Staff sickouts skyrocket at NYC hospitals amid coronavirus outbreak Wednesday April 15th, 2020 at 6:16 AM
April 14, 2020 | 6:02pm
A nurse wears protective gear outside Elmhurst Hospital in Queens. REUTERS/Jeenah Moon
The number of health care workers calling in sick at the city’s public hospitals has skyrocketed amid the coronavirus pandemic — with the absentee rate doubling compared to before the killer virus slammed the city.
The situation is so dire that top officials with Health + Hospitals are cracking the whip — demanding a doctor’s note to document illness for a sick day.
An April 10 memo sent out by top H + H brass to employees at the network of 11 hospitals and clinics suggested that workers at some facilities might be taking advantage of the epidemic because there are “very high rates of call outs and absences that do not appear to be consistent with patterns of COVID infection.”
“Because all of you are critically needed in our facilities, we have to address this issue so that some of our staff is not bearing an extra burden for those who are staying home without approved leave,” the note sent by Health + Hospital’s chief medical officer, Dr. Machelle Allen, and the head of human resources, Yvette Villanueva said.
The memo, first obtained by The City, added, “As a response to this staffing emergency, we will be implementing new processes to ensure that those who are out and using sick or COVID leave are entitled to use that leave.”
Health + Hospitals staff requesting sick leave now must provide a doctor’s note or other proof that they tested positive for COVID-19 test or are displaying symptoms from the virus or another other illness within five days to get sick pay.
Both H + H CEO Dr. Mitchell Katz and Mayor Bill de Blasio said maintaining adequate staffing has been a major concern because a workforce stretched thin by high sickouts and toiling under hazardous conditions as they try to save very sick coronavirus patients.
Nurses at many hospitals have complained of a shortage of personal protective equipment such as masks and gowns, exposing them to COVID-19 from patients and others. Some have died from the coronavirus.
Katz said “a lot of people, large numbers of people are calling in sick — double the usual rate. … We’re definitely seeing a large number of people missing in action.”
Katz, in an interview with the Journal of the American Medical Association Monday, said that many hospitals workers are sick from COVID exposure but others are out because they’re scared about getting infected and spreading COVID to other family members.
He said it’s a big morale booster when sick nurses and doctors recover from COVID-19 and return to the front.
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“It’s a very fluid, difficult situation right now,” said, Katz.
He repeatedly called the medical workers “heroes” and said he’s even trying to find a way to give them bonuses during tough fiscal times triggered by the pandemic.
De Blasio, during a Tuesday press briefing, said Health + Hospitals is hiring, adding, “We need those key health care workers right now.”
Unlike other departments such as the NYPD, Health + Hospitals has not provided specific stats on its absenteeism rate. The mayor promised Tuesday the data will be released soon.
Asked about the sick out memo, Health + Hospitals issued a statement Tuesday that said, “We are in unprecedented circumstances and our frontline heroes are going above and beyond to keep New Yorkers safe.
“We are doing everything we can to adjust to a rapidly evolving situation, and in the process reduce undue burden on employees and ensure that our facilities are staffed appropriately. Understandably these are frightening times, and we are all pulling together so that we can save more New Yorkers.”
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When a new flu-like virus first emerged out of Wuhan, two “dangerously false” assumptions started to spread about who was affected by COVID-19, one expert claims.
The editor of a prestigious British medical journal has slammed the “dangerously false” information that initially circulated about coronavirus, warning it is a more serious disease than previously thought.
The Lancet editor Richard Horton has been an outspoken critic of the UK government’s failure to prepare for the COVID-19 pandemic despite warnings in late January about the new disease emerging from Wuhan.
He has previously referred to this failure, inadequate testing and lack of supplies of personal protective equipment (PPE) as a “national scandal”. Now, in an article published in the Lancet he said early comments the disease was flu-like and only affected older people were misconceptions.
“As deaths accumulate, the early message that severe acute respiratory syndrome coronavirus 2 causes mostly a mild illness has been shown to be dangerously false,” he wrote.
“One in five patients develop complications and are at grave risk. A further misunderstanding concerns age.
“An impression was given that only older people are at risk of serious illness. But the average age of non-survivors is under 70 years. Two-thirds of those admitted to hospital in China were younger than 60 years.”
In Australia, three people in their thirties were reported to be on ventilators in intensive care wards last week, with Deputy Chief Medical Officer Paul Kelly calling it a “wake up call” for younger people.
NSW Health statistics show the 20-39 year old age group has the highest number of cases, with slightly more women than men contracting the virus.
China has been widely criticised for failing to warn the world early enough that the mysterious new disease was being transmitted between humans in Wuhan. That secrecy, combined with world leaders being slow to prepare, has led to an unprecedented pandemic that has infected more than 2 million people and killed more than 119,000 worldwide.
The virus has also seen billions of people warned to stay home and created an economic crisis not seen since the Great Depression, with countries only now grappling with how to lift restrictions and return to a semblance of normality.
There are more than 6300 confirmed COVID-19 cases in Australia, with 2870 in New South Wales, 1291 in Victoria, 998 in Queensland, 433 in South Australia, 527 in Western Australia, 150 in Tasmania, 103 in the Australian Capital Territory and 28 in the Northern Territory.
The death toll now stands at 62, after a sixth person died in Tasmania earlier today.
Horton said the public health crisis has seen patient numbers in intensive care doubling every two days and doctors left feeling overwhelmed and bewildered.
“Deaths are so frequent that hospitals have created emergency mortuary space, often in car parks, moving bodies at night to avoid media scrutiny,” he wrote.
“Intensive care teams are doing truly remarkable work. But it is a huge physical and mental struggle.”
“The focus of the political debate about coronavirus disease 2019 (COVID-19) has so far been almost exclusively about the public health dimensions of this pandemic. But at the bedside there is another story, one that has so far been largely hidden — a story of terrible suffering, distress, and utter bewilderment.”
