COVID19 Factors We Should Consider/Current Events

[bikesandcars]

A dude much smarter and more accomplished than everyone here put together talking in a language some people might understand and thus save themselves some needless panicking.

LOVE ray Dalio... this is one of my favorites: (" "):

[Mark Rippetoe]

To be clear, I don't give a shit who's right or wrong here, only what the facts are.

I'm not accusing you of agreeing with me. GOD no. I'm just grateful that I didn't have to read that other shit.

Appears they've apologized for the arrest (and it looks like the dad and daughter were part of a larger group playing a softball game).

Colorado Police Apologize to Man Arrested While Playing Tee-Ball With Daughter

The city apologized shortly after it happened. The apology is absolutely not the point.

[ltomo]

From a footnote from Table 1:



So it seems, from that particular document, that confirmed and presumed are in the same bucket.

And from the other document:



Here, "presumptive" means that a positive laboratory test was carried out, just not by the CDC.

Presumptive presumably means presumed, which, in the seven page guideline, has the opposite meaning (i.e. no laboratory test needed), and and gives the same definition to both "probable" and "presumed".




It seems there is some serious miscommunication between CDC and NCHS (National Centre for Health Statistics). A doctor following the NCHS guidelines will report a [highly suspected but not laboratory test confirmed] case as "presumed" or "probable". Which one she chooses is a matter of whether her morning bowel movement weighed an even number of grams or an odd number.


What am I missing here?

Thanks for the info. Seems like the issue isn't the guidelines as written, but how they're being interpretted and reported. That's also how I read the Minnesota and Montana doctors' complaints.

[Mark Rippetoe]

And for everybody except lazygun, third down, "Daily Counts":

COVID-19: Data - NYC Health

[Shiva Kaul]

spacediver, there is no issue (nor government conspiracy). Documentation of test results will typically be provided for something like U07.1. Even if it isn't, "presumptive positive" is a longstanding technical term (also used for other epidemics) and no one actually doing coding is going to accidentally write that down. Finally, "presumptive positive" is no longer even used for COVID-19, because the CDC has not required confirmation tests for a long time. If this seems abstruse to you, well, this is "coding".

If the government wanted to inflate numbers, they'd simply retain the original rule about uncertain diagnosis:

If the diagnosis documented at the time of discharge is qualified as “probable”, “suspected”, “likely”, “questionable”, “possible”, or “still to be ruled out”, or other similar terms indicating uncertainty, code the condition as if it existed or was established.

(This is rejected for COVID-19).

[spacediver]

The city apologized shortly after it happened. The apology is absolutely not the point.

Oh I know, I'm just saying that an apology suggests that there wasn't too much more to the original story than was reported (other than more people being involved than just one family).

Some people were suspecting that perhaps there was more to the story that would perhaps legitimate the cops' actions. I was one of those, and it turns out that there wasn't (i.e. the guy didn't physically threaten the cops, etc.)

[Mark Rippetoe]

If the government wanted to inflate numbers, they'd simply retain the original rule about uncertain diagnosis:

If the government wanted to inflate the numbers, they'd let the media do it for them: Coronavirus: One-day-old baby dies of Covid-19 complications in Louisiana, coroner says | The Independent

[spacediver]

spacediver, there is no issue (nor government conspiracy). Documentation of test results will typically be provided for something like U07.1. Even if it isn't, "presumptive positive" is a longstanding technical term (also used for other epidemics) and no one actually doing coding is going to accidentally write that down. Finally, "presumptive positive" is no longer even used for COVID-19, because the CDC has not required confirmation tests for a long time. If this seems abstruse to you, well, this is "coding".

If the government wanted to inflate numbers, they'd simply retain the original rule about uncertain diagnosis:

(This is rejected for COVID-19).

If presumed and presumptive positive have different meanings, then explain this:

Deaths with confirmed or presumed COVID-19, coded to ICD–10 code U07.1

And over here, they seem to be acknowledging that they over-estimate COVID deaths relative to "some local and state health departments":

Provisional death counts in this report will not match counts in other sources, such as media reports or numbers from county health departments. Death data, once received and processed by National Center for Health Statistics (NCHS), are tabulated by the state or jurisdiction in which the death occurred. Death counts are not tabulated by the decedent’s state of residence. COVID-19 deaths may also be classified or defined differently in various reporting and surveillance systems. Death counts in this report include laboratory confirmed COVID-19 deaths and clinically confirmed COVID-19 deaths. This includes deaths where COVID-19 is listed as a “presumed” or “probable” cause. Some local and state health departments only report laboratory-confirmed COVID deaths. This may partly account for differences between NCHS reported death counts and death counts reported in other sources.

And if that isn't clear enough, look at this:

Coronavirus disease deaths are identified using the ICD–10 code U07.1. Deaths are coded to U07.1 when coronavirus disease 2019 or COVID-19 are reported as a cause that contributed to death on the death certificate. These can include laboratory confirmed cases, as well as cases without laboratory confirmation. If the certifier suspects COVID-19 or determines it was likely (e.g., the circumstances were compelling within a reasonable degree of certainty), they can report COVID-19 as “probable” or “presumed” on the death certificate (5, 6).

Now, I think it's important to make intelligent estimates in the absence of confirmed laboratory tests (that's part of what makes the fluMOMO data valuable).

But there should be clear and consistent standards and terminology, and it looks to me that there is sloppiness here that compromises data integrity.

In short, there are two points here:

1) You're mistaken: deaths that are suspected as likely, but not laboratory confirmed, are indeed being coded as U07.1.
2) There is sloppiness in the consistency of communication/standards between CDC and NCHS, which is doubly fucked up considering the latter seems to be a subset of the former.

Again, I may have missed something. Correct me if I'm wrong.

[Shiva Kaul]

The provisional death count webpage still cites the old March 24th document, which indeed proposes to include "likely" cases in U07.1, and conflicts with the final implementation on April 1. The text on the page simply seems out of date. The page is obviously grappling with shifting definitions - U07.1 didn't even *exist* until mid March, so how are there U07.1 deaths tabulated before then? What I've been talking about, is how the reporting works from April 1st onwards.

U07.1 does not include "likely" cases - that is made clear in the ICD guideline. However, there is definitely remaining sloppiness in the NVSS webpage. I inquired about it, and I'll let you know what they say.

[Jovan Dragisic]

LOVE ray Dalio... this is one of my favorites:

Check out the new series he started on LinkedIn. Seems he’s just getting warmed up on this thing, it will probably prove to be the next big theoretical approach for the enlightened era that normal people will be living in a few decades from now.