Tracking the UK "Second Wave" Death Toll

Adam Larson (aka Caustic Logic)

September 27, 2020

updates Dec. 8

As the United Kingdom sees a rise in Covid19 infections, PM Johnson and others have suggested a new round of stay-at-home "lockdown" order may become necessary. Many are frustrated and confused. For example, independent journalist Anna Brees, a lockdown skeptic, shows the UK deaths curve (still looking totally flat at the end, and asks "lock me down for this?" 

As I see it, the first round of lockdown was "for this" - to make the people make that the death curve, instead of the one they were on the way to. As this shows and everyone knows, daily deaths had been doing nothing but rising sharply before they leveled off and then fell rather suddenly, starting in mid-April. That's about 2 weeks after restrictions were imposed and new infections witnessed a similar, if milder, decline. Most logically that's less contact, making less infections, and thus less fatalities. If that had been delayed, deaths would have kept rising to even higher levels it would take longer to arrest and then climb down from. 

Of course, it's a "second wave" and the deaths from that they worry about, and these haven't happened yet, aside from perhaps the low-rumbling start of them. I had just been looking gain at UK deaths again and noticed they've been rising - they had been down 4 or 5 most days, sometimes zero. But now they've gone back up to 10, 15, 26 a day and rising, with revisions pushing tallies into the 30s, and the latest full day currently says 45 deaths just in England and Wales on September 23 (these are Public Health / NHS stats - ONS still tallies a higher number for England and Wales, I noticed - 51,917 there, to official UK total 42,060 including Scotland and Northern Ireland). 

That rise doesn't yet show up clearly on a scale distorted by highs around 1,000 deaths per day, but it's a bad sign, and just the start of what will wind up hurting. Having a look at recent infections, it's clear that second wave is real and has already been happening. Official stats when I checked a few days ago - note the last day is tiny, provisional - all these days at the end can change, mostly up and probably just by a bit. With that, it's been hitting up to 5,000 confirmed cases per day. (in fact one day now revised to 5,197, and the site currently says for daily cases not yet plotted: 6,042. They will need to expand their graph.

https://coronavirus.data.gov.uk/cases

Maybe all those freewheeling protests are having an impact? Maybe some herd-immunity vigilantes are even out there deliberately spreading it to save the UK from tyranny? Possible. But mainly it's just the communicability of this virus plus a lot more communing than was happening; regular commerce and social activity. But then see the photo below from Trafalgar Square yesterday, September 26 (Time). To the extent this spirit prevails, their activity is not being done carefully except where it's required - and it largely has been, which is what's got these people so frustrated they prove as loud and clear as possible that they need to be babysat, even as they demand not to be. Babies, after all, don't understand.

Already confirmed infections are near past April levels. That's partly due to wider testing, of course, so it's not really that big in comparison - yet. And I do not foresee near-April levels of deaths coming on (above 800/day for a month straight back then), nor even the same rate scaled down to current real infections. "Protecting the vulnerable" can never be done totally, but it has been done fairly well, and that's been the main thing, IMO, that lets deaths remain so low people can easily pretend the danger has gone away for good. But again, it can't be done totally, and with this scale of infections that we know of, more yet that we don't, and especially if higher levels are yet to come -it will be harder for those of us in serious danger to keep avoiding this extremely contagious pathogen.

If second waves happen for real and not just in British leaders' agendas - maybe France would see one?  2nd wave - cases now far above April levels, confirming up to 16,000 cases in a day, and deaths are back up to 40-50 a day since Sept. 15, already with three spike-catchup days of 80, 154, and 150 each (in a slightly smaller populace than the UK). https://www.bing.com/covid/local/france?vert=graph

Now the UK death toll remains almost flat so far, but of course it takes time to die from the virus, so trying to call the second wave death toll is clearly premature. Almost instantly on seeing cases near 5,000/day, I predict the daily deaths will rise to 50, then 100, then hitting triple-digit daily tolls regularly, just from what we see here. Depending how high it gets, they may again see 300 dead in a day or more. Depending how long it takes to rein that back in, it could add a hell of a lot more deaths along the way. 

Projecting 2 Weeks' Deaths

Premature or not, I tried for a data-based estimate, and was able to show my initial guess  (" triple-digit daily tolls regularly, just from what we see here") was high. I tried to line up dates between cases, hospitalizations, and deaths in various ways - something I hadn't tried yet and didn't know how to do. For reference, I used this drugs.com page with a timeline of general progression that lines up with the bits I've heard: first symptoms is day 1 - fever, cough, aches, etc. Around days 7-9 dyspnoea and sepsis set in, in bad cases. Day 12 or so, improvement begins or ARDS forms, patient is admitted to ICU.  "Day 15: Acute kidney and cardiac injury becomes evident" and then "Day 18.5: The median time it takes from the first symptoms of COVID-19 to death is 18.5 days." (which would make it day 19.5, I think, starting from 1)

First I rushed off with a comparison of cases to deaths 18 days later (giving a crude cfr of 1.28% for what it's worth). But confirmation doesn't happen at infection. I suppose just when varies ... but the above gives 6 days on average in ICU, in turn usually 12 days after infection.  ... I tried a lineup of the curves for cases, hosp, deaths, on the idea surges would tend to show up similarly at the right times, besides scattering to surrounding days and mixing with other days' scatter. But with all the local wiggles and uncertain variables, it was hard to say. Generally, having the three set about  a week apart makes for a basic fit. Somehow I decided to use: hospital 6 days after confirmation, death 9 days after that (just 15 days total span). A ways in I realized even this wasn't the best, but I don't have the combination of skills and time to get it right, and it doesn't matter much - the differences are only so big, and some will cancel each other out.

Over the most recent 23 reasonably complete days, I count: 

372 deaths up to 9/23 (from 9/1), out of 

37,979 cases up to 9/8 (corresponding days), and 

3,207 hospitalized up to 9/14 (corresponding days).

I calculate a 0.98% crude CFR (case-fatality ratio) - nearly 1% of known cases have died so far. That's rather low and more like an Infection-Fatality ratio (IFR), historically, but confirmation is probably much higher now than it has been, bringing IFR and CFR a bit closer to synonymous.)

8.44% hospitalization rate - some 92% are considered ok to quarantine at home, but 8% require intensive help

11.6% crude "hfr" (hospitalization-fatality rate) between the 23 paired days (deaths 6 days later) - nearly 12% who have to go to the hospital never leave.

Using this cfr and hfr compared to daily cases and hospitalizations from Sept. 25, I project a total of around 519 deaths set for the next 14 days, as broken down below. 

The "cfr" I get comparing deaths 15 days from cases seems fairly steady down the line, but my hospital fatality rates are increasing over time. Around Sept. 5/6 hospitalizations is where it starts rising faster, from about 9% (as set up) to as high as 17.7 and 19.5%. An average of last 12 days gives a 13% hfr, which seemed to better fit the actual rise in deaths. so I used that. In fact the latest death tolls might show I'm still estimating low. 

