Is the COVID-19 pandemic already past its peak?

[ElliotSmith]

TL;DR Summary

Is the CV19 pandemic already past it's highest point?

Has the CV19 pandemic already peaked?

 

[PeroK]

https://www.worldometers.info/coronavirus/

All we can say is that we hope so. Especially with the vaccines available.

 

[ElliotSmith]

https://www.worldometers.info/coronavirus/

All we can say is that we hope so. Especially with the vaccines available.

According to google's statistics graph for CV19 infections and deaths, both are falling dramatically everywhere.

Let's hope that this trend continues.

 

[russ_watters]

Has the CV19 pandemic already peaked?

Twice!

 

[Rive]

Twice!

This kind of question is just like the frequent ones on any amateur stock betting (I won't say investment!) forum.

 

[hutchphd]

I think we can be confident that the downward trends are real and will likely continue through the summer in the Northern Hemisphere. It is imperative that we monitor the efficacy of the mRNA vaccines against the mutant strains and are positioned to provide boosters sufficient to counter these effects in the fall. Personally, I am mildly optimistic (and at least there are grownups now in charge in the US)

 

[phinds]

In America, probably. Africa and South America maybe, maybe not (probably not)

 

[PeroK]

The global peak was early January, where we reached about 850,000 new positive tests per day and 17,500 deaths per day. Globally it's fallen considerably since then - with under 500,000 new cases per day.

Of the countries that have been most seriously affected, only Brazil and a few European countries (Czech Republic, Portugal and a few others) are still at or near the peak.

Even with vaccinations well underway, there is still the potential for a large increase in daily cases, which is why the emergence from lockdown measures is likely to be gradual.

There are, of course, very large populations where the virus has not been widespread: most of Africa, Asia and the Far East. (I looked this up a few days ago and the UK has very similar numbers, in terms of cases and deaths, to the whole of Africa!)

Those are the two obvious potential scenarios where we could see a surge in cases. It's not impossible that Europe, North and South America will end up with the vaccination program in a race against a growing number of cases. In fact, the numbers from Israel suggest that's what might be happening there.

 

[hutchphd]

n fact, the numbers from Israel suggest that's what might be happening there.

Do you have a reference for this? I am finding it difficult to get straight data about Israel.

 

[PeroK]

Do you have a reference for this? I am finding it difficult to get straight data about Israel.

https://www.worldometers.info/coronavirus/country/israel/

The daily numbers in Israel have been high throughout the last two months.

 

[PeroK]

https://www.worldometers.info/coronavirus/country/israel/

The daily numbers in Israel have been high throughout the last two months.

PS If I am allowed one piece of personal analysis of the data that none of the news reports has highlighted:

The death rate in Israel (and across the Middle East) is much lower than in Europe and North and South America. I'd be sceptical in projecting what happens in Israel to Europe directly. For example, Israel and Belgium have similar populations, almost the same number of positive tests, yet Israel has 5,500 deaths to Belgium's 22,000.

And, in fact, the UAE has an even lower case fatality rate. For example (and I'm just picking the nearest European country):

The UAE and Hungary have similar populations and positive tests, but the UAE has only 1,140 to Hungary's 14,000.

It's not clear to me, therefore, how useful data from these countries really is, vis-a-vis the overall effectiveness of the vaccine in preventing death!

 

[pinball1970]

Summary:: Is the CV19 pandemic already past it's highest point?

Has the CV19 pandemic already peaked?

For the UK, Peaked (again) and now heading in the right direction, downwards.
We hit a high of 68,000 cases in a day and 1800 deaths towards the end of Jan to where we are now at about 10000 cases and around 600 deaths per day. High but falling
Hospital cases falling too.
as @hutchphd pointed out and the big worry now is the new variants and how effective the available vaccines will be.
A few threads on papers regarding that issue on here.

 

[jim mcnamara]

I am not going to put up a bunch links, just ignore the garbage you read from Vitamin D supplement vendors.

Vitamin D is actually a hormone deeply involved in the immune system. Cells in the pulmonary system actively respond to infection more effectively when sufficient levels of calcitriol (Active form of Vitamin D) exists.

@PeroK - there are several randomized controlled tests going on Re: Covid and Vitamin D (synthesized by sunlight). I think the UK's NHS now encourages people to take Vitamin D supplements. Correct me here, please. Anyway, Vitamin D sales are way up in the UK.

