Talk:COVID-19 pandemic/Archive 39

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10-fold COVID-19 mortality overestimation

Proposed text:

On February 28, 2020, Anthony Fauci, et al., wrote in a NEJM editorial that "… the case fatality rate may be considerably less than 1%. This suggests that the overall clinical consequences of COVID-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%)."[1]

An article to be published in the Cambridge journal Disaster Medicine and Public Health Preparedness states that the '0.1%' figure in the above parenthetical was incorrectly presented as 'case fatality rate' rather than 'infection fatality rate'. The paper concludes that "Sampling bias in coronavirus mortality calculations led to a ten-fold increased mortality overestimation in March 11, 2020 U.S. Congressional testimony. This bias most likely followed from information bias due to misclassifying a seasonal influenza infection fatality rate as a case fatality rate, evident in a NEJM.org editorial."[2]

The author, Robert B. Brown of the School of Public Health and Health Systems, University of Waterloo, Canada, notes that by May 9, 2020, "… it was clear that the coronavirus mortality total for the season would be nowhere near 800,000 deaths inferred from the ten-fold mortality overestimation reported to Congress." and that "it seems unlikely that so many deaths were completely eliminated by a non-pharmaceutical intervention like social distancing …."

The paper includes a flowchart that "summarizes biases and potential effects of viral mortality overestimation" and cautions that "Failure to intervene at the source of the problem, at the upstream levels of information bias and sampling bias, can allow fear to rapidly escalate and may cause an overactive response that produces severely harmful collateral damage to society." Brown also writes that "The public’s belief that mitigation measures were responsible for reducing coronavirus mortality may be a post hoc fallacy if lower mortality was actually due to the overestimation of coronavirus deaths."[2]

This manuscript has been reviewed and accepted for publication; the preprint indicates "This accepted version of the article may differ from the final published version." How to handle? Humanengr (talk) 08:36, 13 September 2020 (UTC)

These are both essentially opinion pieces, no? I'd ignore both of them and wait for better WP:MEDRS sources. Alexbrn (talk) 08:55, 13 September 2020 (UTC)
The Fauci, et al., editorial has 12 references and was published in the New England Journal of Medicine. The Brown article is an 'accepted manuscript' to be published in a Cambridge journal. Neither can be easily dismissed as an 'opinion piece'. The former makes factual claims; the latter presents critical analysis. Humanengr (talk) 09:02, 13 September 2020 (UTC)
See WP:MEDASSESS. Editorials and expert opinion are not what we're looking for for biomedical claims. We need to wait for higher quality sources and better settled knowledge. Alexbrn (talk) 09:16, 13 September 2020 (UTC)
This is not a discussion of 'treatment efficacy' (the domain of WP:MEDASSESS). This regards a misstated epidemiological claim and a critique of that claim. Perhaps an RfC is in order. Humanengr (talk) 09:29, 13 September 2020 (UTC)
I personally think that Humanengr seems to make sense, and wouldn't mind an RfC, if it is necessary. David A (talk) 09:33, 13 September 2020 (UTC)
An RfC would likely by a waste of time; we're not going to overturn the PAGs. An editorial from February is a hopelessly poor source, and an opinion piece from someone doing a PhD who makes the "daring" claim he has found the "worst miscalculation in the history of humanity"[3] raises a big ol' WP:REDFLAG. For sourcing on mortality, we need to use high-quality WP:MEDRS. Alexbrn (talk) 09:39, 13 September 2020 (UTC)
Re 'opinion': The article currently includes statements such as The head of the NIAID, Anthony Fauci, warned that if caution was not used the rate of infections could rebound and he was particularly concerned about opening the schools in the fall. President Trump expressed disapproval of Fauci's statements, saying "To me it's not an acceptable answer, especially when it comes to schools."[3] Fauci's "particularly concerned" and Trump's expression of disapproval are opinion. Again, Fauci (et al.) made a factual claim in a medical journal — restated (as indicated above) in Congressional testimony. The ten-fold claim has been repeated voluminously in public discourse and has played a critical role in shaping public policy. Your assertion that a Fauci statement is a 'hopelessly poor source' is, quite frankly, remarkable. And, for others reading this, it should be noted that Brown is a well-published author who holds a PhD and is seeking a 2nd PhD. (Also, the characterization as someone doing a PhD who makes the "daring" claim he has found the "worst miscalculation in the history of humanity" is not a self-description by Brown but is built on comments by a 3rd-party in a self-published piece.) Humanengr (talk) 10:29, 13 September 2020 (UTC)
False. That quotation ("worst miscalculation in the history of humanity") is from Brown himself. Alexbrn (talk) 21:28, 13 September 2020 (UTC)

Thx for the correction. The 'daring' is from the 3rd-party (Manley). For completeness, here is the text from Manley's article:

This month, Dr. Ronald B. Brown had a daring paper published in Disaster Medicine and Public Health Preparedness, conservatively entitled Public health lessons learned from biases in coronavirus mortality overestimation.

Dr. Brown told me in an email;

“The subject of this article is disruptive, to say the least, although it is not as obvious from the title. The manuscript cites the smoking-gun, documented evidence showing that the public’s overreaction to the coronavirus pandemic was based on the worst miscalculation in the history of humanity, in my opinion. My manuscript underwent an intensive peer-review process. You are the first media guy who has responded to my invitation.”

The other points in my response still stand. Humanengr (talk) 21:33, 13 September 2020 (UTC)

References

  1. ^ Fauci, Anthony S.; Lane, H. Clifford; Redfield, Robert R. (2020-03-26). "Covid-19 — Navigating the Uncharted". New England Journal of Medicine. 382 (13) (published February 28, 2020): 1268–1269. doi:10.1056/NEJMe2002387. ISSN 0028-4793. PMC 7121221. PMID 32109011.{{cite journal}}: CS1 maint: PMC format (link)
  2. ^ a b Brown, Ronald B. (accepted for publication). "Public health lessons learned from biases in coronavirus mortality overestimation". Disaster Medicine and Public Health Preparedness: 1–24. doi:10.1017/dmp.2020.298. ISSN 1935-7893. {{cite journal}}: Check |archive-url= value (help); Check date values in: |date= (help)
  3. ^ "Trump Criticizes Fauci's Warning Against Opening Schools Too Soon In Latest Public Disagreement". KHN. Retrieved 18 May 2020.
collapsing 3rd-party explanation as it seems to have invited distraction from the material points in the proposed text

Below are some highlights re the CFR-IFR labeling error(s) — not offered for inclusion in the article body — from an article by Dr. Malcolm Kendrick that restates and builds on Ronald Brown's paper. The Kendrick article has not been peer-reviewed (it was published in RT); I include it only for its value in understanding Brown's points and for some points it raises that might bear on where to locate the proposed text:

  • The error started in America, but didn’t end there.
  • On February 28, 2020, an editorial … by the [NAIAD and CDC] … [p]ublished in the New England Journal of Medicine … stated: “… the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza.”
  • They added that influenza has a CFR of approximately 0.1 percent. One person in a thousand who gets it badly, dies. But that quoted CFR for influenza was ten times too low – they meant to say the IFR, the Infection Fatality Rate, for influenza was 0.1 percent.
  • The mistake was compounded. On March 11, the same experts testified to Congress, stating that 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.
  • At this meeting, they compared the likely impact of Covid to flu. But they used the wrong CFR for influenza, the one stated in the previous NEJM editorial. 0.1 percent, or one in a thousand. The one that was ten times too low.
  • So, they matched up the one percent CFR of Covid with the incorrect 0.1 percent CFR of flu. Suddenly, Covid was going to be ten times as deadly.
  • [T]he experts … got their IFR and CFR mixed up and multiplied the likely impact of Covid by a factor of ten.
  • [Per Brown's paper:] “Public health lessons learned from biases in coronavirus mortality overestimation”,says: “On March 11, 2020,... based on the data available at the time, Congress was informed that the estimated mortality rate for the coronavirus was ten-times higher than for seasonal influenza, which helped launch a campaign of social distancing, organizational and business lockdowns, and shelter-in-place orders.”
  • On February 28 it was estimated that Covid was going to have about the same impact as a bad influenza season – almost certainly correct. Eleven days later, the same group of experts predicted that the mortality rate was going to be ten times as high.
  • In the UK, … Imperial College experts created the same panic. On March 16, they used an estimated IFR of 0.9 percent to predict that, without lockdown, Covid would kill around 500,000 in the UK. [In his blog post two days prior, Kendrick presented this as "The academic epidemiologists. Neil Ferguson, and others … used a figure of approximately one per cent as the infection fatality rate. Not the case fatality rate. In so doing, they overestimated the likely impact of COVID by, at the very least, ten-fold."]
  • So where can we look to get the current figures on the IFR? The best place to look is at the country that has tested more people than anywhere else as a proportion of their population: Iceland.
  • As of last week, Iceland’s IFR stood at 0.16 per cent. It cannot go up from here. It can only fall. People can’t start dying of a disease they haven’t got.
  • This means that we’ll probably end up with an IFR of about 0.1 percent, maybe less. Not the 0.02 percent of Swine Flu – somewhere between the two, perhaps. In short, the 0.1 percent prophecy has proved to be pretty much bang on.

Further highlights for context from Brown's paper:

  • The main objective of this article is to critically appraise the coronavirus mortality estimation presented to Congress.
  • Findings from a comparative analysis of selected video and texts [from WHO and CDC] are used in this article to critically appraise the validity of coronavirus mortality calculations presented in U.S. Congressional testimony.
  • Results of this critical appraisal reveal information bias and selection bias in coronavirus mortality overestimation, most likely caused by misclassifying an influenza infection fatality rate as a case fatality rate.
  • [T]he World Health Organization also reported that 0.1% is the IFR of seasonal influenza, not the CFR of seasonal influenza as reported in the [NIAID-CDC] NEJM editorial.

