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US deaths pass 1000?? Huh?

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Veritas View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Veritas Quote  Post ReplyReply Direct Link To This Post Topic: US deaths pass 1000?? Huh?
    Posted: October 23 2009 at 11:35pm
According to MSNBC today, Oct23.09, the H1N1 body count in the US is “more than 1000.”
http://www.msnbc.msn.com/id/33449637/ns/health-cold_and_flu/

And here’s a headline from AP today: “US Swine Flu Deaths Surpass 1,000"
http://www.huffingtonpost.com/2009/10/23/us-swine-flu-deaths-surpa_n_332360.html

Where do these people get these numbers?? US surpassed 1000 deaths 5 weeks ago.

Today CDC reports death figures of 411 lab-confirmed and 2416 syndrome-based. To that you have to add the 593 they dropped on Aug30.09 when they reset the counter. Total = 3420. If you do the math, there were 506 new deaths reported by CDC for Wk 41. This weekly number has been pretty consistent for 5 weeks – average 493, range 405-572.

So the real body count to date is likely near 4000 because CDC reports a week behind.

Ok, Ok, 4000 really IS more than 1000, so they are technically right. But why would any reporter report more than 4x fewer deaths than actual?

1) Too lazy to get the right numbers, 2) Intentionally low-balling the numbers, or 3) ??...

The weekly death rate has plateau’d for the last 5 weeks. The fatality figures do not reflect the sharp rise in other indicators over this period, probably because 1) death comes after fever, etc. and 2) deaths likely take longer to report, so the fatality numbers will always lag other metrics.

BTW, could somebody look at that pediatric bar graph for Week 41 and tell me what these ding-dongs at the CDC are up to now.

You’ve got the top yellow part of the bar, which corresponds to “2009 Influenza A (H1N1) Deaths reported Current Week.” That’s OK.

But under that you’ve got a purple bar – “2009 Influenza A (H1N1) Deaths reported Previous Week.”

So, how did someone report in Week 40 pediatric deaths for Week 41?

Then you’ve got the blue bar at the bottom. In the past it has been used to show deaths during past weeks reported in the present week.

Looks like the bar for Wk 41, which should be all yellow, has been deleted.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote IslandCrow Quote  Post ReplyReply Direct Link To This Post Posted: October 24 2009 at 1:53am
My guess is that they are just counting the 'lab-confirmed' cases.

  593 + 411 = 1 004 Clap

My guess is that the truth lies somewhere between that figure and yours Veritas, because not all pneumonia deaths are flu related.  My MIL died a will ago from pneumonia, but that was just her body giving out after been bedridden for almost a year, it was not due to flu. 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote BabyGirl Quote  Post ReplyReply Direct Link To This Post Posted: October 24 2009 at 4:10am
2) Intentionally low-balling the numbers

has my vote
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Post Options Post Options   Thanks (0) Thanks(0)   Quote ymca Quote  Post ReplyReply Direct Link To This Post Posted: October 24 2009 at 4:50am
Originally posted by BabyGirl BabyGirl wrote:

2) Intentionally low-balling the numbers

has my vote


I second this. BTW, the newspaper confirmed flu deaths is 1230+ now
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Post Options Post Options   Thanks (0) Thanks(0)   Quote RoRo Quote  Post ReplyReply Direct Link To This Post Posted: October 24 2009 at 5:24am
Originally posted by IslandCrow IslandCrow wrote:

My guess is that they are just counting the 'lab-confirmed' cases.

  593 + 411 = 1 004 Clap

My guess is that the truth lies somewhere between that figure and yours Veritas, because not all pneumonia deaths are flu related.  My MIL died a will ago from pneumonia, but that was just her body giving out after been bedridden for almost a year, it was not due to flu. 
 
1. The weekly situation report DOES NOT report all P&I deaths for the US. The weekly Morbidity and Mortality reports located;
give the absolute # of P&I deaths in 122 selected cities in the US, that # last week was 684. The MMWR reports from around 30% of the population, but several cities failed to report last week, so this number represents P&I deaths in around a quarter of the population. Extrapolation gives a national P&I fatality number of around 2,700. Of this 2,700 the CDC has determined that 506 are flu related. That is the number that gets reported in the weekly update.
 