The UK remains in the eye of the storm, with more than 11,329 deaths and intensive care units under pressure. Medical bosses believe cases will peak next week and the country is expected to remain in lockdown for another three weeks.
UK Prime Minister Boris Johnson has tested negative for the disease after being discharged from intensive care and is now in recovery at his country retreat, Chequers.
On Tuesday, new figures revealed the number of virus deaths in Britain could be 15 per cent higher than previously believed according to data on deaths outside of hospital.
The Office for National Statitstics said 6235 people in England and Wales had died by April 3 with mentions of COVID-19 on their death certificates.
“When looking at data for England, this is 15 per cent higher than the NHS (National Health Service) numbers as they include all mentions of COVID-19 on the death certificate, including suspected COVID-19, as well as deaths in the community,” ONS statistician Nick Stripe said.
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In London, more than 46 per cent of deaths in week 14 of the year involved COVID-19, according to initial figures.
The UK government has received major criticism for failing to conduct widespread testing for coronavirus and pursuing a strategy of “herd immunity”. Doctors and nurses on the frontline in NHS hospitals have also warned a lack of PPE has put lives at risk.
Horton previously wrote the NHS has been “wholly unprepared for this pandemic” and it was “impossible to understand why”.
He said chief medical officers had a duty to put the country on high-alert following warnings published in late January, however a lack of action has led to “chaos and panic” in which staff and patients would “die unnecessarily.”
“It is, indeed, as one health worker wrote last week, “a national scandal”. The gravity of that scandal has yet to be understood.”
The World Health Organisation (WHO) has warned new cases might be easing in parts of Europe but the outbreak has not peaked yet.
“The overall world outbreak, 90 per cent of cases are coming from Europe and the United States of America. So we are certainly not seeing the peak yet,” WHO spokeswoman Margaret Harris said.
In Australia, Prime Minister Scott Morrison dismissed claims social restrictions would be easing up soon, but said there should be a “reward” for the nation’s “discipline and patience”.
“Yes, we’ve had a good couple of weeks but that does not a virus beat. That’s why we have many more in front of us before we could even possibly contemplate the easing of restrictions,” he told Sky News on Tuesday.
He added: “There has got to be a reward for all of this great effort going in, and there will be, but we’ve got to make sure it is done at the right time.”
“We don’t want to end up like New York or like London or like in Spain or in Italy or any of these places,” he said.
“And the decisions and actions we’ve taken together as a country and the discipline and patience shown by Australians has meant that we’ve been able to avoid those horror scenarios which, you know, Australia is not immune to.
Last updated: Tue 14th April at 8:52 pm
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Operation CoronaVirus Update: “Health care workers are 10%-20% of US coronavirus cases“
It looks like the Coronavirus was introduced in the US not in January of 2020, but earlier, possibly much earlier: in the fall of 2019 or prior to that, around the summer of 2019. It is difficult to determine this exactly, of course.
Now we started to see the tip of the iceberg. This figure: 10-20% health care workers of all cases, probably indicates, that the virus was circulating for some time, and the un-diagnosed infectious people were infecting the health care workers, who in turn were unknowingly infecting the new cohorts of their patients, who saw them for the other reasons.
It also looks like there are at least two, maybe three or more distinct clinical entities of this illness: 1) Acute, with severe cardio-pulmonary symptoms, often lethal, in the otherwise non-compromised patients, in which the coexisting or superimposed Chemical agents’, the various types of the “Novichoks” effects, are possible; 2) The subacute, 3) The moderately and mildly symptomatic, and 4) The asymptomatic clinical types. All of them might be the different illnesses with various causes and their combinations. We do not have enough of the clinical experiences and enough of the observations of these phenomena to classify them definitely at this point.
I would not rely on the Chinese medical conceptualizations of their clinical observations too much. All these phenomena have to be approached anew, with the open mind and the unbiased vision.
Of course, the most concerning are the acute types of the conditions, for which I considered the possible simultaneous use of the Chemical agents or weapons, under the guise of infection or simultaneously, in some forms or fashions.
At least some of these cases might be the targeted killings and the Mafia jobs. This whole affair smells strongly of the Mafia and some of the mysterious powerful Intelligence groups involvement. The recent simultaneous losses in the NYPD, of two detectives from Queens, are somewhat puzzling and alarming.
I think, with all the humble awareness of our universal and omnipresent human propensity towards ignorance reserved, that the FBI, with all their limitations and possible reluctance, should investigate this whole affair as the criminal matter of the extraordinary proportions.
In fact, we might be dealing with the well organized, well thought out and coordinated attempt on the part of the TOC – Transnational Organized Crime to take over the Civilized World and to bend it to their will. The prison releases, which are practiced out of the utter humanitarian necessity, may be the part of their tactics and design. In a way, if it is so, it can be viewed as the assault on the Justice system in the U.S..
I hypothesized earlier, that there is the entity that is above the Mob hierarchically and organizationally, and I called it the New Abwehr. For the German Military Intelligence, throughout their complex and tortuous history, the close and intimate ties with the Organised Crime were often the matters of survival, time tested traditions, and the sheer necessity.
The very peculiar place of Germany in this global Pandemic lends further support to this hypothetical construct and concept: it looks like Germany was very well prepared and she was well aware of what is coming. See my previous posts for more details.
As unprecedentedly and shockingly sad as it is, we have to find enough strength and wisdom to investigate this occurrence very, very thoroughly, professionally, and with the highest of qualities.
Michael Novakhov
7:57 PM 4/14/2020
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NEW YORK (AP) — Between 10% and 20% of U.S. coronavirus cases are health care workers, though they tended to be hospitalized at lower rates …
NEW YORK (AP) — Between 10% and 20% of U.S. coronavirus cases are health care workers, though they tended to be hospitalized at lower rates than other patients, officials reported Tuesday.
The Centers for Disease Control and Prevention reported the first national data on how the pandemic is hitting doctors, nurses and other health care professionals.