And re Fauci, it should be noted that, per NYT 08/25/2020, it appears he is holding to the 1% figure: … more recently, Dr. Fauci has cited the 1 percent estimate, emphasizing that it is 10 times the death rate from seasonal flu. Humanengr (talk) 07:52, 14 September 2020 (UTC)

RfC re 10-fold COVID-19 mortality overestimation

Should the text provided above (or similar) be included at this point? If not, why not and please indicate with specific text from P&G. Humanengr (talk) 10:39, 13 September 2020 (UTC)

Survey 2

  • Oppose use. An editorial from February (even if editorials were permissible sources per WP:MEDRS), is hopelessly unreliable in what is a fast-moving research field. A preprint of an opinion piece by some guy doing a PhD,who makes the "daring" claim he has found the "worst miscalculation in the history of humanity"[4] raises a WP:REDFLAG. Given that it's already been explained neither source is WP:MEDRS, this RfC is a waste of community time bordering on WP:DE in my view. Alexbrn (talk) 11:05, 13 September 2020 (UTC)
Note my response to this same comment above. Humanengr (talk) 21:05, 13 September 2020 (UTC)
And note my response to the response, correcting its errors. Alexbrn (talk) 21:33, 13 September 2020 (UTC)
I'm not sure that the *first* statement about Fauci is a medical claim, so much as an analysis of the decision making process, so WP:MEDRS is not necessarily relevant here, so the "explanation" (explanation = argument + you are wrong ?) is perhaps completely invalid. I agree that the second statement is a statement of fact, so should use the best, most useful source, and follow WP:MEDRS. Also I think the material would be far more relevant on the US page. Talpedia (talk) 01:06, 14 September 2020 (UTC)
  • Support use. This seems relevant to include, especially given the latest statistical mortality data from my own home country, Sweden, which did not have any lockdowns. David A (talk) 15:34, 13 September 2020 (UTC)
  • Oppose inclusion. What, some best-guess estimates, made at a time when everything was uncertain, turned out to be wrong? Heavens, let's call the science police. Neither the original estimate nor the (assumed) correction belongs in this article because both are WP:UNDUE emphasis on a single number for a single country at a single point in time. The actual encyclopedic summary(!) will sound like "In the early months, nobody actually knew what the death rate was." (Also, the death rates have declined as treatment has improved.) WhatamIdoing (talk) 21:41, 13 September 2020 (UTC)
It’s not just “in the early months”. That’s Fauci’s story and (it appears) he’s sticking to it. From NYT 08/25/2020: … more recently, Dr. Fauci has cited the 1 percent estimate, emphasizing that it is 10 times the death rate from seasonal flu.. Humanengr (talk) 21:51, 13 September 2020 (UTC)
  • Oppose. Firstly, and, in my mind, most importantly the source is much too old, dated to the very beginning of the pandemic, in one of the fastest ever moving research areas. Secondly, editorials are generally poor quality sources and are discouraged by MEDRS. The third reason for opposing is that the claim is revolutionary, contentious and controversial as it is challenging mainstream medical thinking and thus the importance of using higher quality sources for such a claim increases, thus relaxing MEDRS sourcing standards is not appropriate in this case. I do not have a problem with the claim of a much lower mortality rate being added if a more recent reliable source is found.--Literaturegeek | T@1k? 21:54, 13 September 2020 (UTC)
Re “much too old”, see my response to WhatamIdoing. Re WP:MEDRS: That is an essay, not P&G; in any case, [thx, WhatamIdoing] ‘editorials’ are not mentioned. Re ‘contentious and controversial’, no RS has disputed Brown's claim (from the paper (top of p. 8) that "A comparison of coronavirus and seasonal influenza CFRs may have been intended during Congressional testimony, but due to misclassifying an infection fatality rate as a case fatality rate, the comparison turned out to be between an adjusted coronavirus CFR of 1% and an influenza IFR of 0.1%."? Until RS dispute that peer-reviewed claim, it stands. Humanengr (talk) 23:11, 13 September 2020 (UTC)
Humanengr, WP:MEDRS is a guideline, not an essay. But speaking of useful essays, I'd encourage you to read WP:BLUDGEON. The TLDR is "don't argue with every single editor who opposes your proposal". WhatamIdoing (talk) 23:17, 13 September 2020 (UTC)
Thx re ‘guideline’ (not sure how I missed that). Also thx re BLUDGEON. Humanengr (talk) 23:44, 13 September 2020 (UTC)
  • Comment I feel this update might be more relevant in COVID-19 pandemic in the United States since this section is a summary. The second source investigates the quality of the decision making at the time. I don't see why this question is not relevant for COVID-19 pandemic in the United States, but I would note that the *best* and *most recent* sources should be used on the topic - rather than one that is related to the Fauci quote. The Fauci quote does seem *politically relevant* given that COVID is a political issue as well as a a medical one. For *this* source, I find arguments along the lines that "this isn't the best source" for the first quote a little disingenuous - I hope that they aren't. The correctness, and accuracy of early decision making does seem relevant, however this discussion should preferably be separated from the discussion of the current best medical evidence on the death rate. Talpedia (talk) 00:51, 14 September 2020 (UTC)
  • oppose per Literaturegeek--Ozzie10aaaa (talk) 22:37, 13 September 2020 (UTC)
  • Oppose per Literaturegeek and and per longstanding and strong consensus that we adhere to MEDRS for Covid-19 topics.Also, the rt.com article is a controversial opinion piece, and we absolutely shouldn't be using it until it gets significant support from mainstream science - and there's a WP:UNDUE thing here too. (And yes, I've read all the responses). Boing! said Zebedee (talk) 07:57, 14 September 2020 (UTC)
    Holy crap yes - Malcolm Kendrick! This rather confirms that WP:PROFRINGE vibe underlying all this. Alexbrn (talk) 08:28, 14 September 2020 (UTC)
  • Oppose per Literaturegeek's reasoning. Bakkster Man (talk) 17:57, 14 September 2020 (UTC)

Discussion

Rather than taking time over a paper from February, can I suggest that we would be better off finding more up-to-date published figures for Infection Fatality Rate (IFR) and Case Fatality Rate (CFR)? See for instance the second graphic in this paper link. This shows the extreme variation of CFR by age, and a steady reduction in fatality over time. Unfortunately this particular piece is not peer-reviewed and fails WP:MEDRS Hallucegenia (talk) 10:22, 14 September 2020 (UTC)

*Updated link for that paper Humanengr (talk) 20:56, 15 September 2020 (UTC)
This sounds like a good idea. David A (talk) 13:17, 14 September 2020 (UTC)
agree as well--Ozzie10aaaa (talk) 13:25, 14 September 2020 (UTC)
Indeed. This RfC is a waste of time. I'm not sure how useful - other than as a political talking point - a single combined national figure is. Changing the perspective slightly to think about risk of dying from infection, this[5] recent paper from David Spiegelhalter makes the point that it is extremely difficult to communicate risk in a meaningful way, because the disease has such an enormous difference of effect according to age and underlying health. I am sure in time this knowledge will become more settled, and published in a way Wikipedia can use. Alexbrn (talk) 13:38, 14 September 2020 (UTC)
I agree, and suggest additional context around the terms being used would be worthwhile to make the statements meaningful. Particularly around the distinction between IFR and CFR, especially that CFR will change as test coverage changes. From the CEBM link [6] in the section: "CFR rates are subject to selection bias as more severe cases are tested – generally those in the hospital settings or those with more severe symptoms. The number of currently infected asymptomatics is uncertain: estimates put it at least a half are asymptomatic; the proportion not coming forward for testing is also highly doubtful (i.e. you are symptomatic, but you do not present for testing)." Of course, since we're talking about WP:MEDRS I think it's worth at least considering if that non-peer reviewed source is accurately summarizing current knowledge (my impression is that it is). Is there a better (peer reviewed) source that could be used to replace this, yet? I don't think it needs to be replaced until better sources are available, if it appears accurate. Bakkster Man (talk) 18:15, 14 September 2020 (UTC)
Two other items from this source to consider placing more weight on: "The current COVID outbreak seems to be following previous pandemics: initial CFRs start high and trend downwards." and "Estimating CFR and IFR in the early stage of outbreaks is subject to considerable uncertainties, the estimates are likely to change as more data emerges." I'd suggest there should be a caveat overall that CFR and IFR estimates are expected to be unreliable for some time, question is how long. Bakkster Man (talk) 19:02, 14 September 2020 (UTC)
Re helpful context and alternate/additional language accuracy: from the WHO on 8 August 2020:

To measure IFR accurately, a complete picture of the number of infections of, and deaths caused by, the disease must be known. Consequently, at this early stage of the pandemic, most estimates of fatality ratios have been based on cases detected through surveillance and calculated using crude methods, giving rise to widely variable estimates of CFR by country – from less than 0.1% to over 25%. … This document is intended to help countries estimate CFR and, if possible, IFR, as appropriately and accurately as possible, while accounting for possible biases in their estimation. The acronym CFR, as applied to the measure of the number of deaths among all persons with a disease, is most commonly referred to as the ‘case fatality rate,’ although strictly speaking this term is incorrect because the term ‘rate’ is used to denote a time component, which is absent in the CFR. Some authors have attempted to rectify this inconsistency by using the term case fatality proportion, or case fatality ratio, which is not bound by the numerator being a subset of the denominator (i.e., the definition of a proportion).Estimating mortality from COVID-19: Scientific Brief

Humanengr (talk) 07:26, 16 September 2020 (UTC)

@David A, Ozzie10aaaa, Alexbrn, and Bakkster Man: See COVID-19 Pandemic Planning Scenarios (updated 9/10/2020) for IFR (by age), Percent of infections that are asymptomatic, Infectiousness of asymptomatic individuals relative to symptomatic, Percentage of transmission occurring prior to symptom onset. Humanengr (talk) 18:30, 14 September 2020 (UTC)

Per this source, the values "Are not predictions of the expected effects of COVID-19." I'm not actually sure they should be in the section of the article without more directly addressing this limitation. Bakkster Man (talk) 19:02, 14 September 2020 (UTC)
The fuller text (w my boldface)

CDC and the Office of the Assistant Secretary for Preparedness and Responseexternal icon (ASPR) have developed five COVID-19 Pandemic Planning Scenarios that are designed to help inform decisions by modelers and public health officials who utilize mathematical modeling. The planning scenarios are being used by mathematical modelers throughout the Federal government. Models developed using the data provided in the planning scenarios can help evaluate the potential effects of different community mitigation strategies (e.g., social distancing). The planning scenarios may also be useful to hospital administrators in assessing resource needs and can be used in conjunction with the COVID-19Surge Tool.