The intensity (angle) of the sun and hence UVB intensity in countries outside of the band of 35 degrees N and S of the equator is too low in Winter to allow the synthesis of cholecalciferol (pre-Vitamin D). This has been known for a long time,

There a several medical conditions that appear to be more prevalent as populations are sampled further from the equator, i.e., sun angle -> cholecalciferol synthesis may be relevant to pathogenesis.

For Covid:
It follows that it is not out of the question to consider a relation: Vitamin D synthesis-> sun angle-> Winter peak for airway and lung diseases. Very like Influenza, Coronavirus and Rhinovirus common colds that we all have seen for years during Winter.

Where is the UK, Israel, and Africa relative to latitude? You may also want to consider that many countries do not have a good medical system, so disease reporting and care is limited. This applies to Africa.

 

[PeroK]

For Covid:
It follows that it is not out of the question to consider a relation: Vitamin D synthesis-> sun angle-> Winter peak for airway and lung diseases. Very like Influenza, Coronavirus and Rhinovirus common colds that we all have seen for years during Winter.

Where is the UK, Israel, and Africa relative to latitude? You may also want to consider that many countries do not have a good medical system, so disease reporting and care is limited. This applies to Africa.

The big outlier in Europe in terms of low CFR is Turkey. Along with Cyprus, Denmark and Serbia(?)

The least affected countries (low case rates) are Greece, Iceland, Finland and Norway.

Either lots of sun or geographical remoteness is the key!

PS I noticed that Utah is something of an outlier in the US re CFR.

 

[russ_watters]

Note that CFR is in part a function of testing rate, and testing rates vary widely from country to country and over time.

 

[FactChecker]

The current trend in the U.S. is certainly down, in cases, hospitalizations, and in deaths, but we will have to wait to see if there are more contagious or more deadly strains on the way. Also, it is hard to tell if we are seeing a reduction in the overall virus down to a low level or only the end of spikes due to holidays, etc., down to the level of a continuing epidemic. All the current U.S. numbers are still high compared to the summer numbers.

 

[Astronuc]

From Covidtracking.com - in the US - https://covidtracking.com/data
https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html

 

[PeroK]

Note that CFR is in part a function of testing rate, and testing rates vary widely from country to country and over time.

Turkey does fewer tests generally than the other large European countries, so that ought to result in a higher CFR, not lower. In any case, Turkey is a big outlier in terms of deaths. E.g.

Italy: Population 60 million, 38 million tests, 2.8 million cases, 96,000 deaths.

Turkey Population 85 million, 32 million tests, 2.6 million cases, 28,000 deaths

I'd say that's worthy of note.

 

[russ_watters]

Turkey does fewer tests generally than the other large European countries, so that ought to result in a higher CFR, not lower. In any case, Turkey is a big outlier in terms of deaths. E.g.

Italy: Population 60 million, 38 million tests, 2.8 million cases, 96,000 deaths.

Turkey Population 85 million, 32 million tests, 2.6 million cases, 28,000 deaths

I'd say that's worthy of note.

Is Turkey the CFR outlier there or is Italy? To me it looks like Italy is the one with the low testing rate, not Turkey. Italy has had 396 tests per death and Turkey 1142; triple.

Italy wad hit hard, early, at a time when testing was limited. Their CFR is high in part because of that (also in part because of their old population).

Anyway, this is why I think overall CFR (and overall case count)isn't very useful as a comparison between countries. Deaths is more useful.

 

[PeroK]

Is Turkey the outlier there or is Italy?

Turkey is the outlier. The UK, France, Spain and - to a lesser extent Germany - are all similar to Italy. Plus a lot of the smaller countries in Europe. We've 120,000+ deaths in the UK, for example.

Turkey stands out worldwide, in fact, in terms of a low death rate. Among the countries with a lot of cases.

 

[russ_watters]

Turkey is the outlier. The UK, France, Spain and - to a lesser extent Germany - are all similar to Italy. Plus a lot of the smaller countries in Europe. We've 120,000+ deaths in the UK, for example.

Turkey stands out worldwide, in fact, in terms of a low death rate. Among the countries with a lot of cases.

