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Observations


5 August at 21:50:12 - an important moment

 

Predicting the future of COVID-19 cases and events is treacherous.

I was quite wrong back in March of this year. A clearly downwards trend in reported cases, reversed itself in a very short period of about 10 days. That inversion has not been forgotten.

 

Yet at the present time, I can't hold back from announcing what I think is an important development.

 

It concerns active cases of the COVID-19 illness worldwide.

 

Let me share these graphs and clips from my database.

 

This is the second day in a row that that worldwide figure did not rise further.

 

These data originate at Johns Hopkins CSSE as usual.

 

Actively Ill in the world - 5 August, 2020

 

Here is this same result presented in a gallery of images.

It includes the dashboard at JH CSSE.

 

Conclusions :

  1. When compared with the Case Fatality Ratio on February 27, changes in that value have been trending downwards during the past month or more. Today, that change is a bit above 10% of the value in February. Again, this is not new. The death rate of this disease is diminishing day after day.
  2. For the 2nd day in a row, those actively ill with COVID-19 in the world have now decreased. That's new. Each day since February, this value always increased unremittingly. Yesterday it decreased for the first time. That was new. Today it decreased even further.
  3. As can be seen in the gallery image, which we'll also place here, the magnitude of this change is important:  429 thousand 192 fewer active cases since yesterday. That's a 6.42% reduction in a day.

 

Change in Actively ill since yesterday - August 5, 2020

This determines the following relationship with those who have recovered from COVID-19 :

 

World R to A ratio (1

The ratio of those who have recovered to those actively ill continues to increase (R:A ratio : 1.661)

which means almost 2 people have now recovered for each person still actively ill.

 

Blind optimism should be avoided since the actual number of those actively ill is estimated today at 6 million, 568 thousand, 833. That remains a huge number of COVID-19 active cases in our world.

 

Nevertheless, we will again risk saying here, that today's results merit being underlined, and this date remembered. 

 

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05/08/2020
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Où les éléphants vont pour mourir

 

Where elephants go to die

 

Un cimetière d'éléphants est un endroit où, selon la légende, les éléphants plus âgés se dirigent instinctivement lorsqu'ils atteignent un certain âge. Ils y vont pour mourir alors seuls, loin du groupe, et pour éviter d'empêcher le troupeau de progresser.

 

Une fois qu'ils ont usé leurs dents molaires après des années de s'alimenter, au point de ne plus pouvoir manger et mâcher des branches et des feuilles plus dures, ils deviennent hypoglycémiques. Ils recherchent des endroits avec de l'eau et ensuite commencent leur randonnée vers le cimetière des éléphants.

 

Alors, y a-t-il des endroits où les humains vont pour mourir?

 

Presque certainement, oui.

Plus dans le temps passé que ce jour, les êtres humains restaient avec le troupeau jusqu'à la fin.

 

Bien qu'ils puissent rechercher ces endroits pour être guéris et non pour mourir, certains mourront lorsqu'ils y iront ce jour.

 

Aujourd'hui, ces lieux pour beaucoup des gens malades sont appelés hôpitaux.

 

Voici un petit résumé graphique pour les données des décès en Belgique dus à la maladie de COVID-19.

 

Deaths by Region, Summarized - 1 August

Au cours des derniers mois, nous avons souvent présenté ce résumé graphique. Il a été étonnamment constant dans ce qu'il enseigne. Quasiment aucun changement dans cette répartition des décès depuis le tout début du passage de la pandémie à travers la Belgique.

 

On pourrait commencer à se former une idée qui conduit à croire que le virus SRAS-CoV-2 tue plus de personnes dans une région que les deux autres en Belgique. Une préférence encodée dans le métériel génétique de son ARN.

 

Les gens cherchent une explication à la légende du cimetière des éléphants depuis des années. Mais les données apparemment inchangées présentées ici de la distribution des décès par région n'ont pas plus à voir avec le virus et son comportement qu'avec les éléphants.

 

Au lieu de cela, il s'agit de la façon dont le troupeau d'humains a décidé de vivre dans ces trois régions. Il s'agit de l'endroit où les hôpitaux ont été construits en Belgique. Vous pouvez les voir sur cette carte.

 

 

 

Et bien sûr, là où se concentrent les hôpitaux, c'est là que se concentrent les laboratoires. Nous avons déjà présenté la carte suivante à plusieurs reprises.