Each scenario is based on a set of numerical values for biological and epidemiological characteristics of COVID-19. These values—called parameter values—can be used to estimate the possible effects of COVID-19 in U.S. states and localities. The parameter values in each scenario will be updated and augmented over time, as we learn more about the epidemiology of COVID-19.

New data on COVID-19 is available daily; information about its biological and epidemiological characteristics remain limited, and uncertainty remains around nearly all parameter values.

The parameters in the scenarios:

  • Are estimates intended to support public health preparedness and planning.
  • Are not predictions of the expected effects of COVID-19.
  • Do not reflect the impact of any behavioral changes, social distancing, or other interventions.

  • Scenario 5 represents a current best estimate about viral transmission and disease severity in the United States, with the same caveat: that the parameter values will change as more data become available.
Of course the parameters are not predictions of effects; they “can be used in models to estimate the possible effects”. Humanengr (talk) 21:35, 14 September 2020 (UTC)
Perhaps it makes more sense to go straight to the source the CDC collected these estimates from ([7]), and reference them directly instead? And, given the recommendations in this CDC document and others, perhaps it makes more sense to present IFR interval estimates across age brackets, rather than a single population-average number (which by this paper is 0.4-1.6% using the Europe data, higher than the current number in the article)? Bakkster Man (talk) 22:33, 14 September 2020 (UTC)
How about if we collect what's available in each category — population-average and age-bracketed IFR — as entered into the public discourse over time? That would be interesting. As for sources, wouldn't it make sense to give higher priority to national or international bodies as those (would seem to) more directly relate to policy decisions? For the U.S., that would be
  • CDC COVID-19 Pandemic Planning Scenarios 09/10/2020 Current Best IFR Estimate by age bracket: 0-19 years: 0.00003; 20-49 years: 0.0002; 50-69 years: 0.005; 70+ years: 0.054
  • CDC COVID-19 Pandemic Planning Scenarios 07/10/2020 Current Best IFR Estimate 0.0065
  • CDC COVID-19 Pandemic Planning Scenarios 05/20/2020 No IFR estimate provided
Humanengr (talk) 02:25, 15 September 2020 (UTC)
Humanengr seems to make sense to me, but I am not a professional in this area. David A (talk) 09:17, 15 September 2020 (UTC)
In general I agree, with a few caveats. First, all the numbers presented should include the high and low estimates, to avoid giving an expectation of certainty to numbers which are inherently difficult estimates to make. Second, I would continue to suggest using the linked PLOS paper's IFR estimates the CDC cited directly, rather than the CDC interpretation of them. The others relate to how much data should be presented in the section, and presenting information overload. I think national estimates primarily belong in an article specific to that country (with some notable exceptions, China for instance). I don't think multiple dates of estimates necessarily make sense either, at least not until enough time and research has passed that there can be an accurate delineation of whether the estimates were decreasing due to refined estimates or improved medical treatments. It's also just likely to create too large a chart and violate WP:NOTSTATS. If we collect enough info, and it appears to be worthwhile, perhaps we can consider WP:NOTESAL. Bakkster Man (talk) 12:27, 15 September 2020 (UTC)
I'd give the CDC table priority as it is more directly linked to policy decisions. (Their table has a footnote that explains the variation from the PLOS paper.) I'll try to put something together to address at least some of the issues we've covered. Humanengr (talk) 07:01, 18 September 2020 (UTC)

@Hallucegenia and Bakkster Man: This other non-peer-reviewed paper from CEBM has graphs for IFR vs time — and will be updated as they "access new outputs from the ONS and MRC models.” Humanengr (talk) 22:06, 15 September 2020 (UTC)

@Humanengr:, thanks for the heads-up! That paper is really useful. I think that's the best we're likely to get just now. I'd like to suggest adding a short section on IFR, along the lines of "As of August 2020, the Infection fatality rate (IFR) in England was calculated to be 0.49% (95% Credible interval, 0.36% to 0.67%), using infection survey data from the Office of National Statistics; and 0.30% (Credible interval. 0.22% to 0.40%), using modelling data from the Medical Research Council. In both data sets, the IFR was observed to be falling over time." What do others think? Hallucegenia (talk) 12:52, 16 September 2020 (UTC)
What do we think the CFR/IFR estimates over time (rather than just the latest best estimates) actually tell us? Specifically, how does it improve the article to provide preliminary tracking of the preliminary estimates? I'm wondering if it's worth stepping back and asking if the CFR/IFR estimates going down is unique to COVID-19, or something relatively common in these situations? Bakkster Man (talk) 14:33, 16 September 2020 (UTC)

On reduction over time, I see in CEBM the text that prefaces the IFR of 0.10 percent to 0.41 percent text already in the article:

We could make a simple estimation of the IFR as 0.28%, based on halving the lowest boundary of the CFR prediction interval. However, the considerable uncertainty over how many people have the disease,the proportion asymptomatic (and the demographics of those affected) means this IFR is likely an overestimate.

In Swine flu, the IFR ended up as 0.02%, fivefold less than the lowest estimate during the outbreak (the lowest estimate was 0.1% in the 1st ten weeks of the outbreak). In Iceland, where the most testing per capita has occurred, the IFR lies somewhere between 0.03% and 0.28%.

Taking account of historical experience, trends in the data, increased number of infections in the population at largest, and potential impact of misclassification of deaths gives a presumed estimate for the COVID-19 IFR somewhere between 0.1% and 0.41%.

Similarly, from this:

During the 2009 'swine flu' (H1N1 influenza) outbreak the reported CFR was 0.1% to 5.1%. Subsequently the World Health Organization reported that 'swine flu' ended up with an IFR of 0.02%, five times lower than the lowest CFR estimates during the original outbreak.

Humanengr (talk) 17:02, 16 September 2020 (UTC)

I agree, something to that effect makes sense to me to include. I'm not sure we need to track multiple estimates over time, just an early and current estimate along with the sources above. Bakkster Man (talk) 17:44, 16 September 2020 (UTC)

Hallucegenia's suggestion of a small IFR section led me to question the structure of the Deaths §. WebMD's 9/01 What Changing Death Rates Tell Us About COVID-19 provides a helpful orienting summary. Among the many helpful points: prioritizing IFR and then CFR over the other measures. So maybe an intro followed by subsections for 'Earliest deaths', 'Attribution of cause of death', 'Excess deaths', and 'Measures of mortality' for IFR and CFR (amended somehow as discussed here). Thoughts? Humanengr (talk) 08:11, 17 September 2020 (UTC)

Your suggestion makes sense in isolation. I went to read through the Deaths section of this article, and found myself asking how much was actually appropriate for this article (about the pandemic) versus relevant for the linked main articles (deaths due to the pandemic, and death rates by country) or the main COVID-19 article (about the disease itself). For instance, is CFR and IFR best left to the national articles and Coronavirus disease 2019#Infection fatality rate? On the other hand, excess deaths clearly belong on this page and the national pages (as that's a result of the pandemic writ large, not the disease itself). Using that metric, I'd suggest that the earliest deaths and excess deaths clearly belong in this article, IFR/CFR and comorbidity would be best left to the COVID-19 article for now (since they're epidemiological estimates), and I guess attribution could go either way (have a suggestion for what you propose makes sense here rather than elsewhere?). Add a brief summary of the top line information (total deaths, for instance) and I think a cleaner, more focused section would emerge.
Sorry to jump around so much, just a lot to digest and get a handle on the article (and related articles) as a whole. Bakkster Man (talk) 18:40, 17 September 2020 (UTC)
Thx for the prompt to consider more broadly. I see COVID-19 pandemic death rates by country includes only CFR but not IFR. Re national pages, taking COVID-19 pandemic in the United States as an example, that only briefly mentions CFR and IFR; also, the infobox there says 'fatality rate' without indicating which rate it's talking about.
The WebMD article linked above says: the most important assessment is what’s called the “infection fatality ratio; CFR … is usually established only after a pandemic has ended by analyzing death records and laboratory-confirmed cases from hospitals and other sources.; The IFR can give you a better sense of the death rate during an ongoing pandemic, while the CFR is what is typically done once a pandemic ends..
That would seem to say IFR belongs and CFR deemphasized throughout for now as, at this point, it is relatively uninformative and largely misleading. Humanengr (talk) 05:44, 18 September 2020 (UTC)
Yeah, that's roughly where I'm at, as well. I think some work into refining CFR/IFR on those other pages makes more sense. I'll take a look this weekend and see if trimming the section looks better. Bakkster Man (talk) 21:30, 18 September 2020 (UTC)
Another helpful clip on this is from Our World in Data: The CFR is very easy to calculate. … But it’s important to note that it is the ratio between the number of confirmed deaths from the disease and the number of confirmed cases, not total cases. That means that it is not the same as – and, in fast-moving situations like COVID-19, probably not even very close to – the true risk for an infected person. … What we want to know isn’t the case fatality rate: it’s the infection fatality rate.[8] Humanengr (talk) 23:38, 18 September 2020 (UTC)

Can we please have a collapsed daily cases map

This gives much more helpful information IMO because you can see what is going on in what country in what week rather than cumulative over the course of the year.

I'd happily update OWID map daily if wikidata is unable to do it.