Here's a table of data for 14 of the countries listed here, sorted by CFR:

Country	Population	Tests	Cases	Deaths	Cases/mil	Deaths/mil	CFR	Test/Death	Tests/case	Tests/mil
Greece	10,423,054	4,958,128	180,672	6,321	17,334	606	3.50%	784	27.4	475,689
Italy	60,461,826	38,229,611	2,818,863	95,992	46,622	1,588	3.41%	398	13.6	632,293
UK	67,886,011	86,272,167	4,126,150	120,757	60,781	1,779	2.93%	714	20.9	1,270,839
Germany	83,783,942	42,872,730	2,399,500	68,772	28,639	821	2.87%	623	17.9	511,706
France	65,273,511	51,162,886	3,609,827	84,613	55,303	1,296	2.34%	605	14.2	783,823
United States	331,002,651	349,843,129	28,827,262	512,593	87,091	1,549	1.78%	682	12.1	1,056,919
Finland	5,540,720	3,183,208	54,532	734	9,842	132	1.35%	4,337	58.4	574,512
Denmark	5,792,202	16,164,539	208,027	2,343	35,915	405	1.13%	6,899	77.7	2,790,742
Turkey	84,339,067	32,436,998	2,646,526	28,138	31,380	334	1.06%	1,153	12.3	384,602
Serbia	8,737,371	2,858,176	439,596	4,351	50,312	498	0.99%	657	6.5	327,121
Norway	5,421,241	3,756,761	68,758	608	12,683	112	0.88%	6,179	54.6	692,971
Israel	8,655,535	11,708,993	757,150	5,604	87,476	647	0.74%	2,089	15.5	1,352,775
Cyprus	1,207,359	1,761,242	33,391	230	27,656	190	0.69%	7,658	52.7	1,458,756
Iceland	341,243	496,506	60,449	29	177,144	85	0.05%	17,121	8.2	1,454,992

It's tough for me to consider Turkey an outlier, when so many are below it (as you listed yourself). Sorting by several of the criteria puts it in the middle. What stands out most to me is tests/death, for which Italy's is lowest and Iceland by far the highest.

What I'd really like to see is a CFR of the second peak only, as I think overall CFR is a pretty weak measure due to the timing of peaks and for many countries a low early testing rate. Looking at the graphs, it looks like Italy's 2nd peak is a little larger than their first peak in terms of total deaths, whereas Turkey's 2nd peak is maybe 5x larger (USA's 2nd peak maybe 2x larger). It stands to reason that the difference in CFR between the two countries is mostly due to the timing/severity of the peaks. Or, rather, I'd like to see attempts to measure the true CFR (IFR).

Note: There still also could be differences in how deaths are counted/criteria for listing COVID. That may play a big role in the numbers.
[edit]
Here's some estimates of IFR: https://www.who.int/bulletin/volumes/99/1/20-265892/en/
Median is about 0.25%.

 

[russ_watters]

Vitamin D is actually a hormone deeply involved in the immune system. Cells in the pulmonary system actively respond to infection more effectively when sufficient levels of calcitriol (Active form of Vitamin D) exists.

@PeroK - there are several randomized controlled tests going on Re: Covid and Vitamin D (synthesized by sunlight). I think the UK's NHS now encourages people to take Vitamin D supplements. Correct me here, please. Anyway, Vitamin D sales are way up in the UK.

The intensity (angle) of the sun...

For Covid:
It follows that it is not out of the question to consider a relation: Vitamin D synthesis-> sun angle-> Winter peak for airway and lung diseases. Very like Influenza, Coronavirus and Rhinovirus common colds that we all have seen for years during Winter.

How strong is the causal link between Vitamin D and these respiratory diseases? Or is it mainly a statistical correlation? Do these studies attempt to separate sun angle from the weather? That would seem difficult to do. Cold/dry weather has known impacts on our respiratory systems that promote cold-weather respiratory infections. I'd be curious to see statistics of respiratory illness prevalence in skiers vs office workers vs homebody humidifier users.

 

[PeroK]

Here's a table of data for 14 of the countries listed here, sorted by CFR:

