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University of Washington COVID-19 fatality prediction for Alaska

Grim but in these times encouraging news is coming out of the University of Washington (UW) where a respected scientist has modeled a national death toll of 81,114 people from the COVID-19 pandemic.

The UW website offering state-by-state breakdowns predicts 154 of those deaths will come in Alaska.

If the prediction for 2020 proves accurate, it would put COVID-19 as Alaska’s seventh leading cause of death, just behind suicide.

Cancer is now the state’s top killer. It claimed the lives of 995 Alaskans in 2017, the last year for which complete data is available, according to the Centers for Disease Control (CDC).

Cardiovascular disease, a largely preventable condition, was closed behind with 831 deaths, and accidents killed 431. Chronic lower respiratory disease and stroke each were slightly more deadly than suicide, which left 193 dead.

The number of deaths in the study conducted by Dr. Christopher Murray, the director of the Institute for Health Metrics and Evaluation (IHME) at UW, are orders of magnitude lower than the numbers some have bandied about.

 Over a million dead?

The coronavirus may be deadlier than the 1918 flu,” CNBC headlined Thursday. It based the report on a global mortality rate of 4.5 percent for those hospitalized with COVID-19.

The Spanish flu of 1918 killed approximately 675,000 people in the U.S., according the CDC. It hit especially hard in Western Alaska where some villages were devastated.

In the state’s northern district, the Spanish flu killed 854 of 7,899 residents – or more than 10 percent – in 1918, according to the Alaska Health and Social Services data.

Flu deaths elsewhere in Alaska varied from a fraction of a percent in the Interior where only three of 9,585 residents were reported to have died to 3 percent along the Gulf Coast to 3.5 percent in Southeast.

“The 1918 flu, which was known as the Spanish flu, didn’t actually originate in Spain,” CNBC’s Berkeley Lovelace Jr. wrote. “It had a mortality rate of 2.5 percent and killed more people — 30 million to 50 million — than the 20 million who died in World War I. If the 4.5 mortality mortality rate of COVID-19 drops, it won’t be as bad as the 1918 flu. If it continues on its current trajectory, it will be almost twice as deadly.”

Twice as many would put U.S. deaths at about 1.35 million – more than 16 times Murray’s prediction.

help blurb

Confusion

The mortality rate for COVID-19 is actually unknown. The 4.5 percent cited by Lovelace is the case fatality rate (CFR), which records the number of people who died after being diagnosed with the disease. That number is now biased by the fact that in many cases only people who show severe signs and symptoms of  are being tested because of limited testing capabilities.

Actual mortality calculations depend on the infection fatality rate, and epidemiologists are having a devil of a time wrestling with how to calculate that.

They know many people who are infected with COVID-19 suffer no symptoms or very mild systems, but they don’t know how many of these people exist because of a lack of testing.

A study of the passengers aboard the COVID-19 swept Diamond Princess cruise ship found that more than half the people infected never showed symptoms, but the virus proved deadly for six.

The CFR onboard the luxury line was approximately 2 percent, but the IFR dropped below 1 percent.

The Centre for Evidence-Based Medicine at Oxford University on Saturday reported that Iceland is now broadly testing. Give the “higher rates of testing, the smaller population, and their ability to ascertain all those with Sars-CoV-2  means they will likely provide an accurate estimate of the CFR and the IFR, the Centre reported. “Current data from Iceland suggests their IFR is somewhere between 0.01 percent and 0.19 percent.”

Creative modeling

Murray got around the issue of CFR versus IFR numbers by simply ignoring them and developing his own metric.

Using the “exponential growth in the cumulative death rate seen in
Wuhan (China) after Level 4 social distancing was implemented, adjusted for the median time from incidence to death,” he constructed a bell curve to document the progressive number of deaths to be expected in the U.S. as the infection spreads and the expected decline as it fades.