The data is important new information but not necessarily surprising, said Dr. Anne Schuchat, who is running the federal agency’s response to the outbreak. Medical staff have also been hit hard in other countries: Media reports said about 10% of cases in Italy and Spain were health care workers.
As of the middle of last week, the CDC had reports of more than 315,000 cases in the U.S. The new report focused on about 49,000 for which researchers had data on whether or not they worked in health care. About 9,300, or 19%, of them were medical professionals. That included 27 who died.
But the data varied in how complete it was, researchers said. In 12 states that did a better job reporting on whether patients worked in medicine, around 11% of cases were health care workers.
Compared with U.S. cases overall, larger proportions of diagnosed health care workers were women, were white, and were young or middle-aged adults. That’s consistent with the demographics of who works in health care, researchers said.
About 10% of the health care workers were hospitalized with symptoms, compared with 21% to 31% of overall cases. That may reflect the younger age of the workers, as well as prioritization of testing for health care employees, the report said.
Slightly more than half of a group of infected health care workers studied said their only known exposure to the virus was at work, but researchers say it’s hard to know for sure how different people caught the bug.
A second report released Tuesday looked at three health care workers who became infected after treating a patient in Solano County, California, in what was one of the first instances of disease spread to medical personnel in the U.S. Workers didn’t initially know the patient was infected with the coronavirus. All three did not wear eye protection or some other forms of protective equipment at least part of the time they were caring for the person, researchers said.
How quickly things can change in the time of coronavirus. In his Monday videoconference, Putin took stock of a worsening situation.
“We have a lot of problems,” Putin said. “There is nothing to boast about, and we must not let our guard down, because in general, as you and your specialists say, we have not passed the peak of the epidemic yet.”
The trendline speaks for itself. While Russia has comparatively few cases compared with the United States or the hardest-hit European countries, the number of confirmed cases has surged in recent days. On Monday, Russia reported a record one-day rise in cases, with 2,558 confirmed over the previous 24 hours.
On Tuesday, Russia hit a fresh record: 2,774 confirmed cases. And Putin is coming in for serious criticism over his handling of the crisis.
In a recent essay, Tatiana Stanovaya of the Carnegie Moscow Center said the coronavirus pandemic had underscored Putin’s isolation from ordinary Russians.
“One of the main topics today is why Putin is almost imperceptible in the coronavirus situation,” she wrote. “He only addressed the nation briefly twice and went to the [coronavirus] hospital in Kommunarka, but he neither gave his own assessments of the crisis nor proposed a plan of action, but limited himself to scattered measures and general words. No drama, empathy or attempts to mobilize.”
Putin, Stanovaya argued, does not wish to be associated with harsh or unpopular measures, leaving such chores to local subordinates. In the case of the coronavirus, the task of rolling out some of the most heavy-handed restrictions has fallen to Sergey Sobyanin, the mayor of Moscow.
The Russian capital has been the hardest hit by the virus. Officially, Russia has 21,102 cases, according to the government’s official tracking website, and the death toll has reached 170. Around half of the country’s recorded cases — 11,513 — are in Moscow, and 82 Muscovites have died.
Sobyanin has taken the lead in enforcing lockdown measures, including the introduction of a controversial digital tracking system designed to keep residents indoors.
A recent outbreak in China has also underscored the severity of the situation in Russia. Health authorities in Shanghai recently reported a surge in imported cases, tracing dozens of cases to a single flight that arrived in Shanghai from Moscow on April 10. Chinese authorities are also fighting an outbreak in city of Suifenhe, on the border with Russia’s Far East, a wave of cases attributed in large part to Chinese nationals returning from Russia.
Kremlin spokesperson Dmitry Peskov on Tuesday deflected questions about the planeload of coronavirus cases that arrived in China, referring reporters to other agencies. But the spike in cases imported to China from Russia has raised a larger question: The reliability of Russian official statistics.
The Russian government says it has carried out over 1.4 million tests for Covid-19. But Moscow doctors have recently begun diagnosing patients as positive based on lung scans because of questions over the accuracy of the tests.
In his Monday videoconference, Putin said the next few weeks would be critical for determining whether Russia is able to effectively flatten the curve and reduce the spread of coronavirus. And he said that the Russian military “can and should be deployed here, if necessary.”
The next two or three weeks may be critical for another reason. The Kremlin is still planning for an important date: the May 9 Victory Day parade, a major celebration to mark the 75th anniversary of the end of World War II in Europe.
The Kremlin says plans are still underway to hold the event, which centers around an impressive display of military hardware rumbling through Red Square. Officials are reviewing plans amid coronavirus. But this prestigious event — on a holiday that is an occasion for near-religious reverence in Russia — presents a hard deadline, and a hard problem, for Putin’s anti-coronavirus campaign.
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eTurboNews | Trends | Travel News.
RiskNET.
In these two cities on the River Rhine, the biggest and most popular local and tourism event is Carnival. In Germany, the cities Cologne and Duesseldorf have been competing who has the best celebration.
Everyone is singing Carnivals songs and hoards of people meet in bars and at events.
Sunday was the day with the second-largest parade in both cities with hundreds of thousands of people on the streets drinking Alt Bier in Duesseldorf or Koelsch Beer in Cologne.
In Cologne ten thousand yell “Alaaf”, in Duesseldorf, the greeting is “Helau.”
Its the funniest event where everyone talks to everyone and simply forget the rest of their problems.
Sunday was the day for fun, and the parade was canceled in both cities.
Originally, the event had been planned to move forward a few hours and the route was shortened, but gale-force winds and strong rainfall struck the western German state of North Rhine-Westphalia on Sunday morning, forcing its cancellation in both cities.
In Venice the cancellation was Coronavirus, in Germany, it was a bad hurricane type wind. Some say if this was a message from God to avoid more long term problems conducting an international mass event during the Coronavirus threat.
In Germany, there are only 16 cases of the virus and no death. The goal must be to keep it like this.