Country	Population	Tests	Cases	Deaths	Cases/mil	Deaths/mil	CFR	Test/Death	Tests/case	Tests/mil
Greece	10,423,054	4,958,128	180,672	6,321	17,334	606	3.50%	784	27.4	475,689
Italy	60,461,826	38,229,611	2,818,863	95,992	46,622	1,588	3.41%	398	13.6	632,293
UK	67,886,011	86,272,167	4,126,150	120,757	60,781	1,779	2.93%	714	20.9	1,270,839
Germany	83,783,942	42,872,730	2,399,500	68,772	28,639	821	2.87%	623	17.9	511,706
France	65,273,511	51,162,886	3,609,827	84,613	55,303	1,296	2.34%	605	14.2	783,823
United States	331,002,651	349,843,129	28,827,262	512,593	87,091	1,549	1.78%	682	12.1	1,056,919
Finland	5,540,720	3,183,208	54,532	734	9,842	132	1.35%	4,337	58.4	574,512
Denmark	5,792,202	16,164,539	208,027	2,343	35,915	405	1.13%	6,899	77.7	2,790,742
Turkey	84,339,067	32,436,998	2,646,526	28,138	31,380	334	1.06%	1,153	12.3	384,602
Serbia	8,737,371	2,858,176	439,596	4,351	50,312	498	0.99%	657	6.5	327,121
Norway	5,421,241	3,756,761	68,758	608	12,683	112	0.88%	6,179	54.6	692,971
Israel	8,655,535	11,708,993	757,150	5,604	87,476	647	0.74%	2,089	15.5	1,352,775
Cyprus	1,207,359	1,761,242	33,391	230	27,656	190	0.69%	7,658	52.7	1,458,756
Iceland	341,243	496,506	60,449	29	177,144	85	0.05%	17,121	8.2	1,454,992

It's tough for me to consider that an outlier, when so many are below it (as you listed yourself).

Israel and the USA are not in Europe.

Iceland and Cyprus are tiny and the Scandanavian countries are small. With COVID there are many outliers of all descriptions among the small and tiny countries. And the more isolated countries.

Serbia is something of an outlier as well, of course, although still quite a small country.

The fundamental point is that Turkey has a fraction of the deaths of the other major European countries. There's a huge gap from Turkey at 1% to France at 2.34% (28,000 deaths to 85,000 deaths): that's a huge difference, however you look at it.

If we look at the deaths:

UK: 120,000; Italy 96,000; France 85,000; Germany 69,000; Spain 68,000; Turkey 28,000

How can Turkey not be an outlier?

 

[russ_watters]

With COVID there are many outliers of all descriptions among the small and tiny countries. And the more isolated countries.

Serbia is something of an outlier as well, of course, although still quite a small country.
[flip]
How can Turkey not be an outlier?

[shrug] I guess if there are a lot of outliers there are a lot of outliers. I tend to define outliers as more limited/rare.

The fundamental point is that Turkey has a fraction of the deaths of the other major European countries. There's a huge gap from Turkey at 1% to France at 2.34%.

That's CFR, not death rate.

(28,000 deaths to 85,000 deaths): that's a huge difference, however you look at it.

That's deaths, not death rate.

Yes, though, there's a big difference in death rate (about a factor of 4). On that we agree. My objection was to the statements about CFR. My point here is that CFR is weak and the infection fatality rates are probably not very different...and that death rates are a more useful comparison than CFR.

 

[jim mcnamara]

Per WHO explanation of IFR and CFR:
https://www.who.int/news-room/commentaries/detail/estimating-mortality-from-covid-19

There are two measures used to assess the proportion of infected individuals with fatal outcomes. The first is infection fatality ratio (IFR), which estimates this proportion of deaths among all infected individuals. The second is case fatality ratio (CFR), which estimates this proportion of deaths among identified confirmed cases.

To measure IFR accurately, a complete picture of the number of infections of, and deaths caused by, the disease must be known. Consequently, at this early stage of the pandemic, most estimates of fatality ratios have been based on cases detected through surveillance and calculated using crude methods, giving rise to widely variable estimates of CFR by country – from less than 0.1% to over 25%.

For COVID-19, as for many infectious diseases, the true level of transmission is frequently underestimated because a substantial proportion of people with the infection are undetected either because they are asymptomatic or have only mild symptoms and thus typically fail to present at healthcare facilities [1,2]. There may also be neglected or under-served segments of the population who are less likely to access healthcare or testing. Under-detection of cases may be exacerbated during an epidemic, when testing capacity may be limited and restricted to people with severe cases and priority risk groups (such as frontline healthcare workers, elderly people and people with comorbidities) [3,4]. Cases may also be misdiagnosed and attributed to other diseases with similar clinical presentation, such as influenza.

Points: The cumulative CFR for New Mexico at the end of January 2021 was 1.96%
CFR is used because of the large number of asymptomatic and/or unreported cases. The true infection rate is not known for New Mexico, for example.

I think Turkey did a very large number of tests per 100k population which drives down positivity.