Hospitalizations themselves seem to increase in the same time, from 130/day for a week up to Sept. 7, then quickly to 164, 192, 192, 205, 198, 208, 231, 247, 248.  Why these rise? wrong day line-up causes an increased distortion, or was causing it, and the higher rate is more accurate? Or hospitalizations and the fatality rate of them are actually rising? It could be that as young and careless people people spread the virus wider, it's now be spreading more to the less eager citizens; they avoid it for so many days and then don't, wind up in the hospital at a higher rate, and then die there at a higher rate than we were seeing 2 weeks ago. 

With this set-up, the longest projection is 15 days out from the latest reported cases tally (again, subject to change). I used 0.98% for each day's cases, and 13% for each corresponding day's hospitalizations (where available - six days later runs out 6 days before the end), to estimated deaths 15 days out. I just averaged the cfr and hfr predictions, which tended to be quite close. The 13% hfr does pull it a bit higher than the cfr alone, adding about 4-5 deaths at the end. So I mimicked that, adding 4-5 from there. We'll see if the current hfr makes it lower or higher than I estimate. This suggests what my earlier try did for a peak of deaths so far at 55 in a day - and I emphasize - so far.

What I'll be Watching

I will come back to check my prediction and bring updates on the confirmed death toll, the reactions of the government and the public, and maybe a look at the unconfirmed death toll. Another post deals with overall UK "excess deaths" (besides sorting out the varied and changing official tallies) - speculative analysis of the true death toll based on when and how people die at above-average rates. many have noted some 30,000 disputed non-covid "excess deaths" above the average, disputed if caused by the virus, or lockdown, or what. It tends to happen right when Covid19 is killing a lot, and when we can see how, it's in mostly cardiovascular ways where the virus might well play a hand. I'm having another go at this, expanded in a few ways, including to track the recent rises in covid and overall deaths, now above average when they had been well below for about 2 months. And I'll bring some more specific clues that bear out my thesis those excess deaths were probably more coronavirus ones never confirmed - and likely even some of the deaths BELOW the average line are as well. I've found so far the true U.K. death toll is probably over 70,000, possibly  as high as 80,000. I'll see about refining that point at that post,  after another week might settle some trend confusion I'll have to explain - maybe after I understand it.  

October 19: I haven't followed all developments. But cases are now at around 18-20,000 per day, hospitalizations are 900-1,000/day, and deaths are higher than I predicted, hitting around 90 most days and so far maxing out on October 11 at 103 (England and Wales - 117 for all U.K.). As before, all days open to revision, mainly up, and especially in the last few days.

December 8 update: I did this to help explain some points, including a conservative prediction of 320+ deaths per day by mid-November. (note: 2,550 is no kind of upper end - I compromised to avoid re-sizing the image to be even taller.

It turns out that was quite conservative and again yielded low predictions. Cases had risen to 20,000 per day on average as London went into lockdown (tier 3 restrictions) October 17, only slowing a climb to 25,000 in early November (with peaks past 31k on Nov. 2 and Nov. 9), and then declining to about 15k by early December. Hospitalizations peaked around 1,800/day all through mid-November, decreasing only to 1,400 by early December. when lockdown was eased in London Dec. 2 (tier 3 to tier 2). The peak of deaths would be 2-4 weeks after the highest numbers of cases, so has probably already passed, but the data may be incomplete. So far the highest tallies are 433 on Nov. 9 and 452 on Nov. 18 (again, England and Wales - all UK: 481 on the 9th, 484 on the 18th). 

I may have finally guessed too high here, estimating 580 daily UK deaths peaking around Nov. 22/23, as if that angled line really matters. I suppose the peak will be right around then, but only about 500 when it settles not much higher than it is by now. 

Comparing covid to all-cause excess deaths (E & W) from the end of lockdown 1 to lockdown 2 and the span between. That adds a bit to the question of what caused all those deaths under lockdown, which I addressed here.

United States: Covid-19 and 4,000+ Extra "Influenza/Pneumonia" Deaths

September 19, 2020

I've been doing some excess and by-cause deaths analysis that's been especially fruitful regarding 2020's weekly fatalities in the United States. So far this suggests - as many others have noted - many thousands of deaths probably caused by unconfirmed and unknown infections by Covid19/SARS 2. I did some tracking of mysteriously surging deaths from heart disease, Alzheimer's, diabetes, and more, using a CDC data table, updated weekly to show weekly totals for many natural causes, by state and national, for both  2019 and 2020 for comparison. That is available here:

https://data.cdc.gov/NCHS/Weekly-Counts-of-Deaths-by-State-and-Select-Causes/muzy-jte6/data

The latest weeks are always incomplete, and weekly data continues to be revised to varying degrees for many weeks afterwards. So this is provisional data, but so far it seems fairly complete and settled over most of the long span examined.

Those other categories might seem unclear in their relation, but the SARS2 coronavirus causes circulatory and other damage in many of those it infects. That will include ones we didn't know were infected, who for example had heart disease to start with, then die soon after an unknown illness maybe even they didn't feel (more likely they just didn't say anything). Case-by-case there might seem no reason to guess covid involvement, but when you see the scale and timing of the rises, it's hard not to see. (a rough sketch of several of these is included at the bottom of this article).

The category I'm looking at now is a little more direct in its relation: "influenza/pneumonia (J09-J18)" - for short I/P. I may be hazy what's included. The related codes are broken down elsewhere as:

J09  Influenza due to certain identified influenza viruses

J10  Influenza due to other identified influenza virus

J11  Influenza due to unidentified influenza virus

J12  Viral pneumonia, not elsewhere classified

J13  Pneumonia due to Streptococcus pneumoniae

J14  Pneumonia due to Hemophilus influenzae

J15  Bacterial pneumonia, not elsewhere classified

J16  Pneumonia due to other infectious organisms, not elsewhere classified

J17  Pneumonia in diseases classified elsewhere

J18  Pneumonia, unspecified organism

https://www.icd10data.com/ICD10CM/Codes/J00-J99/J09-J18

Then I'm hazy on the exact definition of influenza vs. pneumonia. But anyway ... I think it includes the two main classes of influenza (A+B) and a larger number of deaths caused by pneumonia, which I gather has many causes (not a specific virus or bacteria but many of both)but - as I gather - not the fullest list of pneumonia deaths (some may be in other categories here). I suspect Covid19 or "Kung Flu" as a select few have called it, would fit here, as a pneumonia or maybe a flu of unknown cause, until it was given its own category on account of being this deadly super-bug. 

And when people don't know it's covid19 they're seeing, it may keep getting listed here.

I had seen some evidence cold and flu transmission dropped sharply under lockdown conditions, in the U.K. anyway. That makes sense, and I expected lower cases and thus deaths in most or all places that used lockdown and advised social distancing, etc. That includes the U.S. of course, even though mitigation efforts were not universally employed and complied with. In contrast, 2020's I/P death toll is high and erratic, in some states I've looked at (but not others), and on a national level; U.S. totals include quite a few hundred more than expected. 