Monday, today is the largest parade called “Rosenmontagszug” (Rose Monday Parade). The parade is scheduled as planned for 10.30 am in Cologne and 12.15 in Duesseldorf.
Lets party and pray for everyone. It can only be hoped Coronavirus will stay away.
In 2016 authorities almost canceled the Monday parade. Read the eTurboNews article here.
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“It is important to inform the public quickly and transparently about the intermediate steps.” , Bonn’s virologist Hendrik Streeck justified his controversial interim report on the findings in Gangelt. Critics call this “unscientific” and a pure “PR campaign”. These harsh reactions are triggered by the so-called “Heinsberg protocols” – the media marketing of the study by a Berlin PR agency. Fortunately, Streeck was one of the few researchers who recognized the value of representative studies at an early stage and acted accordingly – as we have been demanding for weeks. But did Streeck really go the royal way with his study?
Streeck at least vehemently contradicts his critics: “We examined a total of 1,000 people from 400 households – that’s four times more than the WHO protocol provides. So statistically absolutely representative.”
Regarding this quote, it should be noted that representativity is not a question of sample size, but to what extent the sample used reflects the population in its essential characteristics. An important characteristic of representative samples is their construction as a ” random selection “, ie a random drawing from a population. Statistically, this means that every element of the population must have the same probability of being included in the sample. Statistics and stochastics offer thismany tools that allow such a random selection. In passing, it should be mentioned that our brain is unable to take random samples. This finding is important for statisticians and risk managers, for example in the area of fraud detection. Only if a sample is representative can the population be inferred from the results of the statistical evaluation in order to be able to make generalized statements.
Is the Heinsberg sample representative?
Im Zwischenbericht der Studie ist vermerkt, die Auswahl bilde die Haushalte in Gangelt ab und die Repräsentativität sei mit dem Markt- und Meinungsforschungsinstitut Forsa abgestimmt worden. Unklar ist jedoch, ob die Stichprobe repräsentativ für die Bevölkerung in Gangelt in wesentlichen Merkmalen ist, d.h. insbesondere, ob die besonders gefährdete Gruppe von Senioren in Alten- und Pflegeheimen repräsentativ erfasst wurde.
Der Zwischenbericht dokumentiert bis auf die Einwohnerzahl von Gangelt (12.559 Personen) weiterhin keine absoluten Zahlen. Stattdessen werden lediglich grob gerundete Angaben wiedergegeben. Die absoluten Fallzahlen zu veröffentlichen, wäre kein größeres Problem gewesen, wobei insbesondere eine Aufschlüsselung nach Altersgruppen von großer Bedeutung für die Interpretation der Ergebnissse gewesen wäre.
Darüber hinaus beinhaltet der Zwischenbericht die gerundete Zahl der bislang ausgewerteten Tests (rund 500) und prozentuale Angaben zur Testgüte und den Ergebnissen. Genannt ist die mit einer Spezifität von >99% erhobene Immunität von circa 14% gemäß Antikörpertest, die Quote akuter Infektionen von ca. 2% gemäß PCR-Test und die Summe von beiden als ca. 15%. Der Bericht spricht zwar von einer “Rate”, da jedoch eine Betrachtung zu einem festen Zeitpunkt vorgenommen wurde, handelt es sich um eine “Quote”. Die Letalität betrage damit ca. 0,37% und die Mortalität ca. 0,06%. In der “Ärztezeitung” findet sich der ergänzende Hinweis, dass der Zwischenbericht auf den Testergebnissen von 509 Personen beruht.
Durchschnittsberechnung ohne Berücksichtigung der Unsicherheit entspricht nicht den wissenschaftlichen Standards
Aus Mortalität und Einwohnerzahl lässt sich zumindest die Zahl der Verstorbenen auf 7 oder 8 Fälle (rechnerisch: 7,5) rekonstruieren, indem die Einwohnerzahl durch die Mortalität dividiert wird. Bei 8 Fällen würden sich mit einer Letalität von rund 0,37% (0,365% bis < 0,375%) eine Gesamtzahl von 2.133 bis 2.192 temporär Immunen errechnen, wenn man diese Fälle durch die Letalität dividiert. Das entspräche einem Anteil von temporär Immunen (Immune + akut Infizierte) von 17,0% bis 17,5% in der Gesamtbevölkerung, was höher wäre als der angegebene Anteil von 15% im Zwischenbericht. Folglich muss die Zahl der Todesfälle geringer sein und bei 7 liegen. Daraus errechnet sich ein Anteil von 14,9% bis 15,3% temporär Immunen in der Bevölkerung. Dieser Bereich lässt sich weiter eingrenzen, da nur eine Summe von mindestens 15,0% eine Aufrundung der beiden Teilsummen Immuner bzw. Infizierter auf 14% bzw. 2% zulässt. Bestenfalls wurden in der Studie also 13,625% Immune und 1,625% Infizierte entdeckt. Dies entspricht bei 509 getesteten Personen ca. 8 Infizierten und ca. 69 Immunen.
Bei einer Spezifität von <100% wird die Zahl der Immunen jedoch überschätzt, da sogenannte “falsch positive” Testergebnisse vorliegen können. Die Zahl der gefundenen positiven Testergebnisse setzt sich bei einer (nicht angegebenen, aber zugunsten der Studie unterstellten) Sensitivität von 100% zusammen aus 100% der Personen, die tatsächlich infiziert sind, und weniger als 1% der Personen, die tatsächlich nicht infiziert sind (falsch Positive). Die tatsächlich infizierten Personen errechnen sich als:
(% positive Tests – % falsch Positive) / Spezifität.
Liegt die Spezifität also bei knapp über 99%, ergibt sich der Prozentsatz der tatsächlich Immunen nach Korrektur um die falsch Positiven als 12,8%, was einer Absolutzahl von 65 Fällen tatsächlich Immuner in der Stichprobe entspricht.
