficial here indeed.
I don’t think ANYBODY will be able to answer my initial question here.
There is NO WAY in hell the Italians have tested over 200,000 patients for SARS-Cov2 in a matter of 2-3 weeks due to:
1) such capacity simply does not exist
2) Italians have been under quarantine and when they weren’t they were drinking coffee and not lining up for tests.
3) the time of test > result trajectory > reported data is impossible
4) such high throughout testing capacity simply does not exist
So 200,000+ people under mandatory lockdown went to a clinic (not a drive through test, a physical clinic), lined up and waited to get tested for Influenza which was assumed to be SARS-Cov2?
Or maybe Italy tested 200,000+ samples with RT-PCR technology with machines and labs and tests / swabs they don’t have?
Not trying at all to spin conspiracy theories here but these numbers simply do not add up.
As a corollary: there are a myriad of infections that can present as fever and cough: rhinoviruses, influenza, bronchial infections, gastroenteritis, auto immune flare ups, sinusitis and season allergies, the list goes on.
Right. One issue we’re having globally is that we simply cannot get an accurate fatality rate.
We’re only seeing the sickest, most critical patients and the most overwhelmed hospital systems in cities.
I think MOST patients being tested in hotspots like Lombardy are those who are already at the hospital, and if you’re at the hospital you’re not in good shape.
Probably tons of positive cases at home with a fever, or mild symptoms or no symptoms.
And of course, tons of people who are not tested and probably never will be. Totally asymptomatic.
We can’t get an accurate fatality rate without these “infected but asymptomatic” cases.
Didn’t an Italian doctor do a small study showing 98% asymptomatic positive cases?
I wonder if intubating these patients is actually killing them. I have ZERO evidence but is there an off chance they’re actually treating them incorrectly?
There’s the cytokine storm problem although I just wonder, for some weird and maybe even wrong reason, that the standard of care, the protocol for this particular viral infection is not intubation for most?
If you look at a video of the ICU or ward in Lombardy, everyone is either intimated or negative pressure oxygen. Yes, their Sp02 levels are bad and they have breathing difficulties. So I get why they are following standard protocol - but I just wonder if this particular infection, at its peak, requires a different approach.
There’s truth to this and perhaps I jumped to an invalid American based assumption, stupid given that I’m European.
In Europe, the elderly are out and about, walking, sitting at parks, drinking coffee, the works. They’re actually still doing this as we speak in countries, from what friends and family tell me. Go figure.
However, even if they are in cafes, grocery stores, parks - the numbers are still very high.
This virus is either incredibly efficient and contagious (spread by totally asymptotic carrier pigeon patients > elderly) and/or it’s been there for a long time. Months.
Probably tens of thousands of undiagnosed, asymptomatic.
Aka super carriers.
The virus is smart and has evolved from an evolutionary standpoint. Infect younger and asymptomatic patients with the goal of spreading and infecting as many as possible. Eventually, the more infected, the more that will die. The young are just carrier pigeons and don’t even know it.
- Mean age of 79.5 sheds light on Italy’s extremely high fatality rates; in essence, it’s the (very) elderly that are dying due to complications from viral pneumonia. Which begs the next question...
Why are they overwhelmingly treating patients with antibiotics in cases of viral pneumonia and not antivirals (Remdesivir)/ chloroquine?
Sure, these are “experimental” therapies but decent data out of China/South Korea shows these therapies work. Perhaps they found out too late?
- The younger fatalities (17) show multiple, serious co-morbidities and smoking is not listed; an assumption can be made a fair amount of these younger patients smoke. But again, an assumption.
- Almost 50% of patients showed 3 or more co-morbidities - this is high and important to note. 25% of patients showed 2 co-morbidities. Roughly 75% of patients had 2 or more co-morbidities (!).
- Sample size (2003) is good given their current 3,500 fatality numbers.
Not a medical doctor but a few things I’m struggling to figure out:
- How did so many elderly get infected? Did the disease simply spread in close quarters where many elderly live? Elderly folks aren’t necessarily out and about drinking espresso and touching surfaces yet alone having younger asymptomatic carriers cough on them.
I wonder if Italy is similar to a Kirkland, Washington situation. High density of elderly folks spreading infection.
It’s obvious that SARS-Cov-2 is highly, highly contagious but it’s interesting how we’re seeing these somewhat “bomb” explosions of infection: Wuhan > Daegu > Kirkland > Lombardy > NYC next.
Sure, quarantine works but the rate of new infection stays rather localized and then just annihilates everyone around it.
Perhaps it’s a viral load issue; viral load increases exponentially the more we have infected. Why you see doctors and nurses infected / critical and dying even with full PPE.
Let’s hope the Italians figure out a way to get this curve to fall of ASAP. Hoping they have a similar effect to Wuhan’s curve and just drop down rather than flatten.
Italy is counting ALL deaths as Covid deaths.
Their Covid numbers are simply incorrect.