On analysis, these deaths seems to be below average for a baseline (or below 2019 levels anyway), and by when the extra deaths come in, it's almost certain they were caused by unknown Covid19 infections. Perhaps the most interesting detail is how the biggest spike of these comes right at the year's start, immediately after Christmas and New Year's, suggesting the virus was already circulating widely by then, about a month earlier than known.

Here is the graphic, with some discussion following. It's too small to read in this preview, except that:

* the tall red curve is Covid deaths (mostly far off this scale to 2,000), 

* the darker orange line is 2020 I/P deaths, 

* the lighter orange line running normally beneath it is the same thing in 2019, and 

* the steep green slopes show the seasonal declines in flu cases for for each year, with 2020 being the darker, steeper, and earlier of the two (explained below).

To get a clear picture, I had to trace the data back to late 2019 to be fairly sure I was seeing a pre-covid baseline. For comparison purposes, I tried a bit to find the equivalent I/P tallies from late 2018. One list broke down flu (tiny numbers like 30) and pneumonia, with bigger numbers in the 3,000 per week range - far bigger than the kind of combined totals I've been plotting. The same number included covid-19 deaths in the pneumonia category when they came in, but it started out higher even before those. It must include other illnesses lumped differently than on the table I'm using, which may have their own patterns, but ... for now I'll stick with the 2019-2020 table and the one column, and offer a guess for the late-2018 lead-up, traced back from the visible trend, with a reasonable seasonal increase. (this lack of comparable historical data is also why I didn't even try for a multi-year average - I just use 2019's weekly levels, using a relatively normal year as a stand-in for an average.)

2019 ends with around 8-900 I/P deaths per week, well under what late 2018 probably should be, climbing past 1,000 in a rise that might be all seasonal, or include a few early covid deaths. Then 2020 starts with a jump to 1,555 deaths in week 1, ending Jan. 4. That's 283 more I/P deaths than in the same week of 2019, when it had been about 100-200 per week below that level.  

This is unusual, and it comes just as the first few confirmed Covid19 deaths were coming in. As listed on the CDC table, three deaths occurred prior to the first confirmed infection we heard about at the time, on the 21st. The first listed covid death is on January 4, at the end of that deadliest I/P week. (2 more came the following week, then alternating 1 and 0 for a few weeks before a quick takeoff in weeks 10-13.) 

As of mid-December we were just hearing about a deadly flu in China, but it seemed like a Chinese issue we had some distance on, and it was somehow not certain if it was even contagious. Later we learn it was contagious and was a Chinese problem from October or earlier, and could have spread anywhere since then. And seemingly out of nowhere, some extra-deadly infections occur somewhere in the United States roughly at the Christmas and New Year's holiday. That's a time known for visits to older family members, a few spare days for incubation, and people packed on airplanes flying to airports across the nation and overseas. Note that very frail people can die from the virus and the damage it causes within just a few days rather than the common struggle of 2-3 weeks. It can be incubation then almost instant death. Infected with SARS at Christmas and died New Years to be classed as an I/P death ... may have happened about in about 280 cases nationwide last year. That would be almost a one-in-a-million occurrence, when it had seemed like something that couldn't happen at all.

The elevated I/P death toll stabilizes after the January jolt, but remains well above 2019 levels to week 7, and roughly matches 2019 in week 8 (ending Feb.22). Then deaths rise steadily, just as weekly Covid deaths shoot straight from 9 to 35, 53, 571, and 3,155 over weeks 9-13. I/P deaths peak just before Covid ones, with 1,870 logged in week 14 - 646 more deaths than in week 14, 2019 - in fact an increase of over 50%. 

An interesting detail is how test-confirmed infections of influenza fall off here, a month earlier and more sharply than in 2019. See below bar graphs of weekly test results for the last 4 seasons, broken down by influenza types. The latest is from the weekly CDC update - but that changes, and where it'll be then, not sure. The others from prior years are from quick Bing image searches. 

For my graphic, I took the two relevant graphs (2018/19 and 2019/20) into my graphic, roughly scaled them vertically to my scale, drew a shape (in MS Paint) including the green line between bar tops, then set and stretched it between the right weeks on my timeline (and erased the rest of the shape - I like the tedium up to a point).

So 2020 has a rather sharp decline in flu cases just as Covid19 was taking off. However, by these graphs, infections always fall pretty sharply at around weeks 10-20, and in 2020 testing/confirmation may be low due to "lockdown" and such, which is when the numbers drop so sharply. But also transmissions should be down as people kept a distance from each other. It might be the vast number of actual flu infections dropped just as sharply as these few that ever get confirmed. 

The same should probably apply to all kinds of pneumonia - if it's contagious, it should suddenly spread more slowly under lockdown and social distancing, with the use of masks, etc. Yet something classed as "influenza/pneumonia" - that might be especially deadly and/or extra-contagious - infects enough people to push the death toll far higher than usual. When it strikes just as Covid19 was taking off, there's only one overwhelmingly logical culprit.

Back to my graphic and its narrative: supposed influenza/pneumonia deaths peak in week 14 (ending April 4), then decline sharply by the following week. The infections leading to those deaths must have fallen off several days to a week or more before this. This would be roughly in late-March to early April, which is when most states imposed strong control measures, and president Trump did, to his credit, send out that postcard to everyone, including his hardcore fans who had been doubting the danger, based on some of the conflicting things Trump had said. From here the weekly deaths decline steadily to roughly 2019 levels (around 800/week declining to around 650) by week 19. This still probably includes some Covid deaths and thus less of all the other kinds than in 2019. 

A week after the 4th of July, the flu and pneumonia get a bit deadlier again, just as Covid does the same, but much milder than after the surprise attack of January. The level only rises to slightly above average, and holds about there for 3 weeks before falling again to seasonal levels and even below 2019 at several points. But it should be a bit higher at the end than shown here; final data points tend to be incomplete (the last two so incomplete I didn't even include them). 

And again, this is after after I/P deaths started - and likely stayed - below 2019 levels, aside from the stray coronavirus deaths that probably explain all this erratic overage. Just through week 18, there were 3,988 deaths above 2019 levels. From there to week 34, the ups and downs combine to just 51 deaths above. 4,039 total. But it seems 2020 was a low year, with a baseline of something like 100-200 I/P deaths per week below 2019 levels. That would add about 1-200 extra, likely-covid, deaths per week to explain the levels we see. As the increase only starts clearly in week 1, that math is easy - it would be between 3,400 and 6,800 extra deaths added to all the differences from 2019 levels. including any baseline adjustment for now. I'm pretty sure there is one, but the late-2018 level being unclear keeps me from  being able to say the scale of it, except that I can safely say it will add at least another 1,000 deaths. Conservative total: More than 5,000. 