September 16 confirmed daily new cases (7 day rolling average)

--Investigatory (talk) 07:17, 17 September 2020 (UTC)  Done but open to suggestions for improvement is anyone able to help? --Investigatory (talk) 12:32, 17 September 2020 (UTC)

Investigatory, looks good. The overall state of our COVID maps is still a mess due to lack of standardization and terrible data management practices. {{u|Sdkb}}talk 08:25, 20 September 2020 (UTC)
User:Sdkb why dont we just switch to our world in data maps then? It seems like an impossible job. Also, with the cumulative count maps, are they helpful for the reader, would it be better to prioritize a weekly, or fortnightly or monthly cases map like the one from OWID, so people know where the epidemics are now, rather than since the start of the pandemic? --Investigatory (talk) 11:55, 20 September 2020 (UTC)
@Investigatory: We'd still have to import the data to be able to use it in tables/infoboxes/other applications. And there are drawbacks to being unable to edit map images.
Regarding rolling vs. total, WP:Recentism pushes us toward the latter, balancing out some of the practicality of the former. {{u|Sdkb}}talk 15:08, 20 September 2020 (UTC)
User:Sdkb it takes me 10 seconds to update that map by clicking about 3 times. I think as the pandemic progresses we should definitely move to outsource the data to a verifiable, medrs compatible source such as OWID, because our volunteers bless them, can't be expected to do that job, when there is a very easily creative commons alternative. --Investigatory (talk) 10:39, 21 September 2020 (UTC)

IFR text to replace the last ¶ ("Other measures …") in the § Deaths

This focuses that ¶ on the IFR, consistent with Discussion above.

The most important metric in assessing death rate is 'infection fatality ratio’ (IFR),[1][a] the deaths attributed to disease divided by the number of infected individuals to-date (symptomatic and asymptomatic).[2] The University of Oxford's Centre for Evidence-Based Medicine (CEBM) has estimated global IFR at between 0.10 percent to 0.41 percent, acknowledging that this will vary between populations due to differences in demographics.[3][b] CEBM researchers also note a decrease (in England) in IFR over time;[5] and attribute the rise in daily cases, stability in daily deaths, and shift of cases to a younger population (in the UK and Italy, the two Europeans nations worst hit by Covid-19) to waning viral circulation and misapplied and misinterpreted testing rather than to virus mutation, treatment, or prevention.[6] They point to mounting evidence[7][8] that "a good proportion of 'new' mild cases and people re-testing positives after quarantine or discharge from hospital are not infectious, but are simply clearing harmless virus particles which their immune system has efficiently dealt with" and have also called for "an international effort to standardize and periodically calibrate testing"[9] On September 7, the UK government issued "guidance for procedures to be implemented in laboratories to provide assurance of positive SARS-CoV-2 RNA results during periods of low prevalence, when there is a reduction in the predictive value of positive test results."[10]

Notes

  1. ^ Some refer to this as 'infection fatality rate’; however the term ‘ratio’ is more accurate as this is not per unit time.[1]
  2. ^ Another paper in PLOS Medicine estimated IFR across several areas in Europe ranging from 0.4-1.6%.[4]

References

  1. ^ Tate, Nick. "What Changing Death Rates Tell Us About COVID-19". WebMD. Retrieved 2020-09-19.
  2. ^ CDC (2020-02-11). "Coronavirus Disease 2019 (COVID-19)". Centers for Disease Control and Prevention. Retrieved 2020-09-19.
  3. ^ "Global Covid-19 Case Fatality Rates". Centre for Evidence-Based Medicine. 9 June 2020. Retrieved 18 September 2020.{{cite web}}: CS1 maint: url-status (link)
  4. ^ Hauser, Anthony; Counotte, Michel J.; Margossian, Charles C.; Konstantinoudis, Garyfallos; Low, Nicola; Althaus, Christian L.; Riou, Julien (28 July 2020). "Estimation of SARS-CoV-2 mortality during the early stages of an epidemic: A modeling study in Hubei, China, and six regions in Europe". PLOS Medicine. 17 (7): e1003189. doi:10.1371/journal.pmed.1003189. ISSN 1549-1676. PMC 7386608. PMID 32722715.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  5. ^ "Estimating the infection fatality ratio in England". CEBM. Retrieved 2020-09-19.
  6. ^ Heneghan, Carl; Jefferson, Tom (1 September 2020). "Coronavirus cases are mounting but deaths remain stable. Why?". spectator.co.uk. Retrieved 2020-09-19.{{cite web}}: CS1 maint: url-status (link)
  7. ^ Lu, Jing; Peng, Jinju; Xiong, Qianling; Liu, Zhe; Lin, Huifang (July 31, 2020). "Clinical, immunological and virological characterization of COVID-19 patients that test re-positive for SARS-CoV-2 by RT-PCR" (PDF). EBioMedicine. 59: 1–8. {{cite journal}}: Unknown parameter |displayauthors= ignored (|display-authors= suggested) (help)
  8. ^ Heneghan, Carl; Jefferson, Tom (2020-09-01). "Virological characterization of COVID-19 patients that test re-positive for SARS-CoV-2 by RT-PCR". CEBM. Retrieved 2020-09-19.{{cite web}}: CS1 maint: url-status (link)
  9. ^ Spencer, Elizabeth; Jefferson, Tom; Brassey, Jon; Heneghan, Carl (11 September 2020). "When is Covid, Covid?". The Centre for Evidence-Based Medicine. Retrieved 2020-09-19.{{cite web}}: CS1 maint: url-status (link)
  10. ^ "SARS-CoV-2 RNA testing: assurance of positive results during periods of low prevalence". GOV.UK. Retrieved 2020-09-19.

Humanengr (talk) 08:11, 19 September 2020 (UTC)

Unfortunately, CEBM's estimate is woefully out of date. I'd recommend removing it. I added a new citation noting that more recent serology based estimates put the number at 0.5-1%. Also not sure why the PLOS estimate referenced by the CDC was commented out. - Wikmoz (talk) 22:26, 21 September 2020 (UTC)
Cite #5 above has CEBM data for England as of August 9 (ONS) and July 31 (MRC). Including more from that cite would be instructive in showing the trend: ONS figures imply an IFR as of 4 August estimated at 0.49% (ONS 95% Credible interval, 0.36% to 0.67%). The IFR estimated was higher at 2.63% at the start of our 8-week series on 23 June. MRC figures imply an IFR as of 28 July estimated at 0.30% (MRC Credible interval. 0.22% to 0.4%), having been estimated at a higher 0.69% at the start of our 8-week series on 23 June. Estimates from the MRC data appear to be more stable over time, having fallen by around 55% in the six weeks to 4 August, compared to a fall of over 80% for estimates based on the ONS data. … We will update these IFR estimates in future weeks as we access new outputs from the ONS and MRC models.. Humanengr (talk) 23:11, 21 September 2020 (UTC)
@Wikmoz, reworking, I get this (after some adjustments per subsequent discussion):

The most important metric in assessing death rate is 'infection fatality ratio’ (IFR),[1][a] the deaths attributed to disease divided by the number of infected individuals to-date (symptomatic and asymptomatic).[2] The CDC estimated IFR for the U.S. by age bracket at 0.003% for 0-19 years; 0.02% for 20-49 years; 0.5% for 50-69 years; and 5.4% for 70+ years.[3][b] The University of Oxford's Centre for Evidence-Based Medicine (CEBM) has estimated global IFR at between 0.10% to 0.41% (last revised 2 May), acknowledging that this will vary between populations due to differences in demographics.[5] CEBM researchers have noted a decrease in IFR in England over time;[6][c] and, for the UK and Italy (the two Europeans nations worst hit by COVID-19), attribute the rise in daily cases, stability in daily deaths, and shift of cases to a younger population to waning viral circulation, misapplication of testing, and misinterpretation of test results rather than to prevention, treatment, or virus mutation.[7]

The WHO reported serology testing for three locations in Europe (with some data through June 2) that show IFR estimates converging at approximately 0.5-1%.[8] A summary review in BMJ has noted that while some "serological tests … might be cheaper and easier to implement at the point of care [than RT-PCR]", and such testing can identify previously infected individuals, "caution is warranted … using serological tests for … epidemiological surveillance". The review called for higher quality studies assessing accuracy with reference to a standard of "RT-PCR performed on at least two consecutive specimens, and, when feasible, includ[ing] viral cultures."[9][10] CEBM researchers have called for in-hospital 'case definition' to record "CT lung findings and associated blood tests"[11] and for the WHO to produce a "protocol to standardise the use and interpretation of PCR" with continuous re-calibration.[12]

That includes the CDC age-bracketed data I discussed here. Re the PLOS estimate, I had retained that in a footnote, which I've now elaborated. Re the WHO estimates you inserted, I added some contextual info re serological tests from CEBM. Re the global CEBM value, the data they drew from goes through May 1 which is about the same as PLOS and only one month prior to WHO. Humanengr (talk) 07:18, 23 September 2020 (UTC)

Notes

  1. ^ Some refer to this as 'infection fatality rate’; however the term ‘ratio’ is more accurate as this is not per unit time.[2]
  2. ^ CDC values were derived from a paper in PLOS Medicine that estimated a range of IFR across several areas in Europe, from 0.5% (95% CrI 0.4%–0.6%) in Switzerland to 1.4% (95% CrI 1.1%–1.6%) in Lombardy, Italy (based on data through mid-to-late April).[4] Regarding the differences across the regions, the European researchers noted "the importance of local factors … including demographic characteristics" and "the lower degree of preparedness and health service capacity in northern Italy, which in Europe was affected first by the SARS-CoV-2 epidemic."[4]
  3. ^ One set of national statistics for England (ONS) shows a decrease in IFR from 2.63% to 0.49%; another (MRC) from 0.69% to 0.30%, both over eight weeks ending 4 August.