 

 

 

 

On pourrait supposer que ce sont des effets purement démographiques. Là où il y a plus de monde, il y aura plus d'hôpitaux construits, et c'est la même chose pour les laboratoires. Peut-être comme le nombre d'écoles ou de restaurants. Aussi simple que ça.

 

Voici ces chiffres.

 

Belgian Population

 

Quand on est malade, voyager loin pour être soigné ne semble pas très attrayant.

Au lieu de cela, on va dans un laboratoire à proximité pour son test et dans un hôpital à proximité pour ses soins.


57,7% Flandre + 10,6% Bruxelles + 31,7% Wallonie = 100% de la population belge.

 

Et cela, encore une fois, n'a rien à voir avec le virus ni avec les éléphants.

 

Les cas signalés suivent cette distribution de près.

 

57,49% Flandre + 10,55% Bruxelles + 30,44% Wallonie = 100% des cas signalés.

 

 

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Mais notez que les décès par région ne correspondent pas parfaitement à la distriution de la population. Les chiffres totalisent encore 100%, mais ...


50% Flandre + 15% Bruxelles + 35% Wallonie = 100% des belges décédés, et dus au COVID-19.


Mais comment expliquer ces petites différences observées?

 

Poutquoi un taux de mortalité qui varie par région?

 

Mortalité par région - 2 août

 

 

Pourquoi plus de décès en Wallonie et à Bruxelles qu'en Flandre?

 

  • Y avait-il des différences régionales en matière de santé avant le COVID-19 rendant certaines populations plus susceptibles de mourir?
  • Les personnes qui se sont présentées à l'hôpital dans une région étaient-elles plus malades et, par conséquent, plus susceptibles de mourir?
  • Les soins fournis étaient-ils différents d'une région à l'autre, de sorte que certaines choses faites, ou pas faites, ont contribué à des taux de mortalité plus élevés?
  • Peut-être est-ce aussi simple que de déplacer les personnes atteintes de la maladie hors de leur région et dans une autre pour des soins spécialisés?

 

De telles questions peuvent vous sembler bizarres ou moroses.

 

Ces différences de taux de mortalité par région ne sont pas si importantes, diront certains.


Et pourtant, typique de l'histoire de la médecine, les progrès se font rarement par pas de géant.

 

Au lieu de cela, étudier de petites différences dans les résultats au fur et à mesure que les patients sont soignés et faire de petits changements les uns après les autres, est la façon dont les progrès sont réalisés. Même pour un géant du passé comme Louis Pasteur.

 

C'est ainsi que plus de gens sont finalement guéris.

C'est ainsi que la mortalité due à une maladie est réduite.

Comme un éléphant qui marche, un petit pas après l'autre.

 

Le fait que ce résumé graphique n'ait pas changé depuis le début de la pandémie signifie qu'il manque quelque chose dans notre compréhension des chiffres.

 

On s'attend à ce que ces chiffres changent, même si légèrement, au fil du temps pendant cette pandémie. En Belgique, ils n'ont pas changé. Ce n'est pas le virus. Ce ne sont pas les éléphants. Ce sont les habitudes d'une pratique médicale bien établie. Les choses se font dans un sens et pas dans un autre. C'est une méthode qui est enseignée dans les écoles et pratiquée pendant des années. Pas toujours, mais souvent, sans qu'aucun changement ne soit apporté à ces habitudes de pratique.

 

Il nous reste à espérer que d'autres personnes, des personnes directement liées aux soins de santé en Belgique, se posent ces mêmes questions avec le but d'améliorer les résultats présents.

 

Ceci au lieu de croire que les choses sont comme elles sont, et ainsi, sont comme elles doivent être pour le bien de tous. Un tel langage rappelle Candide de Voltaire.

 

Je suppose que les éléphants ne lisent jamais Candide. Mais ils savent où aller pour mourir.

 

Old elephant

 

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Si vous avez une question maintenant, posez-la ci-dessous.

 

 

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02/08/2020
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Si on met du sel, ils viendront

 

Salt lick 1

 

 

Si vous mettez un bloc de sel dans les bois ou dans un champ, les cerfs et les chevreuils viendront.

Si vous mettez plus de blocs de sel, vous obtiendrez plus de cerfs et de chevreuils.

