USA Swine flu CFR surpasses .006 as deaths accelerate
Scott McPherson
8 Comments
In what is largely now an academic exercise, the CDC today released the latest swine flu statistics. As of the week ending July17th, US swine H1N1v cases climed to 40,617 with 263 deaths. The report can be found at: http://www.cdc.gov/h1n1flu/update.htm .
I have beaten the horse dead three times over with my CFR calculations, so all I will say is that the CFR is increasing, now to an aggregate .006475. This means that of every thousand confirmed or suspected cases reported to the CDC, 6 people died. At the end of June, the CFR was .0045. Of course, I agree that we are still talking about early and relatively small numbers. But the CFR has increased nonetheless, or has remained very consistent, however you might define it.
This weeks-long consistency places this pandemic at the top level of Category 2 status, and if you were to look at the pandemic over the past three weeks, you would conclude -- as you would if you looked at maximum sustained winds in a hurricane -- that this pandemic may have crossed the threshold into Category 3 status. May have crossed.
Category 3 is no small threshold to cross. It changes things. First, it means that we are looking at a much stronger pandemic than the media and the decision-makers would have you believe. Second, while the number of reported cases is declining (as the WHO declares swabbing should cease if only done for purposes of determining infection and not for collection of viral samples), the death toll is not also declining. The deaths attributable to swine H1N1v are accelerating. We had leveled off at around 40 m/l deaths a week, but now have seen a slight spike, to 52.
This may mean physicians and medical examiners are zeroing in more closely on the cause of death, and may now be more willing to test for H1N1v and certify that as a cause or enabler of death.
Anyway, in my blogsite over at computerworld.com, I am about to re-release my "For hurricanes and pandemics, plan one category higher" blog with swine flu references. It should be up by Monday. I would strongly encourage everyone reading this blog to prepare for a Category 3 pandemic. If you always prepare one measure of intensity higher than what may come, you'll never be a)surprised, b)unprepared, and c) short of necessaries.
One look at Argentina might convince you. Argentina (155) just passed Mexico as the nation with the second-highest number of deaths, and I strongly suspect that by the end of July, Argentina will have surpassed the United States in deaths. Keep in mind this is just the first wave, and we are still not seeing the ease of transmission of seasonal flu.
Yet.
Reader Comments (8)
You can't just divide confirmed deaths by confirmed cases anymore (even if you ever could) because the fact that the USA is only testing seriously ill people now will bias your CFR upwards. That would be more than enough to explain your observed increase to the .006475 value.
The testing numbers aren't great for estimating CFR rates for several other reasons including deaths lagging infections, bias towards detection of serious infections and higher quality health care for detected infections.
Barnaby,
Quite possibly. But as I mentioned in a previous post, the likelihood is quite high that early fatal cases of swine H1 were misdiagnosed. That would also serve to raise the CFR. Also, the Mexican CFR is roughly a full 1%, and that did take a lot of swabbing into account.
We may never know when this pandemic truly lifted off. Was it March, was it January, or was it even earlier?
With the global CFR now hovering at .0045, and with demonstrated attack rates among otherwise young, healthy adults and older schoolchildren with no previous "pre-existing health conditions," I would imagine that CFR globally is pretty defensible.
The American CFR was rising even before the USA was encouraged to stop swabbing everyone. That, in fact, is a relatively new request from WHO/CDC, and I believe we are still looking at a backlog of swabs and test results. The data is always a week old, anyway.
Let us all hope this virus is more moderate than these stats show. Thanks for your opinion! Please keep writing.
Scott
right now the world mortality rate is around 0.618 unofficially. argentina is over 5% and many others are over 3. honestly imo its gonna get worse before it gets better. this is only the first wave as you said and the north american seasonal flu isn't here yet.
Unofficially its already a full fledged category 3 pandemic. id like to see WHO's next update. it seems they a ton of cases but only a few deaths every update to keep the panic down.
Unofficially there are
135K cases and 860 deaths
According to WHO there are
almost 100K cases but only 429 deaths
WHO hasn't updated in about a month.
on my previous post i meant to say northern hemisphere not north america.
more people live in the nothern hemisphere than southern so the northern hemisphere winter will be worse than the southern in regards of swine flu
Thanks Scott for your website.
This is the most honest site I have seen on H1N1.
I just wanted to add a link that shows what we know of the CFR in 1918/1919.
http://upload.wikimedia.org/wikipedia/commons/9/9a/1918_spanish_flu_waves.gif
Currently we are running at twice the CFR of the 1918 Pandemic or the first wave for H1N1 is lagging by a month and will be worse if the numbers keep climbing.
This is something everyone needs to really prepare for.
Thanks again.
Scott,
Maybe you can figure this out.
http://www.breitbart.com/article.php?id=upi20090724-101002-6075&show_article=1
"THE ECDC FOCUSES ON THE 31 COUNTRIES THAT MAKE UP THE EUROPEAN UNION AND THE EUROPEAN FREE TRADE ASSOCIATION (EFTA).AS OF THURSDAY, IT HAD RECORDED 19,404 TOTAL CASES IN 30 OF THOSE COUNTRIES, WITH 35 DEATHS.OF THOSE COUNTRIES, BRITAIN CONTINUES TO HAVE THE MOST CASES, AT 11,159, WITH 510 DEATHS.NEXT CAME GERMANY, WITH 2,455 CASES AND 637 DEATHS."
Wow, is that right?! Germany has a CFR of 200+ people per 1000?
Cindy,
Thanks for bringing this story to my attention. I believe the numbers are wrong and the reporter should recheck his math. If there are only 868 deaths worldwide, there cannot be suddenly 510 dead in Britain and 637 deaths in Germany. The CFR in
Germany would be Ebola-like and there would be absolute panic in the streets. Ditto Britain.
Now 63 German deaths would make a CFR of .002, which sounds a little more like it. Britain only reported 29 deaths as of last week, so even a doubling would bring them well under 100. So I think someone hit a few random numeric keys and caused a lot of calamity.
Those numbers -- 510 British and 637 German - could refer to hospitalizations or severe cases. But definitely not deaths.
Thanks!
Scott