Almost every interaction of life and death in nature graphs as a bell curve or what is otherwise known as a Gaussian distribution of probability. Medical authorities all agree COVID-19 will follow a bell curve as it starts slowly, builds to its peak and then declines.

Alaska, like some other states, is now witnessing the building period. The state suffered its first in-state death today.

Murray’s model predicts U.S. death rates will peak around the second week of April. The model is intended to help guide hospitals in their preparations for how to deal with the evolving pandemic.

“Demand for health services rapidly increases in the last week of March and first two weeks of April and then slowly declines through the rest of April and May, with demand continuing well into June,” Murray writes. “The shape of the curve reflects both the epidemic curves within each state and the staggered nature of the epidemic around the country. Daily deaths in the mean forecast exceed 2,300 by the second week of April.”

The study predicts that the demand for hospital beds – especially beds in intensive care units (ICUs) – will exceed the supply sometime in early April, and ventilators – the machines that can help people breath by forcing oxygen into their lungs – could be in short supply.

“We have not been able to estimate current ventilator capacity; however, the number of ventilators implied by the peak, 19,481, also suggests potentially large gaps in availability of ventilators,” Murray wrote.

A hospital bed shortage is likely to be “particularly high in states such as New York, New Jersey, Connecticut, and Michigan,” his study concludes, while a shortage of “ICU beds is more of an issue across all states and is highest in the same set of states listed above as well as Louisiana, Missouri, Nevada, Vermont and Massachusetts.”

Alaska is forecast to have a surplus of hospital beds, but to come up 24 beds short in state ICUs and 42 ventilators shy of demand.

Social distancing

Though the numbers sound precise, Murray admits the path of the pandemic is hard to predict and largely dependent on people maintaining “social distancing” – basically staying far enough away from each other that a virus can’t jump from one person to another.

Who to stay away from in this case is almost everyone given what appear to be large numbers of people infected by COVID-19, but showing no or little sign of infection. The virus has also been shown to have a long life on cardboard, plastic and stainless steel, meaning objects touched by a COVID-19 infected individual could be passed along by those means.

Thus the warnings that have been regularly issued to periodically wipe your hands with a sanitizer or wash them with warm, soapy water, and to avoid touching your eyes, nose and mouth at all times.

Murray concedes the accuracy of his forecast will depend to a considerable degree on how Americans respond to these recommendations on self protection.

He forecast that all 50 states will within a week have implemented at least three of four formal, social-distancing measures – “school closures, closing non-essential services, shelter-in-place and major travel restrictions.”

Alaska enacted the fourth of those on Friday when Gov. Mike Dunleavy ordered “all in-state travel between communities, whether resident, worker, or visitor, is prohibited unless travel is to support critical infrastructure; or for critical personal needs.”The ban runs through April 11, but could be extended.

Murray projected that implementing three of the four measures will be “enough to follow a trajectory similar to Wuhan, but it is plausible that it requires all four measures. As more data accumulate, especially on the timing of deceleration of daily deaths, we may be able to empirically test which of these measures is more correlated with slowing the epidemic curve and reducing the ultimate death toll.”

Slowing the curve – or flattening the curve as many have put it – is intended to lower the burden on hospitals, allowing for better treatment of the minority of people whose lives are threatened by the disease. That is expected to bring down the death rate.

COVID-19 has proven especially deadly to those over age 60 and those with pre-existing medical conditions. Among the hospitalized, the disease kills almost 15 percent age 80 or older and 10.5 percent already suffering from cardiovascular disease.

Murray admitted no one knows how well Americans will adhere to “social
distancing mandates; it will take time to evaluate whether social distancing adherence is fundamentally different in the US compared to Wuhan.”

Not a vacation

Concerns have been raised about Americans treating too much like a holiday the  widespread economic shutdown caused by COVID-19.

Ricky Gease, the director of Alaska State Parks and Outdoor Recreation, Friday said that Chugach State Park, a half-million-acre wilderness reserve that sits hard against Alaska’s largest city, has seen a surge in activity since non-essential services were ordered stopped, leaving thousands who would have been going to work looking for something else to do.