References

  1. ^ Tate, Nick. "What Changing Death Rates Tell Us About COVID-19". WebMD. Retrieved 2020-09-19.
  2. ^ CDC (2020-02-11). "Coronavirus Disease 2019 (COVID-19)". Centers for Disease Control and Prevention. Retrieved 2020-09-19.
  3. ^ "COVID-19 Pandemic Planning Scenarios | CDC". web.archive.org. 2020-09-12. Retrieved 2020-09-23.
  4. ^ a b Hauser, Anthony; Counotte, Michel J.; Margossian, Charles C.; Konstantinoudis, Garyfallos; Low, Nicola; Althaus, Christian L.; Riou, Julien (28 July 2020). "Estimation of SARS-CoV-2 mortality during the early stages of an epidemic: A modeling study in Hubei, China, and six regions in Europe". PLOS Medicine. 17 (7): e1003189. doi:10.1371/journal.pmed.1003189. ISSN 1549-1676. PMC 7386608. PMID 32722715.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  5. ^ Oke, Jason; Heneghan, Carl (9 June 2020). "Global Covid-19 Case Fatality Rates". Centre for Evidence-Based Medicine. Retrieved 18 September 2020.{{cite web}}: CS1 maint: url-status (link)
  6. ^ Howdon, Daniel; Oke, Jason; Heneghan, Carl (2020-08-21). "Estimating the infection fatality ratio in England". CEBM. Retrieved 2020-09-19.
  7. ^ Heneghan, Prof Carl; Jefferson, Tom (1 September 2020). "Coronavirus cases are mounting but deaths remain stable. Why?". spectator.co.uk. Retrieved 2020-09-19.{{cite web}}: CS1 maint: url-status (link)
  8. ^ "Estimating mortality from COVID-19". www.who.int. 2020-08-04. Retrieved 2020-09-21.{{cite web}}: CS1 maint: url-status (link)
  9. ^ Bastos, Mayara Lisboa; Tavaziva, Gamuchirai; Abidi, Syed Kunal; Campbell, Jonathon R.; Haraoui, Louis-Patrick; Johnston, James C.; Lan, Zhiyi; Law, Stephanie; MacLean, Emily; Trajman, Anete; Menzies, Dick (2020-07-01). "Diagnostic accuracy of serological tests for covid-19: systematic review and meta-analysis". BMJ. 370. doi:10.1136/bmj.m2516. ISSN 1756-1833. PMID 32611558. {{cite journal}}: Unknown parameter |displayauthors= ignored (|display-authors= suggested) (help)
  10. ^ Spencer, Elizabeth; Henighan, Carl (September 1, 2020). "Overview of BMJ: Diagnostic accuracy of serological tests for covid-19: systematic review and meta-analysis". CEBM. Retrieved 2020-09-24.{{cite web}}: CS1 maint: url-status (link)
  11. ^ Spencer, Elizabeth; Jefferson, Tom; Brassey, Jon; Heneghan, Carl (11 September 2020). "When is Covid, Covid?". CEBM. Retrieved 2020-09-19.{{cite web}}: CS1 maint: url-status (link)
  12. ^ Jefferson, Tom; Spencer, Elizabeth; Brassey, Jon; Heneghan, Carl (2020-09-03). "Viral cultures for COVID-19 infectivity assessment. Systematic review". medRxiv: 2020.08.04.20167932. doi:10.1101/2020.08.04.20167932.
Looks good. I'd cut the sentence "They conclude..." for brevity. I'd still recommend removing the CEBM IFR estimate from May 2. CEBM's subsequent UK data estimates for that time period are well above their earlier-predicted range. - Wikmoz (talk) 03:47, 24 September 2020 (UTC)
@Wikmoz, Where are you seeing CEBM's subsequent UK data estimates for that time period are well above their earlier-predicted range? I updated the article w the CDC age-bracketed info while we work through these other issues. Re the WHO's 0.5-1%, they say Many such serological surveys are currently being undertaken worldwide [10], and some have thus far suggested substantial under-ascertainment of cases, with estimates of IFR converging at approximately 0.5 - 1% [10-12]. Those are only two cites from Geneva and one from Stockholm.
Re the 2nd para, I can collapse the last two sentences (which are from CEBM) somewhat. Re the quality of serology testing, I've gone back to the BMJ paper that CEBM summarized and am reworking that. Humanengr (talk) 09:14, 24 September 2020 (UTC)
I've edited the 2nd para above to reflect this. Humanengr (talk) 00:03, 25 September 2020 (UTC)
The CEBM citation showing declining IFRs in England have the current weekly IFR based on ONS data at 0.49%, well above the .4% upper bound of their May estimate. The second estimate based on MRC data (now at .30%) was well above .4% into July. Hopefully, their estimates are correct and IFRs are dropping as treatment improves and the demographics shift to younger populations. However the data would seem to also suggest that the IFR prior to May 2 was substantially higher than the upper bound of their initial estimated range. Let me know if I'm reading this wrong though. - Wikmoz (talk) 01:49, 25 September 2020 (UTC)
While I ponder how to best respond, are you ok with the other edits I made above? I'm a bit unsure about the merits of retaining the WHO serology results since their numerical claim seems to be based on only 3 city-scale data points. But with the couching I inserted, it serves as a lead-in to the need for better testing standards. And I just now noticed that the first cite (#10) which is cited by WHO for the Many such serological surveys are currently being undertaken worldwide [10] … claim says nothing about serological surveys being done worldwide. Humanengr (talk) 02:14, 25 September 2020 (UTC)
@Wikmoz, re the CEBM estimates, see my earlier cmt. I've added a footnote w some numbers on the decrease over time and moved the last para up and deleted the old 2nd para. 06:11, 25 September 2020 (UTC)

Cases per country in infobox

Gosh I've never been so hesitant in editing a page, so I'm bring this minor thing here. Perhaps the title "Cases per country" in the infobox show section would be clearer as labeled "Total cases per country" since at first glance, at least to me, I was initially unsure how that map was different than the uppermost map of the infobox... if that makes sense? Also when the "Cases per country" is closed, I was also unsure as to how it would be different than the uppermost map... Aza24 (talk) 19:45, 26 September 2020 (UTC)

Aza24, sounds like a fine edit to me. I think that may have been the label a while back. {{u|Sdkb}}talk 05:42, 27 September 2020 (UTC)
I've added and linked "Basis point" by way of making the metric clearer. kencf0618 (talk) 19:54, 28 September 2020 (UTC)

Cartography

Can we rid ourselves of the units of the United States? Not only is it unduly centric, it is out of place on a global map.

Secondly, are there any cartograms or choropleth or, for that matter, heat maps of the pandemic?

kencf0618 (talk) 20:01, 28 September 2020 (UTC)

I updated it to show the daily new confirmed deaths per million people. I think this map is the most useful, as we know cited in the first paragraph of the text that the case count is vastly underestimated. User:Kencf0618 can you have a play with the "Coronavirus Data Explorer" at OWID here and tell me which you prefer?
  • Furthermore given that the case count is vastly underestimated, I propose that we change the main map to something like deaths per capita. Ping User:Sdkb to help discuss if we should change. --Investigatory (talk) 00:11, 29 September 2020 (UTC)
I find this to be the best map available

— Preceding unsigned comment added by Investigatory (talkcontribs) 00:12, 29 September 2020 (UTC)

Investigatory, I'm not a fan of the fact that the legend is included as part of the image itself—it makes it too small, presents accessibility problems, etc. (see this discussion). The square projection is also non-standard for Wikipedia, compared to the one with rounded corners used at the top.
The current setup is the result of this discussion from way back, and shouldn't really be changed without more input, so I'm going to restore the status quo for now, but I think it might be a good idea to have another RfC about which maps to put in the infobox (it might be a good idea to have it at the WikiProject page and expand the scope to all geographic COVID-19 pages for consistency).
Regarding the total deaths, it looks like the deaths per capita map has actually been being updated by Dan Polansky, but the "as of" date here hasn't been updated, so it's stuck on September 13 (didn't we have a template that updated that automatically? Where did that go?). I'm long since beyond exhausted trying to convince everyone to set up a centralized system for keeping COVID data automatically updated, so I won't opine on that other than to say that it continues to be a major failure with colossal and mounting costs in terms of both reliability and editor effort. I do think it's useful to have a total deaths count in addition to the rolling count for WP:RECENTISM and general informational reasons. {{u|Sdkb}}talk 00:37, 29 September 2020 (UTC)
@Sdkb: Yes we should be able to include the legend separately, thats a minor problem, didn't want to spend the extra effort if it wasn't going to stand. Ping User:Dan Polansky before starting the RfC. I think that we should focus on deaths per capita as the main map, followed by daily deaths per capita 7 day rolling average, then case counts at the bottom, because case counts truly reflect the country's ability to test, and are arguably much less useful than death counts. Re: colossal and mounting costs in terms of both reliability and editor effort I truly respect how well the editors have been able to keep up with the data. However, I propose that if it is truly that unreliable, we can change to OWID. --Investigatory (talk) 00:44, 29 September 2020 (UTC)
Also if you look at my proposed OWID map here, it actually gives a vastly different picture of the pandemic than the current maps, and therefore why I found it to be so useful. --Investigatory (talk) 00:48, 29 September 2020 (UTC)
@Kencf0618: what may is being referred to? I'm surprised any maps on this page actually need units that differ between the US and elsewhere. Nil Einne (talk) 09:02, 29 September 2020 (UTC)
Very interesting and informative discussion all around. 1) Get rid of the states and provinces. 2) The Mollweide project is the standard for this scale of distribution of data. 3) The nestled boxes are to mind in the most useful order. 4) That said, in the interests of standardization an Rfc should take another crack at it. 5) A map of the six WHO regions would be informative too. kencf0618 (talk) 17:23, 29 September 2020 (UTC)

duplicate text in section 'deaths'

☃☃☃☃ In the worst affected areas, mortality has been several times higher than average. In New York City, deaths have been four times higher than average, in Paris twice as high, and in many European countries, deaths have been on average 20 to 30 percent higher than normal.☃☃ This excess mortality may include deaths due to strained healthcare systems and bans on elective surgery.☃☃Comparison of statistics for deaths for all causes versus the seasonal average indicates excess mortality in many countries.[80][81] In the worst affected areas, mortality has been several times higher than average. In New York City, deaths have been four times higher than average, in Paris twice as high, and in many European countries, deaths have been on average 20 to 30 percent higher than normal.[80] This excess mortality may include deaths due to strained healthcare systems and bans on elective surgery.[82]

91.125.77.219 (talk) 00:12, 2 October 2020 (UTC)

 Done. The odd symbols have also been removed. —Tenryuu 🐲 ( 💬 • 📝 ) 02:43, 2 October 2020 (UTC)

Rename to COVID-19 statistic

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.