 

Salt lick 2

 

 

 

On y va encore une fois.
Les discussions sur les pratiques de laboratoire sont à nouveau d'actualité.

 

Celui-ci de Lavenir ...

News clip - testing - lavenir - 29 juillet

 

Pourtant, il est frappant de voir qu'avec le temps, rien n'a changé.

La "solution" de ce problème était bien évident au mois de mars. On est en juillet. Mêmes discussions.

Comme si on venait de découvrir le problème pour la première fois...

 

Cas et Labos - 29 juillet

 

 

Si l'on veut voir plus de cas en Wallonie, augmentez le nombre de sites où les tests sont effectués.

 

Si vous voulez moins de cas en provenance de Flandre, fermez la moitié des laboratoires.

 

Le virus s'en fiche et ne compte pas les cas. Il recherche simplement la prochaine personne à infecter.

 

 

 

Les tests les vendredis - 24 juillet

"Do or do not do. There is no try."

 

--------

 

 

Au cours des 5,8 mois que la Belgique a vécu avec ce petit problème de dépistage, d'autres pays du monde ont fait des progrès importants.

 

Fournir à la population des tests qu'elle effectue elle-même et renvoie au laboratoire est une solution très viable. Il est déjà pratiqué pour la recherche de cancers du côlon (dépistage) en Belgique.

 

Mais au lieu de cela, la Belgique continue de faire exactement ce qu'elle a fait depuis le début.

 

Y compris argumenter sans cesse pour savoir qui a raison dans cette discussion.

 

Qui peut être testé - 29 juillet

 

 

Testing critères trop sévère

 

 

 

 

Voici quelques d'images sur le sujet lié des masques 

 

Masques partout - 29 ,juillet

 

 

 

 

 

Très dur. Très belge. Évoluez un peu.

 

Que se passe-t-il si tout reste le même? Vous pourriez être dépassé. Cette fois par un ennemi invisible.

 

 

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29/07/2020
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What it looks and feels like out in the street - USA - July 7, 2020

Several videos follow.

 

They capture a situation that no one living today has ever experienced.

 

A difficult time. In the USA, in the United Kingdom, in Italy or Spain ... take your pick.

Some countries seem to be passing into less turbulent waters. Not the USA. Or not just yet.

 

In all cases, human resourcefulness is being stretched to the maximum.

 

In all cases of success, people placed as much distance as possible, between themselves and the SARS-CoV-2 virus. Masks, distancing, sterilizing surfaces, waiting appropriate amounts of time before recontacting items brought into the house. Nothing else works as well. 

 

In surgical practice, when results were not those desired, it was often due to errors in technique or errors in judgement, but most often, errors in diagnosis. When one applies a good treatment to the wrong disease, the result is often poor. Here, the diagnosis is known: COVID-19. 

So not wearing masks on purpose = an error in judgement. Laws of probability for something this transmissible, mean that eventually such a faulty judgement leads to loss. A bad result.

Errors in technique are unfortunately common if people haben't been messing with masks aand gloves and disinfectants and hand washing for 5 to 20 or so years. Most of the time, you sneak by, and the patient does too. But if errors in technique happen too often, you're up against the laws of probability once again. Oops! and you have a bad result. 

 

In surgery, bad results, though frowned upon, were privately a source of sadness, and often took years to excuse, and ofte never were. Forty years later, some are never forgotten. All that represents a willingness to bite the bullet, learn from one's mistakes, share openly what one has learned, and get on with a better result the next time. We laughes at ourselves often. But the dedication to "potential patient benefit" as we gave our all (at least many who's company I shared, did just that, each and every time) to select what just might help the paient get better ... that was never taken as a joke.

 

I'm not sure that I see that level of dedication in much of what follows. It's now time for the jokes to end.

There is only one side to take in all of this. That of humanity as it currently exists worldwide. We have to all get on the side of our fellow humans and give them our best. Tired or not. It starts with ourselves. Each one getting her or his technique down perfectly. Teaching it to others. Sharing. And getting enough rest to be able to stay in the trenches. It has come down to that.