The agency was Friday pleading with people to keep their distance from each other.

“As Alaska maneuvers through this pandemic, it is crucial for our mental and physical health to be able to get outside and get fresh air,” an agency statement said, “but social distancing is essential, even in the fresh air.”

The statement suggested that if people refuse to maintain social-distancing standards and cooperate in maintaining clean restrooms, park trailheads could be closed:

“Please help us keep our parks open by following strict social distancing guidelines:

  • “Maintain six feet of distance between you and others at all times
  • “If you feel sick AT ALL– stay at home
  • “Bring your own sanitizers for the restrooms and wipe down surfaces before and after use
  • “If parking lots are full, go to a different location.”

Outdoor recreation has become an issue in some Lower 48 states with some contending it is irresponsible to engage in outdoor activities that might result in injuries leading to a need for medical personnel to be diverted to rescue operations or lead to a recreationist taking up a bed in an already overworked hospital.

“Healthcare workers are begging people to stay home and avoid unnecessary risk that may put more strain on an already over-saturated system. Yet my Instagram feed is flooded with skiers ticking off dream lines and hitting massive jumps all in the name of social distancing,” John Howland wrote at Powder magazine, where he chastised others for their social media posts.

“You’re telling people who have little experience managing risk, to get off their couch, go outside, make an extra stop at the gas station or the grocery store, and get after it. We don’t need this right now. Our health care workers don’t need this right now.”

Without social media, the TV those couch potatoes are watching would only be telling them to go to the liquor store to buy beer and the grocery store to buy snacks.

Update and correction: This story was updated from the original on March 28 to include information on the infection fatality rate (IFR) in Iceland and correct a misleading definition of case fatality rate (CFR).

 

 

 

 

25 replies »

  1. I love is listening to all these govenors say – “I am not listening to President Trump, I am listening to the scientists”. Yet, they are the first to go against science and tell you there are more then 2 genders. Can these hypocrites get anymore hypocritical?

  2. I was just told that commercial fishing was deemed an essential activity after some kind to teleconference with lots of stakeholders on the line. Look at the processor’s staff housing in Cordova and Naknek. No disease transmission possible in those places! And SO many hospital beds.

  3. Might not be too long, they almost have all their extra money they wanted. Then again if it’s biological warfare, or the Great Experiment it might be a little longer.

    Isn’t this distancing thing really just a feel good gesture. I went to the store the other day to pick up some groceries for some elders, so they would keep exposure to a minimum just in case. Now think, the products that I threw in the cart could of been touched by someone that has the virus. Then the cashier scans it and puts it all into plastic bags after of course handling money, bags, and other products from several people all day. I drive out and drop off the groceries for them to take inside their home. With the virus living on surfaces so long, while a good deed I did, I could of easily introduced the virus into their home.

    Keeping new people from coming into the state might be more productive, but if it’s here, it’s moving around fairly easily. Honestly, with all the up roar happening, and the surface life expectancy of this virus wouldn’t you at least expect to see way more numbers. I mean how many months has it been so far. I’m not saying it’s something you want to go out and catch, because being sick sucks, but you have to ask yourself or them “What the Hell”….

    • “Currently there is no evidence of food or food packaging being associated with transmission of COVID-19. It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads. CDC notes that in general, because of poor survivability of these coronaviruses on surfaces, there is likely very low risk of spread from food products or packaging that are shipped over a period of days or weeks at ambient, refrigerated, or frozen temperatures. It is more likely that a person will be exposed by person-to-person transmission involving close contact with someone who is ill or shedding the virus.”
      https://www.fda.gov/food/food-safety-during-emergencies/food-safety-and-coronavirus-disease-2019-covid-19

    • Zip, sorta agree with you. Sooner or later people are going to have to live life, get back to work and return to “normal”. It is what it is. Like the flu, Corona will be spread around to a large portion of the population. Then what? Can we stall it long enough to get a vaccine and not destroy the country? Doubtful. People will die like they do every year.
      But one thing is certain, the “squeaky wheel gets the oil” and the states will reep billion in taxpayer stimulous money to fill their coffers. All the while blaming Trump with their hands out.