A million deaths is a statistic and COVID-19 passed million deaths so this is not an epidemic, not an outbreak, no longer even a pandemic, but a statistic. So this should be renamed to COVID-19 statistic. 2A01:119F:31B:5D00:901:FD57:5FE0:2CF (talk) 15:37, 1 October 2020 (UTC)

Bruh. GeraldWL 15:47, 1 October 2020 (UTC)
I think I just got less intelligent reading this. CaffeinAddict (talk) 03:22, 2 October 2020 (UTC)
No. Jehochman Talk 12:13, 2 October 2020 (UTC)
The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Bloated

This article does not serve the reader because it is too bloated. A reader should be able to read the article and get a good overview of the topic, not every detail available. There are numerous sub-articles that contain the details if desired. I propose we start trimming. For example, in the national responses section, each country should be pruned to a single paragraph with just the most essential information. The ones that especially need pruning are China, USA, and Spain. Jehochman Talk 12:13, 2 October 2020 (UTC)

I'm replacing some of these with {{Excerpt}}. My problem is then to prune the ledes of those sub-articles. This will make it easier to keep all the content up to date, because updates happen in one place instead of two. Jehochman Talk 12:25, 2 October 2020 (UTC)
That's a really good way to handle this. An important notion is that while Wikipedia should have all of this information, this article does not have to be the place where ALL of it is written. WP:SUMMARY and WP:SPLIT are good ways to handle this. The "excerpt" template is a very nice tool to help do that efficiently. --Jayron32 12:33, 2 October 2020 (UTC)

Framing of "Politics"

In the section designated "Politics" there is a paragraph about "big and small government". There are five issues with this. [1] Only one side (so called "small government") is presented [2] After presenting their opinion, it is treated as factual/semi-factual [3] Even though the source is often accurate with information, it is open about ideological leanings [4] It breaks with the internationalism of wikipedia, as "big and small government" discourse is almost exclusively an american debate [5] For readers not familiar with the debate, it will appear confusing and contradictory, as both sides of the "big and small government" have massively expanded and contracted state power regardless of political ideology — Preceding unsigned comment added by MatOregan (talkcontribs) 08:08, 2 October 2020 (UTC)

I've removed the statement per WP:UNDUE. There's no evidence this is a widely-held position, and should be given the prominence in this article. It likely is a useful thing for the text to address in a sub-article, so the concept definitely belongs at Wikipedia, but not in this article, where it seems out of place. --Jayron32 12:36, 2 October 2020 (UTC)

Infobox: date parameter

Currently, the date parameter is set to 1 December 2019. But the source used mentions none of that. According to the Template:infobox pandemic the description of date is "The date of the pandemic". So shouldn't it be the date where the outbreak turned into a pandemic? But, if you click the template, it will redirect to Template:infobox outbreak. So not sure at all what to do here. Feelthhis (talk) 13:59, 29 September 2020 (UTC)

will look--Ozzie10aaaa (talk) 17:34, 1 October 2020 (UTC)
I'd like to suggest we not use the date parameter here, at least not in isolation until the pandemic is declared over. Instead, let's populate first_reported with the earliest available report date (December 31, 2019 per this WHO source) and arrival_date with the range of first human infection. We could consider a different start date in the date field, such as the date the WHO declared a pandemic (as per the article title), when WHO issued the international concern bulletin, or the range of dates of the first reported case. I took a stab at this, with the start date being the December 31 date referenced in the citation already there. Bakkster Man (talk) 18:49, 1 October 2020 (UTC)
Thanks for the edits. I reverted an edit that had changed back to 1 December. Feelthhis (talk) 23:40, 3 October 2020 (UTC)

Continue old RfC: Lead shortening

I found out that my RfC about shortening the lead has been archived, but felt like there are still things to talk about, and I would like to have a consensus. See the discussion for those who haven't. Points 1, 2, 3, 4, 5, 6, 7, 8, and 10 are either rightfully rejected or implemented in agreement.

For point 9, I still find it valid, as the lead is an in-a-nutshell of the pandemic and does not need to specify it in a very specific way, i.e. mentioning the numbers. If readers want to know more, they can just go to the Famines section, and/or the Corona famine article. My two points there stands.

For point final, I find more people to agree on my proposal (2 -- 1), and would like to continue it. Personally I think we can just put "xenophobia" there, I think there's nothing wrong with that. To make it less "awkward" if you feel so, we can merge it as: "Misinformation about the virus have been circulated, as well as incidents of xenophobia and racism."

Mild, unimportant proposal: what about changing the sentence to "Educational institutions have been partially or fully closed, 'or switched to online schooling."?

Pinging old discussion participants @Hzh, Larry Hockett, BlackholeWA, David A, Sdkb, Ovinus Real, and Moxy:, as well as mentioned user Jurisdicta. For broader discussions, I'm pinging @Tenryuu, Another Believer, Tom (LT), Ozzie10aaaa, Alexbrn, and Traut:, hope you don't mind. GeraldWL 10:31, 24 September 2020 (UTC)