 

When one listens to the experts at NEJM, JAMA, Lancet and others, present what they are learning, understand that the experts are still learning a lot. Think of terms like asymptomatic transmission, droplet transmission for hours in closed spaces, the special role of children in all of this, Blood-Type differences in outcomes, more transmission of virus in homes than at the hospital, antibody responses that are hard to make use of,  to name a few. They are learning, they get surprised each day, they still try to keep that "expert look." Don't get angry when they seem to fall flat on their faces. This is noy appendicitis or a duodenal ulcer. We've studied and treated those for years. And still make mistakes because the unknown never drops to zero. 

 

But for SARS-CoV-2 or COVID-19, the unknown may still be a majority of what we have to learn.

That has nothing at all to do with saying the right thing to garner more votes.

 

But we are learning. And the people in the street are learning. Too often the hard way, after a 3 to 6 week delay. Saying goodbye to family members from a distance, through a window. 

 

Just as we wrote back in late February, the right aproach comes from Uncle Remus (no matter how those stories are now taken in the new racial context): "An Br'er Fox, He Lay Low." Continue to be like Br'er Fox. An Br'er Bear too. Lay low.  

 

For all of those at the bedside of sick patients today, from my comfortable seat across the Atlantic, I honestly wish I could be with you at the bedside, doing together all that we can. Sharing what I learned as an ICU Director, and learning more together. Caring for each other while caring for others. I also fear that such dedication to a vocation, might quite likely end as a fatal error if I got on the plane and just showed up where needed. So my prayers for you and yours are constantly in my heart, and often on my lips. Rest assured.

 

As one watches below, nothing else need be said. Nothing else can be said.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

"An Br'er Fox, He Lay Low."

 

This is a much bigger, stickier, and nastier Tar Baby, than Uncle Remus ever imagined and wrote about.

It doesn't have a brain. It just has it's RNA, and a helluv' an effective way to distribute it and assure its Darwinian success.

 

Who will be "the fittest"?

 

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07/07/2020
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Observations about control of the numbers in Belgium

The COVID-19 situation in Belgium, must surely benefit from placing it in the larger context of the COVID-19 situation in our world.

 

The unfailing help of Johns Hopkins CSSE will be turned to. This graphic summarizes the case data from 188 countries with infection as of yesterday June 27 ...

 

World - Daily Cases - June 27, 2020

 

Conclusion :

The burden of daily cases in the world is increasing markedly. If current trends in Belgium are comforting, and they are, the relationship to this curve is nevertheless unmistakable. On the left, when Belgium announced its first cases in February and March, where did these cases originate? From elsewhere in the world. SARS-CoV-2 got into Belgium from elsewhere.

 

And on the right, the world has now many more cases of COVID-19 to report and to "share" with Belgium than in February. An increase of thousands of percent. 

 

And yet, the world continues to "reopen." Belgium continues to reopen. Not just planning to do so, but already well underway, including international travel. At the beach, at café terraces, in grocery and other stores: a rare mask or social distancing "fanatic" still in evidence since the sun has come out.

 

ALL IS NOT DOOM AND GLOOM

While the above continued increase is impressive and concerning, this illness concerns less than 1% of the world's population. 

 

Less than 0

 

So, are we getting too excited abut a disease that involves such a small percentage of our world?

 

That typically happens with events that kill and maim people. Human nature magnifies the problem by asking: "What if it were me?"  Unlike in centuries past, bad news travels much faster today at electron speed.

 

COVID-19 kills about 5% of those who contract it worldwide. That means that the body count continues to be added to each day, just as non-lethal cases increase. But with time, when compared with February 27th, the death rate is slowing.

Trends 4 - Change in Deaths and Death Rate compared with Feb 27

 

Specifically, the death rate from COVID-19 on February 27 was 3.41%. (n°1 below).

On 27 June, 5.04% (n°2). That is of course a higher rate, and a 47.9% change (n°3). 

 

Change in Death Rate explained - June 27, 2020

 

If one backs up far enough to look at the last 90 days ...

 

In dark purple below are the cummulated deaths. This is a body count, and will never come down, but simply round and flatten at the top. It will stay at that maximum forever after the last death is added. An odd epidemiologic monument hidden away in an archive.

 

World 90 days - deaths and death rates - June 27

 

The light purple or gray curve is the change in death rate. It is now coming down.

Again, this is a comparison each day with the death rate on February 27.

 

In the last 8 days, the numbers present like this. In each case the number above the column is the percent above the death rate value identified on Feb. 27. It's still above that date's value. It's coming down. 