Nimmt man nun an, dass die Getesteten für die Bevölkerung von Gangelt repräsentativ sind, dass also besonders gefährdete Cluster wie die Bewohner von Alten- und Pflegeheimen mit in die Stichprobe einbezogen wurden, wäre eine Hochrechnung auf die Bevölkerung von Gangelt tatsächlich möglich. Allerdings entspricht eine Angabe des reinen Durchschnitts ohne Berücksichtigung der Unsicherheit (Konfidenzintervall) nicht den wissenschaftlichen Standards.
Stochastik kann mit Unsicherheit exzellent umgehen
An dieser Stelle wiederholen wir noch einmal unsere Aussage, dass stochastische Aussagen kein Zeichen von Schwäche sind, sondern eine Stärke wissenschaftlicher Erkenntnis.
Der Risikoforscher und Direktor des Instituts für Tranformative Nachhaltigkeitsforschung, Ortwin Renn, weist darauf hin, dass Stochastik aber auch bedeutet, dass wir die bequeme Sichtweise, wir müssten nur A tun, um B zu erhalten gegen eine wesentlich kompliziertere Sichtweise eintauschen müssen. In der Welt der Stochastik existieren stets mehrere Handlungsoptionen, die alle mit unterschiedlichen Wahrscheinlichkeiten und Unsicherheiten positive wie negative Auswirkungen haben können. Diese “Kultur der Abwägung” ist für viele Wissenschaftlicher und Politiker ein Fremdwort. Einfacher ist die Schaffung und Erfindung von uns gerade genehmen alternativen Fakten, so Ortwin Renn.
Bezogen auf die Heinsberg-Analyse lässt sich ein solches Konfidenzintervall mit Hilfe der Binomialverteilung (diese modelliert die Verteilung der Treffer in einer zufällig gezogenen Stichprobe) abschätzen. Die Binomialverteilung ist zwar nur eine Annäherung, da sie wiederholtes Testen einzelner Personen zulässt. Weiterhin kann bezweifelt werden, dass die in die Stichprobe aufgenommenen Personen unabhängig voneinander sind. Jedoch lässt sich mit dieser Annahme die ungefähre Dimension der Unsicherheit verdeutlichen: Finden sich unter 509 getesteten Personen 65 + 8 = 73 temporär Immune, so liegt die tatsächliche Quote in Gangelt mit einer Konfidenz von 95% zwischen 11,6% und 17,7%. Dies entspräche einer Letalität von 0,32% bis 0,49%. Diese liegt vollständig in dem Bereich, den Virologe Christian Drosten bereits Mitte März geschätzt hatte (0,3% bis 0,7%) und der in der “Unstatistik” vom 25.03.2020 rechnerisch nachvollzogen wurde (0,5% +/- 50%), allerdings im unteren Bereich der Schätzung.
Warum keine Aufschlüsselung nach Altersgruppen?
Diese Ergebnisse lassen jedoch nicht den Schluss zu, dass die Letalität (und die Mortalität) von SARS-CoV2 als geringer angenommen werden kann, als bisher vermutet wurde. Denn die Bevölkerung von Gangelt ist erheblich jünger als die deutsche Bevölkerung. So liegt der Anteil der über 65-Jährigen in Gangelt 9,4% unter dem Bundesdurchschnitt und der Anteil der über 75-jährigen ganze 17,3% darunter. Die Letalität ist in der Bevölkerungsgruppe der 70- bis 79-jährigen jedoch mehr als 5x so hoch wie im Durchschnitt und in der Gruppe der mindestens 80-jährigen mehr als 10x so hoch. Bei lediglich 7 Todesfällen, die oben rekonstruiert wurden, lässt sich nicht prüfen, ob in Gangelt andere Verhältnisse vorliegen. Es ist jedoch sehr plausibel anzunehmen, dass die Verstorbenen auch in Gangelt weit überwiegend höheren Alters waren.
Dennoch ist hier die Wissenschaft der Statistik nicht machtlos. Mit Hilfe einer Altersstandardisierung würde sich prinzipiell die Letalität auf die deutsche Bevölkerungsstruktur zumindest näherungsweise übertragen lassen. Geht man davon aus, dass sich Immunität und Todesfälle in Gangelt proportional zur Altersverteilung verhalten, d.h. dass insbesondere in jeder Altersgruppe eine gleich hohe temporäre Immunität (durchgemachte bzw. aktive Infektion) vorliegt, dann würde die tatsächliche Letalität in Deutschland lediglich aufgrund des höheren Alters ca. 10% höher liegen. Aus den publizierten Ergebnissen lässt sich jedoch nicht ableiten, ob die Immunität in den hohen Altersgruppen gleich hoch, höher oder geringer ist als im Durchschnitt von Gangelt. Wäre sie geringer, könnte dies bedeuten, dass die Senioren von Gangelt bislang für regionale Verhältnisse relativ gut geschützt waren und ihre tatsächliche Gefährdung somit durch die Studie unterschätzt wird.
Genau hier wäre echte Transparenz sehr zu wünschen gewesen. Eine Tabelle, die die positiv Getesteten nach Altersgruppen aufschlüsselt und entsprechende Quoten angibt, hätte den Wert des Zwischenberichts für die Öffentlichkeit, für die wissenschaftliche Diskussion und für die politische Entscheidungsfindung wesentlich erhöht. Warum ist dies nicht geschehen?
Eine wichtige Unsicherheit fällt in den “Heinsberg-Protokollen” völlig unter den Tisch
“Wenn wir einen sogenannten peer-review, eine in der Wissenschaft übliche Begutachtung durch weitere Experten, hätten durchführen lassen, bis hin zu einer schriftlichen Publikation, wären Monate vergangen.” So rechtfertigt Hendrik Streeck die Schwächen seines Zwischenberichts. Allerdings gibt es durchaus Spielraum zwischen einer begutachteten Publikation und einem Dokument, das lediglich gerundete Ergebnisse ausweist und auf die Angabe wesentlicher Informationen verzichtet. Dazu zählen insbesondere absolute Fallzahlen, aufgeschlüsselt nach den Altersgruppen, und die Angabe von Konfidenzintervallen.