2. From August 30 to October 17 there were 411 confirmed and 2,416 probable deaths.
Prior to August 30 there were 593 confirmed, but CDC did not track probables. 411:2416 isabout 1:6. If we were to apply this same ratio to the pre August 30 confirmed fatalities, that suggests 3,000 additional probable fatalities prior to Aug 30.
 
Put all that together for a true estimate of the number of fatalities resulting from H1N1 : 411 + 2416 + 593 + 3000 = 6420.
 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote ymca Quote  Post ReplyReply Direct Link To This Post Posted: October 24 2009 at 5:28am
Originally posted by RoRo RoRo wrote:

Originally posted by IslandCrow IslandCrow wrote:

My guess is that they are just counting the 'lab-confirmed' cases.

  593 + 411 = 1 004 Clap

My guess is that the truth lies somewhere between that figure and yours Veritas, because not all pneumonia deaths are flu related.  My MIL died a will ago from pneumonia, but that was just her body giving out after been bedridden for almost a year, it was not due to flu. 
 
1. The weekly situation report DOES NOT report all P&I deaths for the US. The weekly Morbidity and Mortality reports located;
give the absolute # of P&I deaths in 122 selected cities in the US, that # last week was 684. The MMWR reports from around 30% of the population, but several cities failed to report last week, so this number represents P&I deaths in around a quarter of the population. Extrapolation gives a national P&I fatality number of around 2,700. Of this 2,700 the CDC has determined that 506 are flu related. That is the number that gets reported in the weekly update.
 
2. From August 30 to October 17 there were 411 confirmed and 2,416 probable deaths.
Prior to August 30 there were 593 confirmed, but CDC did not track probables. 411:2416 isabout 1:6. If we were to apply this same ratio to the pre August 30 confirmed fatalities, that suggests 3,000 additional probable fatalities prior to Aug 30.
 
Put all that together for a true estimate of the number of fatalities resulting from H1N1 : 411 + 2416 + 593 + 3000 = 6420.
 


Good JobClapClapClap
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Veritas Quote  Post ReplyReply Direct Link To This Post Posted: October 24 2009 at 8:28am
Sorry, RoRo, although you seem to have some of the best numbers going, I’m having more trouble following you than the CDC.

Confusion #1
“From August 30 to October 17 there were 411 confirmed and 2,416 probable deaths.”

These deaths weren’t “probable,” they were real, especially for the families. The diagnosis was what the CDC calls “symptomatic” or “syndromic-based,” which means not lab-confirmed. I think that’s what you mean by “probable deaths.”

Confusion #2
I don’t see how you connect the data on Table III of the MMWR to the mortality data on the weekly flu report. For week 41, MMWR has 684 and the flu weekly has 411 lab confirmed + 2416 syndrome-based = 2827. What connection do you see between the 684 and the 2827?

It appears that the weekly flu report is not limited to the 122 reporting sites that the MMWR is, but if you or someone else can point out where the CDC says otherwise, please do.

Clearly, the pediatric deaths are nationwide, not restricted to reporting sites.   

Confusion #3
“Prior to August 30 there were 593 confirmed, but CDC did not track probables. 411:2416 isabout 1:6. If we were to apply this same ratio to the pre August 30 confirmed fatalities, that suggests 3,000 additional probable fatalities prior to Aug 30.”

No, no, no – not close. In the early stages CDC did not distinguish between lab-confirmed and non lab-confirmed because they were lab-confirming virtually every suspicious death. Now they don’t confirm every death because they couldn’t keep up with 500 per week.

So you can’t take a ratio from Wk 41 and go back with it to the “early days” and say “Aha, there were really 3000 deaths, we gotta’ add those, too!!” No, no, no.   That would be like taking the ratio of hybrid to gas cars today and multiplying the ratio times the number of gas cars in 1960 to conclude there were millions of hybrids in 1960.

IslandCrow
Sure can’t argue with you that 593 + 411 = 1004, and that looks suspiciously like the 1000 number the media are latching on to.

But my guess is that no reporter has followed this thing closely enough to even realize that 593 figure is out there or what it means. Maybe the CDC is feeding them the total figure based on your calculation, which would only confirm what dolts they are.