 

Last 8 days of change in death rate - June 27

Why would death rates be diminishing? One explanation selected out of many, is that medical therapy is learning, as the pandemic proceeds, how to better apply medical therapies that save lives. This, without a vaccine. Another of course is that a significant number of people learned that if you stay indoors and away from sources, you don't die. More and more came to believe in that. It took a while for that to take effect. No one knows where that is headed today.

 

 

A final word of hopeful news at the global level

 

Doing body counts correctly is not the goal, or shouldn't be.

 

The goal is to avoid transmission, and get those who are actively ill to a recovered state.

How are we doing with that goal of saving lives and healing the sick where possbile?

 

There is a gradual improvement. This is expressed below as a ratio: the number of Recovered person(s) for each Actively ill reported case. 

The numbers are large: 4 945 557 recovered. 4 381 834 actively ill in the world today.

That generates a ratio of 1.134 :  1. So just over 1 person recovered for each person still sick. 

This relationship has only turned positive (ratio above 1) in the last 2 weeks.

 

It is hopeful and comforting.

But it does not come on this day with any guarantees of permanence.

World R to A ratio - June 27, 2020

 

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BELGIUM

We are now at a point in the pandemic in Belgium, where confirmed cases and deaths have diminished significantly on a daily basis. This has been noticed at a global level, and resembles the trajectory of most other countries. The virus arrives on a certain date. It does its thing for 4 or 5 months. Then it leaves. That would be nice. But some effort is required to get it out the door and on its way...

New Deaths declining for these countries - June 24, 2020

 

 

These numbers have diminished to a point where those doing the counting in Belgium have changed their method for reporting the COID-19 case results to the Belgian public. When there's nothing to count, the most important task may become deciding where to have lunch.

 

In Belgium, values are now averaged over 7 days, but two days a week, no daily results are reported. Or if you prefer, 0 is the unreported result. That looks like this, and certainly makes for a less attractive and comprehensible graph :

 

Nouveaux cas - 27 juin

Key question on this day

If the need arises, and cases rise again, as happening in other places in our world, will Belgium respond again at its slow pace to an obvious need to resume vigilance?

 

In what follows, all data are taken from SPF Santé publique, through their agency named Sciensano.

The data discussed here, their data, can be downloaded as Excel spreadsheets at this link.

 

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What have we learned from carefully following those data presented over time?

  1. Data accrual has had its problems
  2. Even when data are lacking, conclusions are still drawn and presented
  3. A defensive attitude has arisen which seems to have separated experts, government, and probably the public, and which the Press of course loves. "If it bleeds it leads." Bring on the pain.
  4. The data are presented to the public surrounded by an aura of certainty, while much variability in the numbers actually exists. What follows tries to discover, present and underscore that variability.

 

EXAMPLES :

 

Case data are now presented as 7 day averages, like this:

Tendences clées - 27 juin

 

OK. That seems like a quick read. 

 

If one reads the fine print, (see below) one learns that for their 7 day averages, at least the 3 last days reported have data that "are not yet consolidated." This means the numbers will most certainly change. Or, 3/7th of the numbers are bad numbers. "Garbage in. Garbage out."

 

This can pose a degree of aggravation for anyone trying to follow along day by day. That's less important. They would probably agree.

 

Of course the goal is to get to "no cases to report." Forever.

Just counting whatever comes in, (and complaining about what didn't come in from Flanders once again), that is not the goal.

 

So do current methods of reporting at Sciensano contribute to that goal of completely ending the infestation in Belgium or not? For that should be the goal. 

 

La merde c\\\'est de la merde

 

We have grown used to this footnote. Perhaps too accepting.

We have lived with results that were, as it says again today, "pas encore consolidés" (incomplete) when following reported deaths in Belgium.

 

A very touchy subject in Belgium which still has a death rate around 16% when the world's mortality figure is closer to 5%. 

 

Understanding outcomes that lead to death of a patient is an important part of medical therapeutic success (and failure). Does an illness affect men or women more? In what age groups? Are certain areas in the country more affected? Answering these and other questions about death events comes with the turf of trying to avoid death of a patient when one is charged with selecting and doing the treatments. Basic and essential natural history of a disease is what it's called. 