Doch selbst die spärlichen Angaben des Zwischenberichts lassen keine Entwarnung zu. In Deutschland sind Stand heute (14.04.) 2.969 COVID-19-Todesfälle registriert. Überträgt man die Letalität von 0,37% auf diese Zahl, so entspräche sie einer Gesamtzahl von rund 804.000 bereits bzw. aktuell Infizierten in Deutschland. Das ist ziemlich genau 1%. Bei angenommener höherer Letalität, wie sie oben mit der Altersstruktur von Gangelt begründet wurde, wäre die Quote der temporär Immunen in Deutschland noch geringer.
Eine gänzlich andere Quelle der Unsicherheit fällt in den “Heinsberg-Protokollen” jedoch völlig unter den Tisch: Die Frage, ob die Verstorbenen an oder mit SARS-CoV-2 gestorben sind. Hamburg als bislang einziges Bundesland führt nachträglich Obduktionen durch und kommt damit zu sehr erstaunlichen Ergebnissen. Während das RKI am 08.04.2020 in Hamburg 14 COVID-19-Todesfälle zählte, kamen die Hamburger Rechtsmediziner lediglich auf 8 – ein Unterschied von knapp 43% (95%-Konfidenzintervall von 17,7% bis 71,1%). Mit der gebotenen Unsicherheit bedeutet das: Letalität und Mortalität in Gangelt könnten erheblich überschätzt sein.
Das Medienecho auf die “Heinsberg-Protokolle” war enorm. Die Ergebnisse sind ernüchternd, denn sie bringen nur wenig Licht ins Dunkel. Nähme man sie für bare Münze, so würden 0,37% Letalität bei einer angestrebten “Durchseuchung” von 70% bedeuten, dass am Ende der Pandemie über 200.000 Menschen verstorben sein könnten, vielleicht auch 300.000. Somit bleibt nur zu hoffen, dass wir aus Gangelt möglichst wenig über SARS-CoV-2 lernen können.
Was wir aber jetzt bereits lernen können: Datenethik und Datenkompetenz (Data Literacy) ist bei vielen Wissenschaftlern, Politikern und auch Journalisten nicht besonders ausgeprägt – trotz der jahrelangen Diskussionen um Big Data und Data Analytics. Viele “Experten” scheinen vergessen zu haben, dass zu einem seriösen Umgang mit Unsicherheit vor allem die Fähigkeit zählt, Daten auf kritische Art und Weise zu sammeln, zu managen, zu bewerten und anzuwenden.
Quellenverzeichnis
Authors
Katharina Schüller , study of psychology at the TU Dresden, study of statistics at the LMU Munich, doctoral studies at the TU Dortmund, scholarship holder of the Bavarian Elite Academy and the Nobel Laureate Committee Lindau. Founder of STAT-UP Statistical Consulting & Data Science in Munich. Further information
Frank Romeike , study of actuarial mathematics, economics, psychology and executive master’s degree in risk management. Founder and managing partner of RiskNET GmbH, formerly Chief Risk Officer of IBM. Lecturer at various universities on the topic of stochastics and risk management. Further information
[Image source: Adobe Stock]
A study into Germany’s ‘Wuhan’ has revealed 15 per cent of the town, where the virus first stuck the country, have been infected but death rates have remained low.
Germany launched the Heinsberg Protocol study to examine the rural town of Gangelt in the region of Heinsberg, where the first virus fatalities occurred.
Unveiled on Thursday, the preliminary findings, using the results of 500 of the town’s 12,000 inhabitants, showed that 15 per cent of the population was believed to have been infected.
But contrary to the national death rate, it revealed the mortality rate in the town would be 0.37 per cent. It is less than one-fifth of the mortality rate, based on confirmed positive tests in Germany as a whole, the researchers said.
The study is being led by professor Hendrik Streeck and researchers from the University Hospital Bonn.
It is hoping to test 1,000 people in the town and to date 85 per cent of them have given their permission to be tested.
Prof Streeck tweeted: “Thanks to everyone in #Heinsberg for making our study on #COVID-19 possible. Only thanks to you can we understand the virus increasingly better.”
The study is using antibody tests to sample a random portion of the population.
The death rate – fatalities among those diagnosed – has appeared lower than that of the nation as a whole due to picking up mild cases of the virus which had previously gone unnoticed, researchers said.
In the Heinsberg region as a whole, less than 1 per cent of the population has tested positive for the virus, and 44 patients have died, according to the Robert Koch Institute.
The new research comes as Germany’s health minister Jens Spahn revealed on Thursday that restrictions on public life are taking effect and are flattening the curve on new cases of the virus.
“The number of newly reported infections is flattening out, we are seeing a linear increase again rather than the dynamic, exponential increase we saw in mid-March,” Mr Spahn said.
On Thursday, the national disease control centre announced it is planning to conduct a series of blood tests to determine how many people in the country are immune to Covid-19 and how many were infected without knowing it.
Lothar Wieler, the head of the Robert Koch Institute, says starting next week antibody tests will be carried out on blood given by donors around the country.
His institute anticipates up to 5,000 samples will be conducted every 14 days, with results starting in early May.
A second survey will examine blood from about 2,000 people from each of four infection ‘hot spots’ in Germany. And a third will look at a representative sample of some 15,000 people across the country, with results expected in June.
Germany has confirmed more than 113,000 infections, according to a tally by Johns Hopkins University.
More than 2,300 people have died, a death rate lower than many countries.
Updated: April 10, 2020 12:49 PM
This is good news, although how good remains a matter of debate.
The mystery at the heart of the epidemic is how many people have had coronavirus while experiencing few or no symptoms. The University of Oxford’s model speculates that as many as half of all Brits might have it, which would be wonderful news. It would mean that virtually everyone who gets it shrugs it off with little difficulty; the people crowding hospitals are extreme outliers, prone to severe symptoms for reasons that aren’t clear. It would also mean that we’re much closer to herd immunity, in which 50-75 percent of the population has recovered from an infection, than we realize. There won’t be 12-18 months of “waves” of the disease. There’ll be one epidemic curve and we’re in the middle of it right now.