I can’t agree with your argument that the current death figures include significant non-viral pneumonia deaths. Maybe in two months you’ll have a point. But if you look at the historic data and what the CDC has been saying all along, at this time of year anything that looks like a duck, walks like a duck, and quacks is H1N1. Or should I say, looks like a pig, walks like a pig, and oinks.

But it’s not strictly an either/or situation. In 1918, 80% of the “Spanish flu” deaths were actually due to bacterial pneumonia secondary to the flu, which should give us cause for hope because bacterial pneumonia is more easily controlled with antibiotics, which weren’t available in 1918.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote RoRo Quote  Post ReplyReply Direct Link To This Post Posted: October 24 2009 at 9:15am
Originally posted by Veritas Veritas wrote:


Confusion #1
“From August 30 to October 17 there were 411 confirmed and 2,416 probable deaths.”

These deaths weren’t “probable,” they were real, especially for the families. The diagnosis was what the CDC calls “symptomatic” or “syndromic-based,” which means not lab-confirmed. I think that’s what you mean by “probable deaths.”
 
Context is everything! Confirmed Influenza related fatalities, and probable influenza related fatalities. The fatalities are real, and probably influenza related.

Originally posted by Veritas Veritas wrote:

Confusion #2
I don’t see how you connect the data on Table III of the MMWR to the mortality data on the weekly flu report. For week 41, MMWR has 684 and the flu weekly has 411 lab confirmed + 2416 syndrome-based = 2827. What connection do you see between the 684 and the 2827?

It appears that the weekly flu report is not limited to the 122 reporting sites that the MMWR is, but if you or someone else can point out where the CDC says otherwise, please do.

Clearly, the pediatric deaths are nationwide, not restricted to reporting sites.   
 
The MMWR reports all Pneumonia and Influenza related deaths for that week in the 122 cities. Last week was 684. Since the 122 cities comprise around 25% of the  population, this gives us a crude estimate of 2700 P&I related deaths nationally for that week. The weekly flu report reported 506 new fatalities. This is clearly less than the total # of P&I deaths for that week. This implies that the CDC is already excluding non flu related deaths and only including deaths which are flu related in the weekly flu update. IslandCrow implied that the weekly flu update fatalities could be from all sorts of reasons, not just flu, I disagree, for the reasons mentioned. Confirmed pediatric influenza fatalities must be reported by law and are recorded on a seperate table of the MMWR.

Originally posted by Veritas Veritas wrote:

Confusion #3
“Prior to August 30 there were 593 confirmed, but CDC did not track probables. 411:2416 isabout 1:6. If we were to apply this same ratio to the pre August 30 confirmed fatalities, that suggests 3,000 additional probable fatalities prior to Aug 30.”

No, no, no – not close. In the early stages CDC did not distinguish between lab-confirmed and non lab-confirmed because they were lab-confirming virtually every suspicious death. Now they don’t confirm every death because they couldn’t keep up with 500 per week.

 
Maybe, but I think if you look at some of the known numbers that leads to some unlikely scenarios.
 
Since Aug 30, we've had 53 pediatric deaths out of a total of 2,827 fatalities- about 1.9%.
 
Prior to Aug 30, we've had 46 pediatric deaths from a total of 593 - 7.8%.
 
I doubt if kids were 4 times more likely to die in the summer than they are now. So that implies that the total number of fatalities in the early stages were underestimated.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote RoRo Quote  Post ReplyReply Direct Link To This Post Posted: October 24 2009 at 9:32am
Or alternatively syndromic based pediatric fatalities are not being reported as pediatric fatalities.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Veritas Quote  Post ReplyReply Direct Link To This Post Posted: October 24 2009 at 11:26am
RoRo

You’re not clear on your facts, and your extrapolations seem to me to be way beyond what the numbers support. But I must admit I'm beginning to get more worrisome figures, too.

Where do you come by the fact that the 122 reporting cities represent 25% of the US population?

The CDC doesn’t give any information that I can see other than that “most” of the 122 have a population of >100,000. The CDC link that explains the “122 Cities Mortality Reporting System” is dead. http://wonder.cdc.gov/mmwr/mmwrmort.asp

Also note, in the Wk 41 MMwR there are 8 cities not reporting. All most all of them are over 1 million – Long Beach, New Orleans, Fort Worth, Jersey City, New Haven, Hartford, probably El Paso. So there is some serious under-reporting in the MMWR.