It is very awkward to go to the old discussion and see which points you are referring to. Can you just list the ones you want to discuss again and how you want to change them? Hzh (talk) 14:39, 24 September 2020 (UTC)
Happy to give input but need more details on what needs to be discussed. Jurisdicta (talk) 22:16, 24 September 2020 (UTC)
I am extremely confused as to which point needs further discussion. —Tenryuu 🐲 ( 💬 • 📝 ) 02:17, 25 September 2020 (UTC)
@Jurisdicta, Tenryuu: Sorry y'all, time difference.
Point 9 is this: "Poverty" could just be omitted, as "economic disruption" and "the largest recession" is basically it. As to "famines," we could just combine in to be "including the largest recession since the Great Depression, as well as global famines." This refers to The first sentence of the last paragraph in the lead (this discussion is about making the lead simpler, less technical). David A shows neutral view on that, and the discussion suddenly ends. That's why I'm bringing back this discussion.
Point final is: Last sentence could be shortened to "Xenophobia as well as discrimination towards those being in highly-infected areas were seen.". Sdkb opposes the proposal, saying that it has been subject to a big consensus discussion, however I argued that the sentence, which is centered towards Chinese, is outdated as it's not just Chinese being victimized. Two people, Hzh and Ovinus Real, agreed with the proposal.
Hope that clears up the awkwardness, apologies for that. Also pinging Investigatory, who is in the discussion too. GeraldWL 07:08, 25 September 2020 (UTC)
Well, given how extreme the numbers are for people that have entered extreme poverty and/or starvation because of the shutdowns (100 million respectively 130 million), I still think that they should be briefly mentioned in the lead. David A (talk) 10:04, 25 September 2020 (UTC)
David A, those numbers could have a place in Coronavirus famine, similar to the pandemic numbers being highlighted briefly in this article's lead.. As I said in the previous thread, we don't need to highlight it very specifically in a lead of an article not totally related on the famine, where details are not of concern. Wikipedia is also not a tribute to a specific case, if that's one of your intention, which it seems to be. This is not an awareness platform, nor does highlighting the numbers in the lead going to help alleviate their struggle. GeraldWL 15:10, 25 September 2020 (UTC)
Since when is Wikipedia not an awareness platform? The entire point of Wikipedia is to make people at large more well-informed about verifiable facts and data, as far as I am aware, and these are extremely relevant data regarding the consequences of the global shutdowns. This doesn't take up much room in the page, and is easily among the most extreme truthful information within it. Why are you so obsessed with removing it? David A (talk) 06:25, 26 September 2020 (UTC)
David A, as I said, the relevant data, which I agree with you on that, could feel home at the corona famine article, in which it itself is the subject in discussion. Omitting the numbers to make it more brief does not make things any worse. Okay, you're saying you want people to be well-informed. No numbers detailed in the first few paragraphs does not mean they will not be aware of it. I have repeated this: leads aren't everything, they don't store every specific data, and shouldn't be. I am not "obsessed" in a way that's so insane, it's basically what's right. You don't need lots of details at the lead. It's a summary. Like a film plot; it doesn't cover everything, it just takes the root. Quoting MOS:INTRO, "Editors should avoid lengthy paragraphs and overly specific descriptions – greater detail is saved for the body of the article." GeraldWL 07:11, 26 September 2020 (UTC)
@David A: "The entire point of Wikipedia is to make people at large more well-informed about verifiable facts and data" - that fundamentally is what an encyclopedia is WP:NOT. We don't deal in "facts and data", but rather analysis and synthesis of facts and data, at a couple of levels up, since we are a tertiary text. We need to be a summary of accepted knowledge as found published in reputable sources. Alexbrn (talk) 07:44, 26 September 2020 (UTC)
After reading the lead again and looking at it anew, I don't believe that the information about poverty is excessive. It is one of the global effects of COVID-19 and is brief enough that I don't see an issue with it being included in the lead. Jurisdicta (talk) 20:30, 26 September 2020 (UTC)
Jurisdicta, again, I'm not saying we should entirely forget the info about poverty.
First, I just view the numbers as extraneous, and that if the reader wants to learn more they can just go to the famine section. Not everyone is interested in numbers, like, right off the bat.
Second, I view "social and economic disruption" represents "poverty and famine" too, so it would be simpler to just erase the "poverty and famine" thing as "social and economic disruption" basically sums it up. People will just immediately think of poverty and possibly famines when they hear "economic disruption." This should be distinguished from "not including the info." It's not "brief" as in "containing few words."[1] GeraldWL 07:13, 27 September 2020 (UTC)
No there should be famines. AFAIK H1n1 pandemic led to socioeconomic disruption but not famines. --Investigatory (talk) 08:25, 27 September 2020 (UTC)
Investigatory, the World Bank Organization describes poverty as hunger, lack of shelter, poor medical treatment, inaccessibility to schools, not having a job, and "fear for the future, living one day at a time." It ended with "Most often, poverty is a situation people want to escape. So poverty is a call to action -- for the poor and the wealthy alike -- a call to change the world so that many more may have enough to eat, adequate shelter, access to education and health, protection from violence, and a voice in what happens in their communities."
Given the definition from a prominent organization like World Bank, I think it's safe to include famines as socioeconomic disrupt. Famine is a situation people want to escape. It's a lack of food. It is a call to action. It is also a fear for the future. Just because the H1N1 pandemic has socio/economic disruption but does not have famines, does not mean famines are not socio/economic disruption. GeraldWL 13:49, 27 September 2020 (UTC)
Poverty certainly does not equal famine. Poverty is something that happens to individual people, famines on geographical scale usually. Many other differences, click on the wikilinks --Investigatory (talk) 21:32, 28 September 2020 (UTC)
Investigatory, the only difference I see is that famine is (uncountable) extreme shortage of food in a region while poverty is the quality or state of being poor or indigent; want or scarcity of means of subsistence; indigence; need. Okay, I can take that, however that doesn't take the coronavirus famine away from being "social and economic disruption." Quoting Coronavirus famine#COVID-19 pandemic, "Simultaneously, many poorer workers in low- and middle-income nations also lost their jobs or ability to farm as a result of these lockdowns, whilst children could not receive school meals due to the education shutdown across much of the world." GeraldWL 10:37, 29 September 2020 (UTC)
I would agree with David A that given the significant number of people affected, "poverty" should be mentioned. This would be WP:DUE. However, I do not oppose to shortening it in some way. I also think the term "global famine" is excessive, and I'm not sure the sources support it given that other causes are involved. As for the xenophobia issue, I haven't changed my mind, giving Chinese people a special mention in the lead as victims is WP:UNDUE when far more people have suffered in many different ways worse effects of the pandemic. Therefore if xenophobia is to be mentioned, it would need to be phrased in a general manner rather than about any specific ethnic group. Hzh (talk) 11:58, 27 September 2020 (UTC)
Thanks for the opinion. Tenryuu, do you have one? Looking forward. GeraldWL 10:27, 2 October 2020 (UTC)
Gerald Waldo Luis, I would reword "global famines" into something else, as the entire world isn't in a famine. The sentence regarding xenophobia and racism against non-Chinese people should be lightly edited: there definitely have been incidents where that has occurred, but the lead of the related article that it is linked to, List of incidents of xenophobia and racism related to the COVID-19 pandemic, states that the pandemic has led to an increase in acts and displays of sinophobia as well as prejudice, xenophobia, discrimination, violence, and racism against people of East Asian and Southeast Asian descent and appearance around the world, which is true; just not completely true with the examples given. Both the lead in that article and this one should be altered so that xenophobia against East Asian (and Southeast Asian) people and those with descent from those areas are emphasised, but are not exhaustive of all incidents. For example, I would do something like There have primarily been many incidents of xenophobia and racism against Chinese people [...] Links in original, emphasis added. —Tenryuu 🐲 ( 💬 • 📝 ) 13:34, 3 October 2020 (UTC)
Tenryuu, thanks for your comment. I am interested in knowing what you will replace "global famines" with-- is it "famines"? For me, I think "social and economic disruption" basically says it. Regarding the xenophobia thing, why not just have "xenophobia and racism"? Racism is basically prejudice towards appearance, and I don't think Sinophobia has been much bigger of concern than other types during this pandemic. If a specific group is suggested to be emphasised, I would say "marginalised groups" or "the minorities"-- it's not just hatred towards appearance, LGBTQ people have also been targeted. GeraldWL 15:45, 3 October 2020 (UTC)
Gerald Waldo Luis, "famines" as is is fine. While famines can arise from "social and economic disruption", the latter does not necessarily lead to the former.
Racism is basically prejudice towards appearance, and I don't think Sinophobia has been much bigger of concern than other types during this pandemic. Again, this is in the lead of the other article, not this one; I am not saying that the lead there is fine, just that it exists. What I'm trying to say is: given the amount of weight that the articles currently put on East Asians, it makes sense for the leads to mention that as something WP:DUE. It should be altered such that it doesn't say that only East Asians are the only ones that are experiencing prejudice and discrimination. —Tenryuu 🐲 ( 💬 • 📝 ) 17:44, 3 October 2020 (UTC)
Tenryuu, thank you for clarifying.
At the coronavirus famine article, worldwide restrictions and widespread supply shortages-- basically economic disruption-- cause high-income nations to fall, simultaneously making poorer countries fall even lower, causing people to "lost their jobs or ability to farm as a result of these lockdowns, whilst children could not receive school meals due to the education shutdown across much of the world." There are other topics talked there, such as armed conflicts and the locust infestations, however it seemed to me that these two things have nothing to do with the pandemic and is just another type of famine in 2020. By area, parts where the famine is not caused by economy nor society are Syria and Yemen, but those countries' famines don't have correlations with the pandemic at all. Yes the corona famine does not mean it is caused by the pandemic, but this article only talks about what has been caused by the pandemic.
Regarding xenophobia, I can see where you're coming from. I think I can agree on that. But again, part of me remembers lead as a summary, and that a simple "xenophobia and racism" would suffice. Would support either choices. GeraldWL 18:03, 3 October 2020 (UTC)
Gerald Waldo Luis, let's just focus as much as possible on just the lead for this article. If the concern is that some famines shouldn't be considered to be associated with COVID-19, that is something that should be discussed on that article's talk page. What I'm saying is if the subelement of "social and economic disruption"—the famines—are notable enough to warrant its own article, it's fine if it's being mentioned. One cannot assume that economic disruptions will always lead to famines.
Again, a qualifier should be added to "xenophobia and racism", as that would not prevent it from being a summary, but clarify that while most cases have been discrimination against East Asians, there are other incidents that exist. —Tenryuu 🐲 ( 💬 • 📝 ) 19:31, 3 October 2020 (UTC)
Tenryuu: Regarding your first paragraph, no I'm not talking about that famine article. I'm talking about which part of the article can we talk about in this article. Since this is only about what the pandemic has caused, it is safe to include famines in "social and economic disruption" as all COVID-caused famines featured in the coronavirus famine article is social/economic disruption. Like I said at the bottom of this section, "The lead feels like a "mini article" more than a "summary."" GeraldWL 12:31, 4 October 2020 (UTC)
Gerald Waldo Luis, and I'm saying that I have no problem with famines being mentioned on this article here, since they are a notable effect of the pandemic. What I'm saying is that they should be mentioned, as disruption doesn't necessarily always lead to famine.
Per MOS:LEAD:

The lead section should briefly summarize the most important points covered in an article in such a way that it can stand on its own as a concise version of the article.

Tenryuu 🐲 ( 💬 • 📝 ) 15:27, 4 October 2020 (UTC)
Gerald Waldo Luis please discuss any changes to the lead. the changes you made were medically incorrect, and several major grammar errors. Must be very careful with such a high profile page. --Investigatory (talk) 14:31, 3 October 2020 (UTC)
Investigatory, how are my edits medically inaccurate? Sure I won't deny grammatical errors, but I was just rewording them in a shorter form. There are many things you restored that is just too much: "although the true number of cases are likely to be much higher"-- it has been stated that it is "reported cases," so to reassure is extraneous. "A more reliable indicator for case spread"-- other articles don't use this wording, so frankly I don't see a need in it. "Shortness of breath" is literally "breathing difficulties." Isn't it right that it has "a variety of impacts to the environment?" It's much better than saying "decreased emissions of pollutants and greenhouse gases."
Overall, I view this article as the root to all articles related to the COVID-19 pandemic. Nearly all of the content are either excerpts or summaries of a main article. And because the body is the branch, we should not treat the lead as a branch. There are some parts in the lead I find to be fine, like the Great Depression thing. But to only specify "pneumonia and acute respiratory distress syndrome"? It better be "Complications primarily affect the lungs." If the lead is treated as an overall summary of the whole thing going on, why don't info on diagnosis be included? I think it would be great if we just combine spread+symptoms+diagnosis. This article is about the pandemic, not the disease, so taking up 2 huge paras to talk about a specific topic on the disease in a lead just doesn't make sense.
The lead feels like a "mini article" more than a "summary." There's too much trivial information in it that it wouldn't be called a "summary." GeraldWL 15:45, 3 October 2020 (UTC)
Your revision of the transmission section in particular was medically inaccurate, can we please leave that as it is for now. Its important to keep it all in, its only two sentences, and fine for the lead. We definitely cant combine spread with diagnosis and symptoms, theyre pretty much the most important information on the page. These are the two main complications but it definitely doesn't affect only the lungs.--Investigatory (talk) 12:11, 4 October 2020 (UTC)
how it spreads and the symptoms are most important here, more important than the disease page. --Investigatory (talk) 12:11, 4 October 2020 (UTC)
This was particularly inaccurate Often it can be acquired by touching a contaminated surface. - its literally never been conclusively shown to be acquired from touching a contaminated surface. Also there is an ongoing debate between respiratory droplets and airborne transmission which is why we must say when an infected person breathes, coughs, talks, or sings it spreads small droplets (most commonly) and also particles like aerosols. These both spread through the air but in a very different way, and the lead tries to summarize that. Complications don't primarily affect the lungs, thats different to saying complications include pneumonia and ARDS, which affect the whole body. There isn't a need to over summarize. Wikipedia readers often only read the lead, I think it reads well with all the summarizations we've made so far. As per the warning if theres major changes need to discuss first --Investigatory (talk) 12:11, 4 October 2020 (UTC)
Also singing is a particularly high risk activity, there have been many cases tranmsitted via singing indoors, much farther than the standard 2m social distance --Investigatory (talk) 12:13, 4 October 2020 (UTC)
To IP editor:Sure, it may be important, who am I to judge. But the thing is, that's not how the lead works. Not all readers are interested in an overdetailed summary. The lead should simply cover the basics, sprinkled with some details to not make it amateur. It's like a plot summary, it does not cover all scenes, but rather give important points in the shortest way possible. Sure the disease does not only cover the respiratory, but what about saying primarily respiratory? That would give a clarification. "Authorities worldwide have responded by implementing travel restrictions, lockdowns, workplace hazard controls, and facility closures in order to slow the spread of the disease" could just be shortened to "Authorities worldwide have responded in various ways, especially by restrictingor banning travel and outdoor activities to slow spread of COVID-19."
Because this article is the pandemic and not the disease, we could focus more on the pandemic and not the disease or virus; your words "more important than the disease page" doesn't make sense to me. The disease/virus is definitely more important in their respective article rather than here-- again, I'm not saying they're vague in the pandemic page. I'm just saying that we can focus more on what the disease has caused rather than the disease. I also frankly don't understand how combining symptom+spread+diagnosis is detrimental to the importance of the disease and virus. GeraldWL 12:31, 4 October 2020 (UTC)
To Investigatory: Thank you for showing specifically at which parts I am wrong at, however I have a problem. On your first stance, it appears to me that you could just adjust the said sentence to make it more accurate. Also, I didn't have the intention in "over summarizing," whatever that means. I'm saying that the lead is way to detailed, with sentences that do not belong in leads, like "a more reliable indicator" or "although the numbers could be higher"-- there's the word "reported" there, if the readers think it's the right number then it's their fault for not reading correctly. There's no intention in making the lead to just one or two short paragraphs. But if there are parts where shortening can be implemented, why not? The length of a certain article does not reflect on the importance of it. Thank you for reverting my major change, but there are definitely some edits I made like erasing the "2020" in "March"-- as the year has been said-- which makes sense that you don't have to revert. GeraldWL 12:31, 4 October 2020 (UTC)
Articles on epidemics must show the symptoms of the disease and how they spread in the lead. Otherwise they're pretty useless to the readers who want the info there. Its had many editors working on it all year, cant remove without conesensus. --Investigatory (talk) 12:34, 4 October 2020 (UTC)
Investigatory, dude that's not what I'm saying. Of course, what kind of an epidemic is without the disease, and particularly the virus? I'm not saying that they're vague. Just that we don't need lots of details. Just make it basic, there are some sentences that could definitely be simplified. What is also the problem with combining symptom+spread+diagnosis? I don't see anything wrong with that. GeraldWL 13:09, 4 October 2020 (UTC)
Its not lots of details its very basic language as it is, to explain very difficult concepts. Everything in the lead (that's medical) is important. I agree with you in removing March 2020 and WHO and PHEIC. But others dont, so I think after this very long discussion we have a pretty good consensus. Perhaps the kind of language you're looking for is better in simple english wikipedia? --Investigatory (talk) 13:29, 4 October 2020 (UTC)
I'm not a fan of "shortness of breath or breathing difficulties" but someone wants that in. I think its something to do with WP:MEDMOS as some people like breathing difficulties with SOB being too technical. So its probably a consensus to leave both in. Your edit said "spreading aerially" as a very inaccurate summary of the most important point that it spreads via respiratory droplets and airborne transmission. Those sentences specifically IMO cannot be summarized any more. --13:39, 4 October 2020 (UTC) --Investigatory (talk) 14:02, 4 October 2020 (UTC)
Also the true number of cases is likely to be much higher - other people wanted different wording and were putting in news articles saying this, so I summarized what they were saying then. People think its some kind of WP:CENSOR to not say that explicitly and i agree with them --Investigatory (talk) 14:02, 4 October 2020 (UTC)
I wholeheartedly support you and others summarizing the deaths section that is dense and too much detail IMO. Please also refer to MOS:LEAD where most important points covered in an article in such a way that it can stand on its own as a concise version of the article. I think it does a good job as it is, a few minor things can come out, but all that medical information should stand. People come to this article, IMO to see 1. how the pandemic has progressed (and need to be reminded that the case count is a vast underestimation, and the death count is more reliable) 2. How it spreads 3. what symptoms to look out for 4. preventative measures and 5. impact (although I think much of the historical informaiton can be spun out to other aritcles) --Investigatory (talk) 14:55, 4 October 2020 (UTC)