 

As already presented here in other articles, a trend of incomplete records has been in evidence for months, with only gradual and minimal improvement. Writing to the government officials involved got no response.

 

Age and gender data are chronically missing. In Belgium, it remains at just under 30% of reported deaths.

In fairness, the number of deaths where the location of the death was unknown has dropped from a value in the 30's to 19. It took over 3 months to make that headway.

 

When 9 732 people have died in Belgium, maybe such omissions can be defended.

"À la guerre, comme à la guerre."

 

In our little corner of Belgium, we find them, with 2 728 records incomplete, totally inexcusable.

 

As Benjamin Franklin wrote: "Three can keep a secret, if two are dead."

 

In Belgium, two who did the job right live in Brussels and Wallonia, but the third is in Flanders and he's not talking. That person had and has many other things to do besides look under the bedsheets to see if the decedent was a woman or a man. It may also have required checking a box on a form: ___F  ___M.

Yet another imposition, when the patient is dead anyway. "Dead Men Tell No Tales" said the sign.

 

Mortality Summary with missing data values - 27 June, 2020

 

We've even found the culprits. For yesterday's incomplete records count of 2 728 deaths, one notes that coming out of the Flemish region, only 46% of deaths have complete data. We're not talking about subtleties like ABO Blood type or BSA of the decedent (which would be very good to know for certain living COVID-19 patients), but whether the decedent was a man or a woman, and about how old. Also missing, where they were located physically when they died. Real, basic, stuff.

 

Panneau sommaire - 27 juin

 

Next, as those doing the counting work with the mortality figures they have actually received proceed with their task, another special phenomenon has been observed.

 

Sometimes deaths just disappear from the roster.

 

We have called these "Les ressuscités" (those resurrected). On 27 June the summary panel looked like this. Five more deaths removed from the books yesterday, for a total of 100 such ressurections since 9 May. Up in thin smoke. Should definitely help the Case Fatality Ratio if it continues.

 

Les ressuscités - 27 juin

 

 

Nothing to get excited about.

It's really just epidemiologic book keeping. Happens all the time. 

 

There may even be a Belgian method to their madness. 

 

But for anyone interested in following the numbers, one should know that the shakiness is not only for terminal cases as noted above, but also with the incoming confirmed cases who are still alive. 

 

And as the numbers get smaller, and the Belgians begin to "open up" at the beach and local cafés, one often hears comparisons of yesterday's numbers with those just announced today at noon. They are a population dedicated to their government and the numbers it feeds them. (Government? Did I say government? What government? The one we voted for last elections? Ha!)

 

The Belgian population depends on it's government for direction (96% in one poll, follow government's directives daily in all this pandemic stuff). Not many revolutionaries, anarchists or activists on the horizon here. So deciding on that upcoming vacation to Croatia or Corsica or for an educational visit with the kids to a porc-packing plant in Germany next month, depends on careful consideration of "les chiffres clés" (the key numbers).

 

So just how firm are those numbers?

How many numbers are missing as cases get reported? How variable are these numbers or are they set in stone once published?

Here's a closer look ... On June 26:

 

(click to enlarge)

Case missing data - June 27

 

93 cases where the date of a positive test is unknown, 1394 where the region of the country is unknown, 195 cases with age missing. We've learned to see and accept such gaps from the reported deaths. 

Notice that the 61,106 cases, occupy only 14,388 records in the Excel file. Or, 4.25 cases per record.

 

That fact might look like this:

Good luck finding your personal record if you had a positive test on March 26th, as one example. The highlighted colum are the case numbers reported on a single line of the record.

 

Multicase records

 

Summarizing by region of Belgium, case numbers look like this

Let me help you with this: On the 26th of June, differences as noted between the total cases of COVID-19 presented to the public by region of Belgium, and the data in the Excel spreadsheet.

It's certainly up to them to control how the results emerge, which results emerge, and to whom, and where to place the emphasis. Maybe "SPF Santé publique" should be renamed "SPF Santé presse," or "SPF Santé média."

 

But perhaps more important for any subsequent study, and going beyond just serving government intentions, 3 to 5 cases presented on each record of the spreadsheet (that's on the left here below as the number of cases per record (c./ r.) ).

 

 

Cases by region and number of reports

 

Any subsequent analysis of results may have a real hard time taking these cases apart. That's at least one point. Other reasons to not use this method have been presented, and we'll spare the reader that exercise here.