So where does your 25% number come from? It doesn’t seem unreasonable, but I don’t have a clue and I don’t have time to look up the populations for 122 cities. Those cities could easily represent 50% of the total population for all I know.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote tetano Quote  Post ReplyReply Direct Link To This Post Posted: October 24 2009 at 12:11pm
122 cities are 55 milion of people (my calculation with wikipedia). But 122 cities P&I mortality corresponds to about 60% of total mortality in USA.
In accordance with my calculations , from week 20 to week 39 there was about 1000 ( not 1500 as I previously wrote) deaths exceeding the expectation, expecially in the 45-64 age group)  So I argue about 1700 ( 1000 correspond to 60%) deaths were caused by flu in this period . But others deseases hide flu deaths, expecially cardiovascular one .
I observed that mortality in 45-64 age group is higher than expectation also  in 1-19 weeks

20-39 W

2009

2008

2007

2006

2005

2004

2003

TOT >65

134596

139835

134015

134852

139593

141546

139877

45-64

49602

50677

47815

47842

48145

47539

45103

25-44

13376

14276

14450

14543

14959

15288

15743

1-24

5005

5380

5464

5489

5729

5787

5843

0-1

4472

4860

4911

4631

4741

4638

4641

P&I  20-39

12986

13431

12176

12030

12894

13197

13042

P&I 31-39

5436

5517

5248

4879

5418

5749

5536

1-19 W

 

 

 

 

 

 

 

>65

151514

159020

149761

154995

163064

164743

151567

45-65

52049

52156

50153

50565

50399

49872

45521

P&I

16199

18793

15600

16821

19353

19184

16625

 


 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote RoRo Quote  Post ReplyReply Direct Link To This Post Posted: October 24 2009 at 12:12pm
Veritas,
There has been no mutation in the virus, and yet the proportion of pediatric fatalities has decreased by a factor of four. Either a. the total number of fatalities prior to Aug 30 is underestimated, or b. the number of pediatric fatalities after Aug 30 is underreported. If you have a third option, I'd love to hear it.
 
Tetano actually added up the populations.
I figued in the suburbs and rounded to 90 million.
See the post timestamp 5:24 where I spoke about underreporting.
 
Estimates are just that. When the CDC says 36,000 people die each year from flu, that is not an exact number, it is probably + or minus a few thousand. I estimate H1N1 has killed 6,000 Americans so far, maybe a few hundred more, maybe a few hundred less.
 
"RoRo
You’re not clear on your facts
"
 
I'm going to ask you to play nice. I've pointed you in the direction of lots of useful information, answered all your inquiries with courtesy. I expect the same.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote tetano Quote  Post ReplyReply Direct Link To This Post Posted: October 24 2009 at 1:13pm
In 2006 year there were 56326 P&I total deaths ( http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_14.pdf), in 122 cities they were 37377. Really it  corresponds to 66%.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Pickwicky Quote  Post ReplyReply Direct Link To This Post Posted: October 24 2009 at 1:22pm

It seems improbable US deaths are at 6,400 plus.  That's a 5,000 increase over network news reports.  I think there is some downplaying in the press and elsewhere about the pandemic; however, if the real count was so high, there's some journalist out there that would be raising the roof on this issue. 

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Post Options Post Options   Thanks (0) Thanks(0)   Quote RoRo Quote  Post ReplyReply Direct Link To This Post Posted: October 24 2009 at 1:29pm
But just adding up the CDC numbers alone and you get 3,420 deaths. That's nearly 3 and a half times the figure quoted in the press. Journo's seem to be clueless on this already.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote RoRo Quote  Post ReplyReply Direct Link To This Post Posted: October 24 2009 at 1:39pm
Seasonal flu kills 36,000 a year  - 700 a week on average apparantly. But from April 23rd to August 30th H1N1 killed 593. 700 a week on average in a regular year, and 593 this year in 19 weeks. Yes and I believe in the tooth fairy and Santa Clause.
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