 

[russ_watters]

Per WHO explanation of IFR and CFR:
https://www.who.int/news-room/commentaries/detail/estimating-mortality-from-covid-19

The first is infection fatality ratio (IFR), which estimates this proportion of deaths among all infected individuals. The second is case fatality ratio (CFR), which estimates this proportion of deaths among identified confirmed cases.

To measure IFR accurately, a complete picture of the number of infections of, and deaths caused by, the disease must be known. Consequently, at this early stage of the pandemic, most estimates of fatality ratios have been based on cases detected through surveillance and calculated using crude methods, giving rise to widely variable estimates of CFR by country – from less than 0.1% to over 25%.
[emphasis added]

CFR is used because of the large number of asymptomatic and/or unreported cases. The true infection rate is not known...

Thanks/yes, that's my point. I'd actually amplify their wording a bit: CFR is directly measured/calculated, whereas IFR can only be estimated via more complicated means (additional data and assumptions). CFR is cited because it's easy and known. But it isn't very useful/meaningful and doesn't tell us much to compare country to country (state to state). If anything, it tells us more about data limitations than disease severity.

[edit]
I do have evolution of case fatality rate over time for Pennsylvania. On June 1, using a 3 week lag (June 22 for deaths), the cumulative CFR was 8.9%. As of today, it's 2.8%. For the second peak only (starting in Nov), it's 2.2% (still surprisingly high). But then, our testing rate per population is lower than the national average whereas the death rate per population is higher than the national average. So we're quite low in testing rate vs deaths.

 

[PeroK]

I think Turkey did a very large number of tests per 100k population which drives down positivity.

Actually, it's the opposite. Turkey does less testing than the other major European countries.

 

[jim mcnamara]

When there is limited testing or redundant testing ex: for first responder medical people, it alters estimates (that's what they are) of positivity results. There for number of cases. Which alters CFR.
Thanks for the correction. IMO, either direction, too much or too little screws thing up.

 

[Ygggdrasil]

There is reason to believe that Turkey's Coronavirus deaths are underrepotred. For example, here's a paper with some researchers explaining why they believe Turkey's Coronavirus cases and deaths to be underreported: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7436880/

One way to assess Coronavirus deaths independent of testing is to look at excess mortality. While there is no data for the country as a whole, the excess mortaility statistics from Istanbul suggest a significant undercounting of deaths. The NY Times excess deaths tracker reports 15,500 excess deaths in Istanbul vs 8,714 reported COVID-19 deaths: https://www.nytimes.com/interactive/2020/04/21/world/coronavirus-missing-deaths.html

How does this compare to other countries:

Italy: Population 60 million, 38 million tests, 2.8 million cases, 96,000 deaths.

Turkey Population 85 million, 32 million tests, 2.6 million cases, 28,000 deaths

Italy: Population 60 million, 85,600 excess deaths, 55,535 reported COVID-19 deaths. 1.4 excess deaths per thousand
Istanbul: 15.52 million, 15,500 excess deaths, 8,714 reported COVID-19 deaths. 1.0 excess deaths per thousand

The discrepancy is still there but not as large a magnitude as before (which is reasonable considering Italy was one of the hardest hit countries by the pandemic).

 

[.Scott]

My personal estimate is that the COVID death rate has peaked - but there will be lots of less deadly COVID peaks in the years to come.

Per the John Hopkins COVID chart, on Jan 21 of this year, the COVID death rate peaked at 17,836 deaths per day.

Clearly, COVID has reached the point (the case count) where is can effectively mutate.

I fully expect that it will become an important component of the world's seasonal flu mix.

I suggest that to avoid an eventual "first infection", get vaccinated. Better to be introduced to this new agent through vaccination than infection.

 

[cmb]

Summary:: Is the CV19 pandemic already past it's highest point?

Has the CV19 pandemic already peaked?

Your question differs to the title.

Also, unclear what you mean. Peak of what metric?

The peak of total cases will occur when the last person to ever get it has it. Not before.

The peak of case 'rate'?

The peak of death 'rate'?

The daily rolling average, versus annual?

I suspect that once this is all over and we are no longer in the middle of it, one will be able to use statistics to show exactly what one wants to show about it.

I suspect a 5 year rolling average of annual death rate over the century, for example, will make Covid cases disappear as if nothing abnormal happened.

Whereas if one takes the 'rate of change' of 'death rate' then there will be two or three very tall narrow peaks signalling something odd this year.

Questions. Statistics. Politics. Accuracy? ... Sighs!