  4. THIS IS WAR and we aren’t near the end. We have to deal with stores as virus transmission epicenters. If covid 19 has 1% mortality rate. 154 deaths would only be 15400 infections. Until we get mass testing treat everyone as if they having it. Keep calm and carry on.

  5. Nobody got excited when an estimated 80,000 Americans died of flu and its complications last winter(2017-2018), according to the US Centers for Disease Control and Prevention. This means it was the deadliest season in more than four decades — since 1976, the date of the first published paper reporting total seasonal flu deaths, said CDC Spokeswoman Kristen Nordlund.
    In previous seasons, flu-related deaths have ranged from a low of about 12,000 during the 2011-2012 season to a high of about 56,000 during the 2012-2013.

    I still say more people will go bankrupt than die of Corona flu.

  6. This is not the Spanish Flu.
    Not even close.
    The Spanish Flu killed 2.6 million Europeans.
    Coronavirus has killed 16,000 Euros.
    Pushing the martial law agenda in Alaska will not work.
    Americans have fought too hard from freedom of fascist regimes to sit quietly inside after one of the hardest winters in years.
    The average flu has sickened 50 million people with as many as 62,000 deaths.
    7,000 people die each day across the country (from various medical causes) yet the media focuses on one or two seniors who are dying from COVID 19.
    This is a challenge for all Americans (especially in the private sector) to stand up for our economy and our future.
    The MSM has taken the panic approach from day one and it is not helping anyone.

    • Jeff,
      I believe if you contact the Recall Dunleavy campaign online they will now send you a petition to your house to sign.
      Yes, the recall effort is still moving forward during these challenging times.

  7. Good one. No one knows where the IFR and CFR will settle out. Less than 1/2 of a percent is being tossed around now. We may never know how many asymptomatics are in the population. Is all of this worth the pain?
    Wonder how the influx of fishery folks will be handled. About 5 weeks for Cordova and 10 for Bristol Bay.

  8. Also, keep in mind it is an election year and we have seen more Democrat hoaxes than Pelosi jas Botox (Russian Gate, Ukranian Gate, Supreme’s Gate, etc..). Those screaming we are all going to die the loudest are going to try to run for president. Cuomo of NY will replace Biden and Michigan Gov. Gretchen Whitmer is trying to be his female VP. Amazing really how slimy all these people are. Democrats.. Never let a good crisis go to waste. Believe 1/3 of the crap, if that, that you read.

    • The village idiot speaks. Again then again, then again. You are using up oxygen that could be better utilised.

      • Sorry Monk, I do get carried away during times like this..But, I am having a hard time figuring out which part of my statement you disagree with? The infamois “never let a good crisis go to waste” statement, Dems will float someone other than “Lunch bucket” Joe, Pelosi has more Botox than Dolly has silicone, Dems and their hoaxes, or Dems would love for the economy to be destroyed and in turn blame Trump? So, if you are offended this “village idiots” apologizes.

  9. Dr. Deborah Birx on Thursday provided encouraging coronavirus numbers suggesting that some of the predictive models were incorrect.

    “There’s no model right now, no reality on the ground, where we can see that 60-70 percent of Americans are going to get infected in the next 10-12 weeks,” she said.

    Without specifically naming the Imperial College, Brix referred to models that predicted there could be 500,000 coronavirus deaths in the United Kingdom and 2.2 million deaths in the United States.

    The scientist of the model revised the estimate of deaths in the United Kingdom to be roughly 20,000 people or fewer.

    Birx said that the actual data coming in from other countries were different than some of the direst projections.

    She noted that in major countries, there was never an attack rate of over one in over 1,000 people.