This adds to the notable but yet-to-be-calculated overages in deaths from (at least) heart disease, Alzheimer's, diabetes, and unclassified causes (R00-R99), which also can relate to unknown covid19 infections, and swell just before, after, and during spikes of covid deaths. Just heart disease is over by more than 2,000 deaths in the worst point, weeks 15, just before covid deaths also peaked at 16/17,000. Alzheimer's and diabetes were both up about 600 deaths the same week. To be revised, but here's my prior US total analysis, with numbers that have been changed since, and including a rough version of this I/P pattern, from week 4 on (where they differ, the new one is both updated and more carefully done). Some of these other death causes had showed high early levels I mostly ignored, but after re-examining the New Year's I/P deaths, I should extend this back further when I revise (after the next weekly updates, if they come).

On the Covid-19 1% IFR "Blunder" that's Actually the Truth

Adam Larson (aka Caustic Logic)

September 10, 2020

additions on: 9/11, 12, 14, 16 ...

https://www.rt.com/op-ed/500000-covid19-math-mistake-panic/

I call out RT and the author to Malcolm Kendrick ("skepitc, doctor, writer, blogger" - on Twitter) to retract this nonsense. We've had more than enough of this already, but the usual folks are loving this -yet another supposed proof almost no one died from Covid-19 now that it's over, nor was much of anyone ever going to die, except of course from control measures. As his nodding fans all know, this "lockdown" stuff was a horrible mistake, if not an evil plot.

Kendrick argues here a simple math mistake no one double-checked was the basis for the global lockdown reaction - which was already pioneered in its most extreme form by China before the alleged mistake. But anyway ...  It's a short enough read I won't summarize it first, just in explaining how terribly wrong it is, below. If you aren't clear on CFR vs. IFR, it explains that.  

Kendrick: "Covid’s CFR was likely to be about one percent, so one person dying from a hundred who fell seriously ill. Which, as time has passed, has proved to be pretty accurate." False. The global average Case-Fatality Ratio (basically % of KNOWN infections who've died) has usually been around 5% - US is around 3% - almost everyone is over 2% and some are past 10%. The UK currently boasts 11.7% (as currently listed at the Bing tracker). This UK doctor thinks it's less than 10% what it actually is. Because skepticism?

"Almost no-one is dying of Covid anymore" he says. Because of actions including a slowed spread, deaths in the UK have gone from terrible to mild, nearing zero some days. Like many such skewed thinkers in the UK, he conflates this (along with a mythical reading of Sweden's experience) into a global reality. Global daily deaths, with spikes and dips from reporting variance) show the current numbers are almost on par with the worst days. It's been far better in those places hit early, but the virus has been getting its foot in more and more doors worldwide since then. 

So the virus proved harmless after a bit for some reason, as Kendrick concludes, and he then goes on to complain:

"But because we panicked, we’ve added hugely to the toll. Excess mortality between March and May was around 70,000, not the 40,000 who died of/with Covid. Which means 30,000 may have died directly as a result of the actions we took."

I have mapped this out, as shown. Kendrick could not say how these thousands of deaths happened so quickly atop the thousands of covid ones, then mellowed the same way. In the US, we can see the excesses are mostly in classes of death consistent with unknown Covid-19 infection - cardiovascular in nature, and spiking just when Covid deaths do, just before and after, etc (see here). I say this is 70-80,000 UK people dying almost entirely from Covid-19 infection. 

Excess deaths all over suggested the mark of one million dead was passed some time ago. Now it's officially past 900,000 and I estimate 1.6 to  1.8 million actually killed so far. Annual flu deaths range from around 350,000 in a light year to 650,000 in a bad year, with little to no intervention slowing it. This has killed at least 150% of a bad flu year, almost entirely in the last 6 months, despite massive and bemoaned efforts to slow it. Kendrick ... claims to still believe the early predictions it would kill no worse than a yearly flu. He seems to believe it has killed, and will kill that way. He's not alone here in being grossly out of step with reality.

Kendrick says (thinking UK and expanding it to the world) "no deaths were prevented." None. And he's thinking UK wrongly. He thinks the virus stopped killing at those exponentially increasing rates until about 2 weeks after lockdown was imposed, then fall sharply to a low murmur you can think of as gone ... all on its own, coincidentally if not mockingly right when people were trying to make that happen. 

As always for such fantasists, he insist on using past-tense phrasing: "no deaths WERE prevented," not "have been." Covid "was never" going to kill many, etc. He's probably been one of those calling the crisis over from the minute it started. The man goes on to make a number of other dubious claims I'll skip to get to the central point - the predictions of a 0.1% IFR (infection fatality rate) that Kendrick says have been borne out, vs the deadly, lockdown-justifying tenfold exaggeration, which was "horribly, catastrophically, running-into-Mars-at-5,000-miles-an-hour wrong." 

However ... If the 0.1% estimate was actually blundered to 1% (I didn't re-check his reasoning there), it's sort of interesting, and a rather lucky turn, as a 1% IFR roughly predicted the reality to come. It seems the early guesses were the blunders here, and ones with deadly potential if people were to believe in and act on them in the current reality. People in the U.K. especially are hungry to be so misled, and this smug doctor Kendrick has fed that, just casually splashing more fuel on that fire of deadly ignorance. 

Oh, and he's a doctor, so he must know, right?

Let's start with his sources. It seems that 0.1% estimate came from an early statement by the CDC's Dr. Anthony Fauci in February - one he clearly doesn't stand by today. Kendrick buys and leases it out anyway, even boosting it to a maximum estimate: "Covid was never going to kill more than about 0.1 percent – max." He also cites another February prediction from the CDC that mused the virus' effects would be "akin to those of a severe seasonal influenza,” where only something like one in a thousand will die. The scandal, to Kendrick, is how those same experts soon came out saying it would be ten times worse - 1% were likely to die. They didn't stand by the first guess for long at all. Or maybe they did just conflate CFR and IFR and bungled what they meant to say - maybe on purpose. I mean there clearly is some plan to all this exaggeration and fear-control, right? They wreck the economy, get us in masks, and viola, every dictator's wet dream - people in masks and a wrecked economy. (it's a complicated plot, I gather)

This is supposed to be our glimpse of the truth? Two seemingly retracted early guesses and a supposed mix-up? 

Kendrick says the facts bear it out. But if just 0.1% of infections - or anywhere close - result in fatality, the following would not already be established facts:

* Bergamo, Italy: city and province have around 0.55% of their POPULACE already killed. That means even if everyone had been infected, it PROVED about 5-6 time deadlier than Kendrick would have you believe. Most of the 6,000 killed were by early June, when serology tests showed about 56% had antibodies. (see here) That lapses but not much, so let's say 58% infection rate.

So Bergamo estimate IFR = 0.95% - not 0.1%. 

* CDC report: In Orleans and Jefferson Parishes, Louisiana, "The overall IFR was 1.63%" (Reported deaths were divided by number of persons presumed to be recovered to calculate the IFR) 

- "IFRs found in other seroprevalence studies are lower, ranging from 0.5%–1.2%"

- No mention of 0.1% IFRs here. Some bunch of blunders? More CDC stuff you can only trust up until they started getting more facts in March? 