 

Here is an opportunity for the conspiracists to chime in: "No surprises here. They are keeping a separate parallel record with all the data, line by line. And of course, you will never see that record."

 

"Will the conspiracist please sit down now? Thank you."

 

They did the same thing with death reports we saw above: Lumping more than one death on a line of the record.

It has taken just over 3 months to not get those sorted out. Not even close. Not a pinch of improvement in months. Until perhaps the last week. We'll see. The beat goes on.

 

But with cases, certainly the number of cases reported to the public, one might assume that they must match up perfectly with what is contained in their Excel spreadsheet.

 

If not, where are the numbers coming from? Which are the correct numbers?

 

Let's have a look ...

We'll look at cases as reported, and data from their Excel spreadsheet.

 

Let's go back to June 20th and the week preceding that date. That's a week or two before today's date of June 27 when this was written. Certainly that amount of time should permit the smoke of numbers "not yet consolidated" to clear. The data extracted from reports and the database look like this :

 

(click to enlarge image)

 

Excel vs reports

 

If one focuses on the two green lines, the row above are the numbers out of their Excel spreadsheet, and below, the numbers reported. They don't match up very well. On the 20th, no data on the spreadsheet for the 19th, since these data are not in yet, one supposes. 

 

Let's look at a specific day, June 15 :

Not only are the reported cases (71) different from those in the spreadsheet (148), but the 148 new cases occupy only 88 lines of the spreadsheet (1.68 c./ r.). So still, they are doing with the case records, just as they did with the death records. Making them, well ... inseparable forever. Just wonderful for subsequent study of what actually transpired in 2020 in Belgium. "Do they still teach History in school? No? Then we should be OK."

 

Excel vs reports and records

 

Let's just work for a moment with Total Confirmed Cases. Somehow that should provide an overall view with greater clarity. Less chance of getting lost in the details.

 

How many new cases are added, to get to the next day's value of Total Cases?

That depends if you are reading the values given in their Reports (and presented by the media), or in the Excel spreadsheet (which they are kind enough to share). In both cases, these are "their" numbers.

 

"Answer is?" : It doesn't match up perfectly. But should it? Here are the values for the June dates indicated.

 

Total cases - June 20th and before

If one calculates the % error between reported and Excel total cases, that error is small, since the numbers are large. So they slip by pretty easily. But should each pair of numbers be the same?

 

Many people who have been following along, might answer: "Yes. The numbers should be the same."

 

Why aren't they the same?

I don't know. Ask Sciensano. That's a pretty solid response. Ask them. It's a valid question.

 

But my hunch is that we are in a soup of Belgian numbers. Un potage fait maison.

 

I also am pretty convinced that the Chef keeps tinkering with the case numbers, just like with "Les Ressuscités" for the deaths that one day, just disappear from the soup, ... I mean, from the count. 

 

Some will defend that it's just how this job is done. You tinker with the numbers already presented as somehow definitive, and you change them. They're just not definitive yet and need some help getting there. Then you decide what to tell others. Or don't see the need at all.

 

But clearly, or not so clearly ...

 

One should not tie up too much attention and cognitive force on memorizing today's numbers when they come out at the next noon. That's a recommendation to our readers. 

 

Count on it. In the days to come, as they work up the 7-day Averages and compare with the previous 7-day Average of new cases, those numbers are just floating in the soup. Take a taste, but don't drink the whole bowl. And especially, don't ask for the recipe, since it changes every time they make the soup.

 

If you have your doubts about my suggestion or numbers presented, download their Excel spreadsheet today, and again in 5 days, and see how the case numbers for the same date  have been modified. 

 

Is it a random thing that now, no data are presented for Sundays and Mondays, getting back ino the swing of things on Tuesday? Is Tuesday a "what the hell" choice?

Probably not. Cases are always lowest on Tuesdays :

 

Cas totaux par jour de semaine - 27 juin

 

Any Tuesday is much more likely to be a "Looking Good!" day for all those listening attentively.

 

Of course, the monthly mortality figures can be glossed over in Tuesday's presentaion, since those numbers risk being less reassuring:

 

Décès par jour de semaine - 27 juin

 

"So you mean, it's a conspiracy?"

Almost certainly not, but who knows.