    “The predictions of the models don’t match the reality on the ground on either China, South Korea, or Italy,” she said.

    Birx also addressed reports that raised the alarm of New York City hospitals running out of ICU beds, ventilators, and creating “Do Not Resuscitate” (DNR) policies for patients.

    She revealed that she spoke with health officials in New York, that there were still ICU beds and 1000-2000 ventilators available, and that there were no DNR policies enacted.

    • Depending on which numbers you are interested in, the Imperial College models are off by a factor of 4 – 20 high. And those models are the ones the hair-raising predictions of illness and death are based upon. Models generally suck. Keep that in mind the next time you listen to a climatista prediction of doom.

      Another bit of news courtesy Mike Cernovitch yesterday evening. Northern Italy has a history of a high death rate during flu season. This is something that helps explain their high death rate during Wuhan.

      Fallout from this applicable here in ANC should include the following:

      – Plastic bag ban should be toast. It will take a while.
      – Mass transit should be dead. Completely dead.
      – High density housing should likewise be dead, as should zoning changes to encourage it (Project 21).
      – Coddling the homeless should also be dead.
      – We can now make a good case for both the Knik Arm & Turnagain Arm bridges so as to spread out ANC residents a bit (or even a lot).

      Things we don’t know from the Muni (Ethan and his Assembly);

      – How many infections have taken place on the People Mover? There is some discussion that the NYC subway system was complicit in spreading Wuhan in NYC.
      – How many infections are in the homeless population?
      – What is happening to those who work in the Great Petri Dish for homeless that used to be called the Sullivan and Ben Boeke? Do they go home after work or do they stay in semi-isolation after work?

      There should be serious analysis of why the hotspots in Seattle, NYC and now New Orleans came to be. Figure that out and take real, serious steps to keep that from happening. I suspect the New Orleans outbreak is entirely related to the city leadership decision not to cnx Mardi Gras.

      We’re gonna be busy after this. And we’re gonna need a bunch of new politicians. Cheers –

      • March 3
        Mayor De Blassio: During a press availability, the NYC mayor declared, “So again, want to come back to this point, occasional contact, glancing contact, temporary contact, it does not, from everything we know about coronavirus, lead to transmission. It needs to be prolonged, you know, if not intimate, at least prolonged, constant contact.”

        March 4
        Medical investigators found nine new cases in New York, including “the Westchester man’s wife; his son, a 20-year-old college student in Manhattan; his daughter, 14; and a neighbor who drove the man to the hospital.”

        Health Commissioner Bardot tells reporters, “There’s no indication that being in a car, being in the subways with someone who’s potentially sick is a risk factor, because, again, it goes back to the issue of casual contact.”

      • The Imperial College model-Does that assume no intervention? Because it appears we are comparing apples and tourmaline. Perhaps Alaska should seal its borders and just let it rip and see if the predictions of >10,000 deaths is correct or not? Or better yet those who think its all bs should go get it and let us know how it goes? What’s a little fluid in your lungs between friends.
        Here is my prediction-The USA will take actions like Italy
        and we will keep deaths down and then we will say, see it was overblown and never a real concern. beautiful

      • ag,
        Bridges,thats a good one.Wonder what that would do to Anc property values, and of course property taxes.Since those fine residents would no longer be Anc residents.They’d be KPB or MSB residents.
        And of course who or how will someone pay for either multi $ Billion project.We cant even cobble together funding for the Port.

      • I don’t care what the bridges will do to ANC property values. I care that ANC residents aren’t forced to live elbow to elbow like those in SEA and NYC. How’s that working out for them these days? If the choice is a bit more space to live, I choose that.

        Remember that Ted had funding for Knik Arm already in AK, but Sarah in a remarkable display of self-serving hubris, chose to spend it elsewhere. Both bridges will be funded, likely by the feds.

        Remember that we had enough money to fix the port, but screwed it up both times. Cheers –

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