* New York City Covid-19 deaths: 23,741 (conf. + prob.) - est. by excess deaths: ~25,500 (quick calc.). So just among the city POPULACE (8.4m), not the infected ... something like 0.28% to 0.3% of those once alive in New York City HAVE - ALRAEDY - DIED from the coronavirus - not 0.1% "max" of those infected. 

Similar death rates have been recorded in places like Madrid and Rio De Janeiro, and Mexico City looks especially bad by excess deaths. Those three cities are a mixed-bag for lockdown measures, but all have used at least some control measures people like Kendrick would complain were destructive.  My data is behind or fragmentary, but last I checked  all three come out somewhere well past 0.25% of the POPULACE already killed - not 0.1% of the infected. 

Guayas province, Ecuador, est. from excess deaths of 13-14,000 (as reported just by the start of summer) say close to 0.35% of the POPULACE has died. That will be higher among the infected, and both rates will be higher in their temporary capitol Guayaquil (it's a mess and data is scarce). 

Back to NYC: Among those infected ... est. infection rate 28-30% (just over 27% had antibodies in August - NYC study - NYT report) = 2,352,000 to 2,520,000 estimated infections. Therefore NYC est. IFR = 0.94% to 1.08%

That's eerily close to what we see in Bergamo AND to what that "blunder" had said. Kendrick moans how this error - that turns out quite correct - is what prompted nearly every national and local government on Earth to respond in these drastic ways - after consulting their best expert minds, and just as many of them were dealing with raging infections, swamped hospitals with sickened staff, and unchecked surges of fatalities presaging far more than 0.1% were in serious danger.

Then someone made a typo, and they all decided to lock down. Huh. From Shanghai to Tehran and beyond, including before the error was made. Huh. 

So ignorant predictions of February suggested it would be flu-like, but the facts since have clarified the IFR is frequently as high as and higher than the "blunder" estimate - IN FACT about 1% of those who get this virus so far have died. That average includes the deadly early attacks and should fall in time, unless people gets careless enough, or the virus mutates. But it'll stay far closer to 1% THAN TO 0.1% "max." I'll let Kendrick put the 1% reality back in context - he did that well when he was calling it a fatal error:

"You may not think that percentage is enormous, but one percent of the population of the world is 70 million people – and that’s a lot. It would mean 3.2 million Americans dead, and 670,000 Britons." 

Yeah, if that were happening, that'd be terrible. You'd want to know and take it seriously, right? Because something like that ... even if you slowed it down with drastic measures, but then people resisted them left and right, you might have about 70-80,000 dead in the UK by 6 months in (about now). You might have 250-300k in the US, 900k confirmed worldwide and likely 1.6-1.8 million dead six months in, just thankful it hasn't been worse so far. You might be annoyed with idiots who dismiss the danger with this kind of lazy, self-centered "skepticism" that threatens us all. 

9/11 add: Will Merthon on Twitter with a detailed argument even the 0.1% mix-up never happened - Kendrick  passed on a flawed bit of deduction by Ronald Brown published by Cambridge University, involving his own mix-up regarding influenza mortality. P. Hitchens asked if anyone dared respond to Kendrick's "terrific article." I suppose he'll ignore my response.

9/12: People are pointing to Iceland as the low-IFR standard for the world - not Bergamo, Madrid, Louisiana, New York City ... It's said they have (or had) one of he best views of infection rates via widespread testing. If so, it adds some weight to there being only so much higher than 0.63% infected (2,161 confirmed cases to date, pop. 341,243). It might be five times that, but just comparing known deaths (10) to known cases, basic CFR: 0.46%. That's low. Few nations have anything below 1-2%, and most center somewhere near 5%, ranging not much past 10% in worst cases.

The best way to find the actual death rate - in Iceland as anywhere - will not be to compare confirmed AND unconfirmed cases with those same confirmed deaths (the basic CFR-IFR correction used at the Kendrick level). It would be fairer to compare confirmed AND unconfirmed deaths to the same totality of infections. Right? Apples AND oranges compares to apples AND oranges. This is excess deaths type analysis. I'm having a look into this and will report back. 

I noticed the Louisiana study via Dr. Eric Feigl-Ding Sep 6 - he's got some combo of knowing his stuff and having some kind of anti-virus bias for some reason. He also directs us to a re-analysis of Diamond Princess cruise ship outbreak - a case I might have recalled above. A confined and older-skewed population yields a higher-than-usual IFR of nearly 2%, or - mainly - they suggest past estimates were low, based on flawed methodology and then being too decisive or getting taken too literally. In contrast the authors here are methodical and I didn't get to just what they conclude.  2.0% does come up. previously I had: 3,711 passengers and crew - 712 cases - 13 deaths by most reports, some say 14 = 19% infected, and an estimated IFR of 1.83% to 1.96% on the Diamond Princess - even worse than those areas in Lousiana, about 2% of those infected on that cruise wound up dead. NOT 0.1%. tops. Not the 0.3% tops this herd immunity enthusiast adduces from some reading off of Iceland. 

About 1.9% matches the unusually clear (if not definitive) number of cases (and deaths!), and Fig. 1 in the analysis notes "combining the age-stratified nCFR from China with the age profile of Diamond Princess patients, 15.15 deaths should be observed on the cruise." How that last 15% of a death would be observed in unclear, but  that's about what I got in another way. IFR in China ... that's something else to check on.

Add 9/14: More on the IFR that has no one answer: It can get this bad:

* IFR = 30.86% at Life Center in Kirkland, Washingtomn, USA - of 120 residents, 81 (67.5%) were infected and 25 died.

* IFR among people 80+ in Lombardy, prior to mid-March control measures: 30% https://swprs.org/studies-on-covid-19-lethality/

* Belgium nursing home IFR est. 28% to 45% (ibid)

* 2% Diamond Princess

* 1.63% in 2 parishes in Louisiana (1.72% for African-Americans there) 

* 1.4% in Conn. to May 3 (Reason)

* Spain: 0.82% (based on confirmed Covid-19 deaths) and 1.07% (based on excess all-cause deaths).

https://www.medrxiv.org/content/10.1101/2020.06.20.20136234v1

Note some of the are from a useful article at Swiss Policy Research that considers in detail places with high levels like 1%, agrees with it, but suggests there may be 2-5 times as many cases as seroprevalence studies suggest. NYC may be 50% infected or more - Bergamo 114% or more? Again and again he notes "people with anosmia (temporary loss of the sense of smell or taste), a very typical Covid symptom" tended to not have antibodies, suggesting others without antibodies also had it, and maybe a huge portion that would drive down the CFR (twice as many cases to the same number of deaths halves the death rate). For the moment that seems possible, but I've also read than antibodies hold in a vast majority of cases, not in 1/5 to 1/2 of them. 

As for Dr. Fauci's initial 0.1% guess - as WebMD reports: "Fauci and other public health experts have since put the COVID-19 death rate at about 0.6% -- six times that of a typical flu season -- which is the latest CDC projection. “It looks like now that the fatality rate of a person who gets infected with this, on average, is around six times that of the seasonal flu -- so around the 0.6 [percent] range,” say Amesh A. Adalja, MD."