To know if Oxford is right or wrong, we need blood from a random sample of the population to see how many people have COVID-19 antibodies, the smoking gun that proves someone has had the virus and recovered from it. A study like that was done recently in the German town of Gangelt, in Heinsberg. Result: 15 percent, which is three to five times higher than experts’ best guesses of what percentage of the U.S. is infected.
Data from coronavirus deaths in Gangelt suggests an infection mortality rate of 0.37 percent, significantly below the 0.9 percent which Imperial College has estimated, or the 0.66 percent found in a revised study last week.The 15 percent figure from Gangelt is interesting because it matches two previous studies. Firstly, there was the accidental experiment of the cruise ship the Diamond Princess, which inadvertently became a floating laboratory when a passenger showing symptoms of COVID-19 boarded on January 20 and remained in the ship, spreading the virus, for five days. The ship was eventually quarantined on February 3 and all its 3,711 passengers tested for the virus. It turned out the 634 of them — 17 percent — had been infected, many of them without symptoms. The mortality rate on the vessel was 1.2 percent — although, inevitably being a cruise ship, it was a relatively elderly cohort.We gained another insight into SARS-CoV-2 from a Chinese study into 391 cases of COVID-19 in the southern Chinese city of Shenzhen. In this case, scientists tested everyone who shared a household with people who were found to be suffering from the disease. It turned out 15 percent of this group had gone on to be infected with SARS-CoV-2 themselves. Again, many showed no symptoms.
Fifteen percent was also what Spain’s infection rate was estimated to be per a model (not a serological study) published late last month. The good news from Gangelt, obviously, is the possibility that COVID-19’s fatality rate is much lower than everyone thinks due to the iceberg of asymptomatic cases lurking beneath the surface of the data, largely undetectable. But is Gangelt an outlier or representative of Germany as a whole? The wrinkle is that the virus arrived there early, in February, via a carnival attended by thousands. It had a lot of time and opportunity to circulate locally. That being so, some scientists think 15 percent transmission isn’t cause for optimism under the circumstances:
“To me it looks like we don’t yet have a large fraction of the population exposed,” says Nicholas Christakis, a doctor and social science researcher at Yale University. “They had carnivals and festivals, but only 14% are positive. That means there is a lot more to go even in a hard-hit part of Germany.”…Early results from hospitals are already circulating among some experts, says Christakis, who thinks these data will get us “closer to the truth” about how far the infection has spread in US cities. “If you see 5% positive in your health-care workers, that means infection rates probably aren’t higher than that in your city,” he says.
If New York City had “only” 15 percent infected, would that be good or bad news at this point? It would mean 1.2 million people were immune, for a true fatality rate of around 0.5 percent — but it would also mean 7.4 million were still vulnerable even after a nightmarish month, with herd immunity still a long way away. Also, bear in mind that the model that estimated 15 percent infection in Spain had much lower estimates for most other European countries:
What’s more, there’s reason to believe that coronavirus deaths are being undercounted — possibly by a lot — which means the true fatality rate would be higher than we expect. Here’s Lyman Stone’s visualization of deaths in New York State over time:
The many multicolored lines bunched around the 3,000 line show deaths from all causes week to week in New York during previous years. The solid red line shows deaths from all causes week to week this year. The solid black line shows confirmed COVID-19 deaths week to week this year. Notice the massive spike in the red line in weeks 11-12, when official coronavirus deaths were just beginning to appear. That’s a LOT of unexplained “excess” deaths. And given how sharply the black line has risen this past week, the spike in the next red line should be truly massive. Stone’s guess is sensible: “Hospitals may not be overwhelmed simply because many people are dying alone in their homes [from coronavirus] without any medical care at all.” We already have plenty of anecdotal evidence of that, in fact. This is much worse than the flu, even if the death rate from the disease ends up being lower than thought.
Here’s another visualization showing how freakish the spike is:
Even so, it’s possible that the Oxford model is right and what we’re seeing right now with the death spike in New York is a tiny fraction of a much bigger infected population that’s recovering from the disease with few symptoms. Some point to the fact that there was an increase in “non-flu flu-like illness” last month even before COVID-19 was supposed to have been spreading widely as evidence that many more were being infected than doctors realized:
Others point to the fact that California has had a minor outbreak despite its massive size and wonder: Could the state have encountered the virus sooner than known, with many millions developing immunity before COVID-19 made an impact nationally?
The trend has been particularly surprising, experts say, given the state has a large number of people in poverty and homelessness, and saw a substantial amount of travel to and from China last year.One theory centers around the idea of herd immunity – the concept that a large percentage of a population has already contracted and become immune to an infection, slowing the rate at which it spreads to others.Stanford researchers are looking into the possibility that coronavirus first hit California undetected last year, much earlier than anyone realized, and was only seen at that time as a particularly nasty and early flu season.
The problem with that theory, though, is that California hasn’t experienced any freakish death spikes like New York has. New York is slowly en route to herd immunity right now and there’s an immense amount of suffering involved. To believe that California has already arrived there, you need to explain why their path didn’t require anything like the same amount of suffering.
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‘Going outdoors is what stops every respiratory disease’
A veteran scholar of epidemiology has warned that the ongoing lockdowns throughout the United States and the rest of the world are almost certainly just prolonging the coronavirus outbreak rather than doing anything to truly mitigate it.
Knut Wittkowski, previously the longtime head of the Department of Biostatistics, Epidemiology, and Research Design at the Rockefeller University in New York City, said in an interview with the Press and the Public Project that the coronavirus could be “exterminated” if we permitted most people to lead normal lives and sheltered the most vulnerable parts of society until the danger had passed.