 

Much more likely, hideous inefficiency, further paralyzed by government preferences directed at a bunch of nice guys who usually just sit quietly at their desk and get their surveillance work done. Without any TV cameras rolling. Now they're being pushed on each day to "get some good numbers." So they do.

 

 

"What becomes of all these numbers?"

If one elects to calm one's nerves and avoid obsessing, the real importance lies of course in how the numbers are put into use. What is the message being sent to the public? Here's an example of that reality in Belgium :

 

Data taken from their daily or weekly report, presenting graphically the age and gender of those who died.

 

Deaths by age and sex (sans footnote)

 

One might have a quick look in passing at the above graph, and conclude that those over age 60 or so are mostly involved, and that males and females are almost equally at risk of dying of COVID-19. Depending on one's age, one might feel a lot better, or a lot worse. But wait! A  footnote has been removed from the graph (but added below) ...

 

That footnote informs us that for 2 724 deaths, the age or gender or both of the decedent is not even known.  Yet they divide up the pile by age and gender to present thir truths.

 

They're just not going to be stopped it seems.

 

Deaths by age and sex

 

So what is the right thing to do with this graph?

Choice #1: Release it to the media who can show it several times a day to the public? Perhaps not but has been happening daily.

 

Choice #2: A better choice might be to place it in the bottom drawer of one's desk, and spend one's time solving Belgium's problem (almost completely a Flemish problem) with getting simple case data (age, gender) reported correclty and promptly. Sounds like too much work with an unwelcoming audience.

 

Choice #3: Tinkering 3 months after the fact and still getting nowhere fast. Then publishing the same graph. That's about where we are today.

 

If the present misuse of data continues, who knows? Perhaps tomorrow, in response to a graphic like this one below, someone will announce on TV :

 

"We are happy to report that things in the world are now better, or will certainly be tomorrow."

"Time to plan that trip to Mexico after all. Tomorrow that curve should drop to zero or almost zero."

 

Weathermen of the pandemic.

 

World - Daily Cases - June 27, 2020

 

A final opinion :

It might be better for Belgium's epidemiologists (and the government that controls them) to focus on how to get rid of the lingering fat tail on the graphic below, and while there's still a chance to do so.

This pursued through any and all means available and necessary.

Naively put: this remains a very infectious disease. Belgium, work on your fat tail.

 

Nouveaux cas c tail

Implementing such known actions might be a much better pursuit, than getting the data right so a Minister of This Or That can announce to the people that they can all go on vacation and send kids back to school when they get back with their tans.

 

Such messages and plans for reopening while the tail is still fat, and the world is still sick and infectious, need a wiser approach.

 

Yesterday, the process of contact tracing in Belgium (which never actually got it together), was taken apart, leaving now only 40 or so contact tracers. They apparently didn't have enough work and some people refused to talk to them about their contacts. "Some people were rude with us. Just not enough to do..." they said to the Press. The government reacted: "Your fired! And you, and you, and you!"

 

Forget the word "preparedness." It's not currently in any of the 3 languages spoken in Belgium.

 

Instead, it's time for Belgium to decide to participate in uniting the world, not just in its little country with its anachronistically still divided 3 regions. Fat tail. Fat chance.

 

If the "experts" and government are still a little touchy about that 15.9% mortality rate, here is the cause of that statistical result. No matter how the statisticians turn on their heads to find excess deaths and compare with Z-Scores the mean rates in Europe and the world, Belgium's mortality rate is still way up there on the list: Belgium you started everything too late. But over time, you finally began to get it together without being showy. You are still continuing that proud and polite tradition of carefully thinking through all your options, until there is no longer any option left. It seems an entrenched tradition. Then announcing that you have already been doing the right thing since years and years.

 

While trying to keep Church and State separate here ...

 

Proverbs 16:18, which says “Pride goes before destruction, a haughty spirit before the fall.”

 

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A word or two for the epidemiologists in the audience

Before you get the numbers just right and leave your offices to join in the festive and folkloric carnivals, get your mind right.

 

As Seneca wrote centuries ago ...

 

"Si non sit ignoranti quem portum navigantibus nullus suus ventus est."

 

 

Which port

 

 

No numbers can defend for very long, bad decisions. That includes a decision for inaction when right action is needed.

Be proud. Speak up. At least one person is listening.

 

 

 

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28/06/2020
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