That's lower than what I see - in especially deadly places - but not by a whole lot. And others are faring better, bringing the average down.

* IFR CDC cited range (0.5%–1.2%) refs not openly available, refer to studies in Spain, Switzerland, Brazil. And I suppose it doesn't have to bottom out at 0.5.

* IFR for Belgium, general population est. 0.30% to 0.62% https://swprs.org/studies-on-covid-19-lethality/ 

* NYC to April 1: 0.4% https://reason.com/2020/06/28/cdc-antibody-studies-confirm-huge-gap-between-covid-19-infections-and-known-cases/

* Missouri April 26: 0.2% (ibid.)

* Utah to May 3: 0.1% (ibid.)

Reason article (June 28) noted "These are just snapshots, and the IFRs in Utah and Missouri may have risen as the epidemic progressed in those states, especially if people infected in May were more vulnerable to the disease." So That 0.1% is likely the best it gets, not the "max" death toll there or anywhere. 

Iceland: situation report - Covid-19 conf. cases 2,165 (+4 today) - conf. deaths: 10. Basic CFR: 0.46%. Unconfirmed infections will be higher. Unconfirmed deaths will also be higher, I bet. I had a look at government stats - small numbers that vary a lot week-to-week (population 341,243 - it's a tiny place.)

https://www.statice.is/publications/experimental-statistics/deaths-ex/

The site notes "It is worth pointing out that the number of deaths for 2020 are preliminary and likely to somewhat underestimate the true number of deaths, mainly due to late arrival of death notices." So there might be more than seen here. Also cause-of-death data is unavailable (another page there explains "Reports on causes of death are usually ready a year after.") But I checked (incomplete) deaths by age as a decent indicator. I'll share this graphic I made to visualize it - deaths of those aged 75 and over are below average as much as above, but it's unusually erratic, and the patterns of just when seem related to the rising cases (peaking a bit before and after peak cases) and perhaps unknown cases in late 2019 (as data in several other places suggests). Being 85+ seems pretty deadly all the time, but note how younger classes (lighter sections and gold rings) seem to die at higher levels in April, just after the peak of known cases, and into May. Also note a rise in elder deaths in July, from quite a low level, accompanying a rise in known cases then - and the deaths fall again as case transmission falls. Possibly coincidence, but likely not.

But this isn't much to clearly suggest additional deaths to go with the additional spread. A  few dozen over-average seem likely - possibly up to about 100 depending on average vs. baseline, and something like 60 as a reasonable high end. But more so than usual, I can see it being zero. 

The Center for Evidence-Based Medicine reported that, for Iceland, "Screening suggests 0.5% are infected;  the correct figure is likely higher due to asymptomatics and many not seeking testing: estimates suggest the real number infected is 1%." The high testing rate was noted, speculating they missed less than half the true infections. That would be a good rate - most places likely miss 3/4 of them or more. 

I have 0.63% now with confirmed infections. Let's say 1% was fair, and 1.5 to even 2% is fair now.

* IFR 0.19% if 1.5% inf. by now (5,119) and still just 10 dead 

* IFR 0.88% if 2% inf. (6,825) and 60 dead

* IFR 1.17% if 1.5% inf. and 60 dead

It's somewhere in that broad range - quite possibly at or near the low end. 0.25% or so may be it. Perhaps the virus did spread widely and less-fatally in Iceland. I suspect not one care home outbreak happened, or their care homes are so tiny you can't tell, so only a worst-case-scenario gets to the 1% range here. 

As such, I suppose the IFR varies well below the 1% seen in hotspots, in the right conditions, and even below the 0.5% end of the CDC's cited range. Down to 0.2% may also be plausible, and even 0.1% - but only in fluke cases (like Utah's early phase). Of course it goes even lower - to about zero - in certain demographics, but then it gets to 30 and 45% in others. But all considered, that 0.6% CDC estimate might be the fairest baseline - places will come out somewhere near, above, or below that line. 

Add Sept. 16: Kendrick: "Sweden, which did not lock down, has had a death rate of 0.0058 percent." But that's not what the Swedes say. Official anti-lockdown government's own website says:

"What is the fatality rate of COVID-19? Globally, it is estimated that 0.5–1 percent of those who are infected with COVID-19 die. ...  this might change as new knowledge becomes available. ...  A study by The Public Health Agency of Sweden estimates the fatality rate in the Stockholm region to 0.6 percent, for all ages. The fatality rate among those 70 years or older is 4.3 percent, whereas it is 0.1 percent among those younger than 70 years."

https://www.folkhalsomyndigheten.se/the-public-health-agency-of-sweden/communicable-disease-control/covid-19/

It seems Kendrick the bogus health data expert crunched out 0.0058 from legitimate data, and conveniently forgot to move the decimal over 2 BEFORE making it a percentage. The report in fact says "Dividing the number of deaths with the number of infections gives an IFR estimate of 0.58% (c.i. 0.37–1.05%)" He re-calculated it himself to be sure, and left the decimal point. 

https://www.folkhalsomyndigheten.se/publicerat-material/publikationsarkiv/t/the-infection-fatality-rate-of-covid-19-in-stockholm-technical-report/

Covid-19 and an Unexplained Rise in "Unclassified" Deaths

September 5, 2020

Updates Sept. 15

Sept. 15 note: This post takes a valuable look at likely covid deaths in different categories, but the title subject ("unclassified" deaths) is less clear than it seemed. It is new - the CDC's excess deaths page doesn't include this.  "... causes of death where the underlying cause was unknown or ill-specified (i.e. R-codes) were excluded (except for R09.2, which is included under the Respiratory diseases category). Counts of deaths with unknown cause are typically substantially higher in provisional data, as many records are initially submitted without a specific cause of death and are then updated when more information becomes available (4)." Indeed - I looked into that after I noticed that category rises so sharply over time in all places, and upon a weekly update I noted the numbers had shrunk slightly, while some other classes had grown a bit. But it seems some numbers a ways back are settled, only getting an occasional 1 or 2 removed and mostly staying the same, and still remain well over average in an interesting pattern. I think the later weeks' data will do the same, but I'll have to try for a clearer view of the scale after the dust settled a bit better. The next update should be soon, and I'll check again a week later. (end note).

---

A study published by JAMA (the Journal of the American Medical Association) a while back looked at increased death rates for specific ailments - aside from Covid-19 - during the pandemic, in five hard-hit US states: Massachusetts, Michigan, New Jersey, New York (city, state aside from city), and Pennsylvania. This found "Between March 1, 2020, and April 25, 2020, a total of 505,059 deaths were reported in the US; 87,001 (95% CI, 86,578-87,423) were excess deaths, of which 56,246 (65%) were attributed to COVID-19" while about 1/3 of this huge toll were seemingly caused by something else worth some attention. 