“[W]hat people are trying to do is flatten the curve. I don’t really know why. But, what happens is if you flatten the curve, you also prolong, to widen it, and it takes more time. And I don’t see a good reason for a respiratory disease to stay in the population longer than necessary,” he said.
“With all respiratory diseases, the only thing that stops the disease is herd immunity. About 80% of the people need to have had contact with the virus, and the majority of them won’t even have recognized that they were infected, or they had very, very mild symptoms, especially if they are children. So, it’s very important to keep the schools open and kids mingling to spread the virus to get herd immunity as fast as possible, and then the elderly people, who should be separated, and the nursing homes should be closed during that time, can come back and meet their children and grandchildren after about 4 weeks when the virus has been exterminated,” he added.
Wittkowski argued that the standard cycle of respiratory diseases is a two-week outbreak, including a peak, after which “it’s gone.” He pointed out that even in a regime of “social distancing,” the virus will still find ways to spread, just more slowly:
You cannot stop the spread of a respiratory disease within a family, and you cannot stop it from spreading with neighbors, with people who are delivering, who are physicians—anybody. People are social, and even in times of social distancing, they have contacts, and any of those contacts could spread the disease. It will go slowly, and so it will not build up herd immunity, but it will happen. And it will go on forever unless we let it go.
Asked about Anthony Fauci, the White House medical expert who for weeks has been predicting significant numbers of COVID-19 deaths in America as well as major ongoing disruptions to daily life possibly for years, Wittkowski replied: “Well, I’m not paid by the government, so I’m entitled to actually do science.”
IMAGE: Journeyman Pictures / YouTube.com
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General
Description
Mark Alexander Milley is a United States Army general and the 20th Chairman of the Joint Chiefs of Staff. As Chairman, he is the highest-ranking and senior-most military officer in the United States Armed Forces. He previously served as 39th Chief of Staff of the Army. Wikipedia
Born: June 18, 1958 (age 61 years), Winchester, MA
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M.N.:
The Operation CoronaVirus, by the New Abwehr, is the combination of the Biological, Chemical, and the Cyber-Information-Political types of Warfare, and it would be useful to recognize it as such.
The Operation CoronaVirus, by the New Abwehr, is the combination of the Biological, Chemical, and the Cyber-Information-Political types of Warfare, and it would be useful to recognize it as such.
Where is NATO? And Where is Trump? – Defense One https://t.co/GNmC7T6HP0
— Michael Novakhov (@mikenov) April 14, 2020
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The affiliation of its authors with the German Marshall Fund of the United States is noted and is telling, not only for the quality of writing but for the poosibility of the attempt to create yet another sophisticated cover and diversion, the devices, in creation of which the New Abwehr are the unsurpassed masters.
But first, we have to understand the nature of this crisis, from all the perspectives, including the medical-epidemiological ones.
If my hypothesis about the use of Novichok chemical weapon in this Pandemic, and the (almost obvious) attempts to put Russia in the front (very possibly, with her own unwitting and active, and very foolish consent and the willing, blind participation), and to use her as the focus of blame and the perfect cover, are correct, we have, inevitably, to look at Germany’s, and specifically BND’s role in INVENTING (!), researching, and acquiring the Novichok agent, which were covered openly and pointedly (to create another cover) by the mass media.
“In the 1990s, the German Federal Intelligence Service (BND) obtained a sample of a Novichok agent from a Russian scientist, and the sample was analysed in Sweden, according to a 2018 Reuters report. The chemical formula was given to Western NATO countries, who used small amounts to test protective and testing equipment, and antidotes.[33]“
Apparently, there many various types of Novichok weapons, including those that might be suitable to imitate or to act in conjunction with the viral epidemics, as the cover and the enhancement.
The timing: right around the 75-th Anniversary of Nazi defeat in WW2, cannot be missed, with all its symbolism and the various emotional reactions.
It would be a serious omission: not to look into all of this, in my very humble and the non-specialist opinion. This hypothesis has to be investigated very thoroughly: it might hold many clues.
Michael Novakhov
10:10 AM 4/14/2020
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Defense One – All Content.
But more than just ideas, this crisis has also had an immediate impact on NATO’s exercises, force posture, and readiness. The NATO mission in Iraq is effectively paused. The biggest U.S. military exercise in the post-Cold War era — DEFENDER-Europe 20 — has been scrapped. The movement of troops from the U.S. and across Europe is seen as too risky. Even though there are no current signs of widespread contagion among allied forces, they are hunkered down and the emphasis is on force protection. Pentagon leaders insist the U.S. military is ready to fight through the pandemic, if needed, but clearly such paralysis underscores the fragility of NATO’s military operations and deterrence posture.
NATO’s primary task is territorial defense. Russia initially tried to take advantage of the situation by poking at NATO’s defenses, and has been pumping out disinformation to try to undermine unity and seed conspiracies (such as the lie that NATO is responsible for COVID and its spread.) This won’t stop. And given how this pandemic has catalyzed Russia’s own health and economic crisis, we should worry about a scenario in which Russia seeks to test the alliance further to distract from domestic problems.
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If NATO does not seize this moment, the coronavirus crisis could undermine the alliance’s credibility and raise questions about its purpose yet again, only this time in a perilous post-pandemic world. If NATO fails to be seen as a player in alleviating the security burden caused by the pandemic — such as helping with airlifting supplies or demonstrating alliance solidarity — it will only give ammunition to those that want to weaken or dismantle it. Given that every NATO economy will be under tremendous strain in the coming years, it is hard to see how the 2-percent issue of allied defense spending will get any easier.
Fortunately, every crisis brings opportunities. First, NATO has a unique capacity to organize strategic airlift to support the fight against the pandemic both in ally and partner countries. Such capabilities have already helped deliver protective gear and medical supplies to numerous allies and partners in Europe. And as the pandemic spreads further in the Middle East and Africa, NATO should deploy its capabilities to help provide supplies and relief, which will be especially important given anticipated efforts by China to do the same.
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