The 5 states with the most COVID-19 deaths experienced large proportional increases in deaths due to nonrespiratory underlying causes, including diabetes (96%), heart diseases (89%), Alzheimer disease (64%), and cerebrovascular diseases (35%) (Figure)." ... "New York City experienced the largest increases in nonrespiratory deaths, notably those due to heart disease (398%) and diabetes (356%)." Of course they also suffered the sharpest and deadliest outbreak of the virus. Coincidence?

https://jamanetwork.com/journals/jama/fullarticle/2768086

"... Not Elsewhere Classified"

I believe they use this data source, or similar:

https://data.cdc.gov/NCHS/Weekly-Counts-of-Deaths-by-State-and-Select-Causes/muzy-jte6/data

I had my own look at this, seeing several things appear to rise, but noting what I label "unclassified" is the big rise. This is the column just to the left of diseases of the heart, headed "Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)." Another source gives the R00-R-99 code as signifying "symptoms, signs, abnormal results of clinical or other investigative procedures, and ill-defined condition/s regarding which no diagnosis classifiable elsewhere is recorded." This also breaks down the definition so:

a) cases for which no more specific diagnosis can be made even after all the facts bearing on the case have been investigated;

(b) signs or symptoms existing at the time of initial encounter that proved to be transient and whose causes could not be determined;

(c) provisional diagnosis in a patient who failed to return for further investigation or care;

(d) cases referred elsewhere for investigation or treatment before the diagnosis was made;

(e) cases in which a more precise diagnosis was not available for any other reason;

(f) certain symptoms, for which supplementary information is provided, that represent important problems in medical care in their own right.

In context, what is it? Maybe just semantics? From the patterns I see, it may be other deaths were wrongly classed early on as heart disease, Alzheimer's, etc. and later were increasingly shifted to this unclear category? See below how the others were higher and then decline, just as the line for this (usually green) rises dramatically. If so, that's not mainly from more of it happening, just more of the same that's been happening getting lumped under this heading - which might become a new proper heading linking it to likely unknown Covid-19 infections. I suspect the vast bulk of these are just that, causing damage that proves fatal anywhere from a couple of days to a few months (so far) after infection. 

In most states, unclassified R00-R99 was a small number on a weekly basis in 2019. In smaller states, it's only noted in sporadic batches - frequently 12 added every few weeks to couple months (see below, Iowa). I didn't look very deeply into the patterns like seasonality, aside from US total, which showed the number holding pretty steady throughout 2019. So I guess it should start about normal in each of these places in 2019 and when we check in here at the end of January in Massachusetts, Michigan, New Jersey, New York City, New York state (aside from the city), and in Pennsylvania. It should hold steady, or if it changes, more likely it would fall a tiny bit. But here's what happens during the same SARS 2 / Covid-19 pandemic:  

Notes: with these and others, the final data point seems incomplete - things are often dropping then, but probably not to the degree shown. Somewhat crude plotting here, as usual - I think I missed a week for NYC so it end at the right level but too soon - so from some point, the data shifts right one week. The numbers are also included right here to compare. Curves vs. angles: curves just used mainly at sharp changes or to help visibility of other lines, because too big a pain to do at all spots.

This and the plottings below aren't authoritative, just to show the basic trend. 

Pennsylvania's excess deaths analysis bears repeating here: I've found the state was hit harder with Covid-19and/or likely-related "excess deaths" than most realized, even for a while half-listing a death toll close to what I suspect - nearly twice the level otherwise reported. As noted at lower right of this graphic I did recently, some other class of deaths - non-Covid as far as we know - must be well on the rise. The CDC data and JAMA study help explain why these other deaths rise - most likely they're NOT other.  Those shown in green above come to some 150-200/week for some some of these weeks that are about 500-900 deaths above average - that's around 25% of the above-average, and more than the confirmed covid deaths, which were continuing at between 95 and 125/week.

And this same mysterious syndrome or class of might be what's killing so many confirmed covid victims in England past their new 28-day cutoff. Some have been killed by flying debris or anything, before or after the cut-off, and get counter anyway or not, depending on the date. But by the numbers, it's far more who die pretty swiftly from the virus' damage, but fail to be counted because it was just a bit too slow. See: https://libyancivilwar.blogspot.com/2020/08/on-calculating-true-uk-covid-19-death.html

A Wider, National View

After finding this data source and seeing what JAMA already covered, I considered what other states might be worth a look.

Connecticut (pop. 3.6m): I had noticed Connecticut was especially hard-hit per capita, close to on par with New York and New Jersey (just confirmed Covid deaths there add up to 0.124% of the populace killed so far, most of those before the end of May). A look at trends there  shows a similar pattern - as I plotted it:

Here, as with the rest, looking at more, including:

* Diseases of the heart - moderate correlation in rising along with Covid deaths

* Diabetes - moderate to little-no correlation

* Alzheimer's - strong correlation 

* Cerebrovascular disease - JAMA study notes it, but it didn't seem clear in some cases I checked

* Influenza - complicated - actual transmission rates may be down, deaths should be, but often rise - possibly including dual infections (where flu follows covid and then kills) or undiagnosed / mis-categorized covid like many of these others might be.

The rises in those are clear enough, but the odd pattern again is with unclassified - whatever this means, it rises so dramatically to hold a solid presence above 40/week for 6 weeks, hitting 50 3 times, so that by week 28 (July 5-11) it accounts for more than 10% of all deaths statewide. 

US totals: clear rise in heart disease (2019 compared), Alzheimer's, diabetes, and also influenza (2019 trend compared).  That's quite a few likely covid deaths mischaracterized. And for the green line - even with less hard-hit states pulling the average down, the unclassified kind of death at least rises massively, from a starting baseline around 800/week to well over 3,000/week nationwide. I checked this category for 2019 and found it was steady all the same 31 months of that year: a stray 523/week at the low end, 648/650 at the high end, and otherwise all tallies were close to 600/week (range otherwise: 563-635), as shown here, increasingly divergent. Note how influenza deaths rose far above normal during the peak, then fell quickly to normal seasonal levels, just as the unclassified deaths were increasing far above their norm (which should be on par with flu).

For reference, unclassified deaths so far since week 4 in 2020: 785  - 771 - 788 - 805 - 841 - 932 - 917 - 900 - 876 - 905 - 994 - 994 (repeated) - 1016 - 1091 - 1065 - 1230 - 1229 - 1378 - 1525 - 1624 - 1790 - 1953 - 2222  -2441 - 2764 - 2928 - 3079 - 3263 - 3381 - 3224 - 2551. Total 46,045 deaths. Some of these will be the same kind as last year, and let's say it's higher than in 2019, as seen at week 4-6, 770-790/week. Average 780 x 31 weeks = 24,180. Above that line is another roughly 22,000 deaths most likely caused by unknown Covid-19 infections. This will add to the confirmed deaths (now over 191,000), and the other likely unconfirmed that were listed under heart disease, Alzheimer's, etc. This comes in the last 6 months, with the bulk of it in the last third. This is likely to continue at similar rates if not higher, depending just what the hell it is and how much more of it happens. 

Comparing to historic averages: I didn't do much of that here, except for good measure with heart disease in most cases, and with unclassified, influenza, and all-causes deaths for the US total (all just compared to provided 2019 tallies - no broader averaging). Take any of these basic 2019 trends with the basic idea of seasonal death rates; they stay about the same day-to-day, only rising with extra illness deaths in the winter, peaking around January-February about 10% higher than usual levels in the summer. As shown with US, in 2019 it was around 5,800 all-causes deaths per week in winter, and falls to about 51,000 in summer. 

I was a bit surprised to see nearly all these specific causes follow the same pattern, some more clearly than others - a bit more deadly in the winter, and less so in the summer, absent a bad heat wave. So most of these will start near peak in late January, and should fall slightly all the way across on average (there are a lot of week-to week ups and downs, likely caused more by reporting variance than actual death rates. True differences we can see will be trends playing out over at least 2-3 weeks).

Three more sample states going into that national average:

Florida (pop. 21.7m) seemed worth a look for several reasons. Only a slight increase may be notable for Alzheimer's and diabetes, but heart disease is clear in pushing a bit below, then well above the expected norm, at just the right time to provide a likely answer to that mystery. It's just now dipping back to seasonal norms. Green unclassified holds the usual pattern, seeming to increase over time and/or pick up the slack of other decreasing categories, apparently dropping a bit now from a high around 400/week. (note marked drops in last data had applied to different weeks than when I started - these are updated - week 34 will soon say something higher and plausible at such points, as week 33 now does).

Washington (my state, pop. 7.5m) - early deaths, then fairly well controlled. Early lockdown measures: schools closed March 12, general stay-at-home order 3-23, etc. It doesn't seem it ever took off enough to make these patterns very clear. Heart disease seems to have its yearly decline interrupted by upward trends, shortly before the peak of covid deaths. It's hard to tell if Alzheimer's rises in February and in March reflect the same. Diabetes is even less clear. Unclassified, however, clearly rises over the year, if to a lesser degree than in the other places - it starts about 15/week and ends around 50 - a rise of some 333%.

Iowa (pop. 3.16m) - sparse enough they felt (along with Nebraska, Arkansas, and the Dakotas) no initial lockdown was needed - it worked for a while, but Iowa's seen increased cases and deaths recently. Details: Unclassified is sporadic here (low population, at least), with two 12 weeks in a row the only continuous points, and that's right at the first peak - likely significant. Because of that lack, and a mix-up, I also plotted cerebrovascular here. It shows a notable rise in its high spikes shortly before peak, if not a clear trend.  Heart disease dips well below average as the vulnerable protect themselves amid a mild early outbreak. Then it rises to bit above average or above right before and during the first peak, holds average then rises again just before the second near-peak in late July. Alzheimer's seems to rise the same at both peaks, a bit earlier than heart on the first one, and may stay a bit higher than usual. Diabetes shows little pattern - a slight rise at the first peak, perhaps faintly at the second one.

Conclusion 

It's still not clear to me just what this green lines show, but it seems to be a very interesting subject worthy of some consideration. 

When the issue of other deaths has come up, it tends to come with a note on disruptions to the medical system caused by "lockdown" and fear, often suggesting this is the main cause of increased "other" deaths. I should at least mention this aspect. There are likely some very few deaths of these kinds, including:

* people dying of a heart attack, etc. who are afraid to getting the covid at the ER and die at home. I don't expect very many of those, and I've seen no evidence that emergency rooms were closed for such urgent cases - it seems in general just optional and routine procedures were postponed to make room.

* There might also be deaths caused by delayed medical visits, like the ones where they find that lump in time. These will mostly take a longer and varying time to become fatal, not coming in a massive surge just after and before the peak of covid deaths, and mostly won't be in the surging classes. Who suddenly dies from Alzheimer's because some routine check-up was cancelled?   

So in short, the main issue is just what's causing these deaths, not scraping for reasons to blame "lockdown" for everything possible. The patterns are pretty clear - the main problem here with "lockdown" is it failed to prevent a further tens of thousands of deaths caused by this virus so far. That's not to deny the reality of the real costs of these policies, just to say an increased death rate is not one of them - 99% of all the deaths we know of and more are caused by SARS 2/Covid-19, not by the measures imposed to keep its killing from being even worse.

More Analysis

Add Sept. 9: Something said look at Louisiana, and the numbers seemed interesting. But once plotted, it's not so clear for the work, and some discontinuous data. There are big spikes in heart disease and cerebrovascular deaths near covid peaks, but not much for multi-week trends aside from: diabetes and Alzheimer's may be a bit elevated - supposed influenza deaths rise when they fell in 2019, as it happens, just as covid was killing the most  - heart disease deaths drop well below 2019 levels in the end.

California: I figured scale might help clarify the patterns, but California didn't seem to show much aside from a strong rise in unclassified deaths. Maybe they were ahead of the curve there, and avoided mis-classification, using this mystery classification more readily. I didn't see anything notable for Diabetes or flu, but Alzheimer's has some suspiciously-timed peaks, and supposed heart disease deaths drop well below 2019's levels, and then the numbers are pushed back up as Covid-19 and control measures battle it out. 

Texas: You can thank Alex Jones for a big part in this. They had things fairly under control considering it's Texas, but it's gotten stupid and deadly, with 3,357 coronavirus deaths in just 2 weeks in July. 

Diabetes and Alzheimer's should peak around that February rise we'll ignore, then hold fairly steady while slowly declining. Instead, they rise up and down without a decline, and Alzheimer's blue line rises solidly at the covid mega-peak of deaths in July. And out of obscurity, that green line of unclassified deaths has risen to match Alzheimer's at some 250 deaths per week, when it had been around 30/week at year's start.

I'll pause on Texas to compare peak weeks 29 and 30 (I didn't want to pick just one) in a bar graph with same weeks in 2019:

* weeks 29 and 30 2019 = 2,247 deaths in the categories heart (804+828=1632),  

diabetes (104+103=207), alzheimer's (192+159=351), and unclassified (29+28=57).  

* Weeks 29 and 30 2020 = 3,304 in those same categories (heart 995+959=1954, diabetes 154+162=316, Alzheimer's 291+255)=546, unclassified 255+233=488 - all are up, the last with a 756% increase!), plus Covid-19 (1,642+1,715=3,357 = 6,661 total. I took 2019 as a fair predictor of expected deaths in the 4 classes, took each one's overage and added it up for another 1,000-1,100 likely Covid-19 deaths.

Arizona: clear rises in Alzheimer's then heart just before small May peak for covid-19 - heart 

rises again (from a lower baseline) at the July peak ...

unclassified rises to 150 and even 175 per week, when it had been just 25.

Alabama: I had to look and see what effect the Tuscaloosa coronavirus parties of June might have had. 

https://libyancivilwar.blogspot.com/2020/07/to-tuscaloosa-corona-party-runners-up.html

not a lot in my current area - fatalities take off a bit, then far worse, but this happens everywhere. 

possible rises in Alzheimer's, repeated upward tumbling of heart disease deaths, little to no increased use of R00-R99.

These mixed findings and lasting curiosity have me doing a national review for just this category. I'll have at least one more graphic and some text notes to come.