References

  1. ^ "BRIEF | meaning in the Cambridge English Dictionary". dictionary.cambridge.org. Retrieved 2020-09-27.

dispersion

How is it possible that this article doesn't mention dispersion?! There's not even an article on it or the the dispersion factor k! This describes how much a disease clusters. The lower k is, the more transmission comes from a small number of people.

As https://www.theatlantic.com/health/archive/2020/09/k-overlooked-variable-driving-pandemic/616548/ explains and as scientific articles have said for a long time already and as Japan discovered already in February, COVID-19 is an overdispersed pathogen, meaning that it tends to spread in clusters, but this knowledge has not yet fully entered our way of thinking about the pandemic—or our preventive practices.

I'm shocked that Wikipedia is at the level of daily newspapers on COVID-19. --Espoo (talk) 13:45, 4 October 2020 (UTC)

Yes it does spread in clusters. We refer to superspreading events. The mitigating factors are usually to do with ventilation and avoiding crowded indoor spaces. I have seen that atlantic article its quite good but we cant cite it. I havent seen a good review that goes into this in any detail. Annals review on transmission is the best we have at the mo --Investigatory (talk) 15:12, 4 October 2020 (UTC)
This is why I removed R0 from the transmission section, and talk about how the number of secondary infection varies, and the superspreading events (the clusters). --Investigatory (talk) 15:19, 4 October 2020 (UTC)
[9] put that in with a systematic review. You can always make the article K (dispersion factor) if you like, epidemic curve was also only made this year in respose to the pandemic and that needs some work --Investigatory (talk) 15:35, 4 October 2020 (UTC)

basic reproduction number

The information given here is very different from that in herd immunity. --Espoo (talk) 22:04, 2 October 2020 (UTC)

Espoo, mind specifying? GeraldWL 12:11, 3 October 2020 (UTC)
This article says: Initial estimates of the basic reproduction number (R0) for COVID-19 in January were between 1.4 and 2.5,[56] but a subsequent analysis concluded that it may be about 5.7 (with a 95 percent confidence interval of 3.8 to 8.9).
Herd immunity says: 2.5–4 --Espoo (talk) 19:40, 3 October 2020 (UTC)
Espoo, they use different resources; Herd immunity uses one that was in September, while the ones here are from April. —Tenryuu 🐲 ( 💬 • 📝 ) 21:52, 3 October 2020 (UTC)
Even if the different studies resulting in different estimates were from the same months, this info should be in both articles. I'm quite surprised the present article's info is out of date and even more surprised that my heads-up resulted in this back and forth instead of an edit of the article. Even more shocking is that Coronavirus disease 2019 doesn't even mention this topic, which is regularly used to support disinformation about COVID-19. --Espoo (talk) 07:13, 4 October 2020 (UTC)
I'm quite surprised the present article's info is out of date and even more surprised that my heads-up resulted in this back and forth instead of an edit of the article. WP:SOFIXIT. —Tenryuu 🐲 ( 💬 • 📝 ) 00:47, 5 October 2020 (UTC)
Since some of us don't always have time to fix problems at the moment we notice them, it should be enough to leave a note on a talk page as a heads-up. Especially when this can help editors more informed on the topic realize that other things probably need to be updated too. --Espoo (talk) 09:42, 5 October 2020 (UTC)

RFC to update and confirm current standing of transmission in lead

Does current consensus reflect the following sentences as a summary of how COVID-19 is transmitted in the lead of COVID-19 and COVID-19 pandemic articles? --Investigatory (talk) 05:58, 5 October 2020 (UTC)

The disease spreads most often when people are physically close.[a] It spreads very easily and sustainably through the air, primarily via small droplets and sometimes in aerosols, as an infected person breathes, coughs, sneezes, talks, or sings.[2][3] It may also be transmitted via contaminated surfaces, although this has not been conclusively demonstrated.[3][4][5] It can spread for up to two days prior to symptom onset and from people who are asymptomatic.[3] People remain infectious for seven to twelve days in moderate cases and up to two weeks in severe cases.[3][6]

Notes

  1. ^ Known as "close contact" which is variously defined, including within ~1.8 metres (six feet) by the US Centers for Disease Control and Prevention (CDC), and being face to face for at least 15 minutes, or sharing an enclosed space for a prolonged period such as 2 hours, by the Australian Health Department.[1][2]

References

  1. ^ "Quarantine for coronavirus (COVID-19)". Australian Government Department of Health. Retrieved 25 September 2020.
  2. ^ a b "How COVID-19 Spreads". U.S. Centers for Disease Control and Prevention (CDC). 18 September 2020. Archived from the original on 19 September 2020. Retrieved 20 September 2020.
  3. ^ a b c d "Transmission of COVID-19". European Centre for Disease Prevention and Control. Retrieved 12 September 2020.
  4. ^ "Q&A: How is COVID-19 transmitted?". World Health Organization (WHO). Retrieved 12 July 2020.
  5. ^ "Transmission of SARS-CoV-2: implications for infection prevention precautions" (PDF). www.who.int. World Health Organization. 9 July 2020. Archived from the original on 9 July 2020. Retrieved 18 September 2020.
  6. ^ Cite error: The named reference ECDCQA was invoked but never defined (see the help page).
  • Support as nominator my reasons are that it most often transmits via respiratory droplets as per WHO, CDC and ECDC. It also spreads via the airborne method, as most reflected by ECDC and "not ruled out" by the WHO. The draft update of the CDC cited in the archive also supported it being spread by the airborne method. Both the ECDC and the WHO in the citations state that there has been no conclusively transmitted fomite transmission. Breathing, coughing, sneezing, talking and singing can transmit the virus, and singing is its own separate risk which needs to be identified in the lead, as this leads to a lot of aerosolisation and super spreader events. --Investigatory (talk) 06:02, 5 October 2020 (UTC)
  • Comment also as we know the WHO has been slow to update its guidance the whole year. CDC also has been accused of political interference, I agree with their draft update available from the internet archive. The ECDC agrees entirely with the sentences as cited. For the writer of this RfC, this review has been instrumental in updating the transmission method, which concurs entirely with the ECDC, the CDC's draft, and the WHO has stated that it doesn't rule it out. --Investigatory (talk) 06:13, 5 October 2020 (UTC)
  • Comment/query this seems appropriate. Is this just to provide consistency across COVID-19 articles or was there something contentious? MartinezMD (talk) 10:08, 5 October 2020 (UTC)
Not very contentious at present. Just very contentious in the past, and want to ensure that the CDC's paid editor does not overrule consensus again. --Investigatory (talk) 10:38, 5 October 2020 (UTC)
  • Oppose. A spot check on WP:V shows this proposed text is way too cavalier, to the degree it has a POV problem. The cautiousness of the sourcing is not reflected, and the uncertainty about aerosols from EUDCD is not reflected in the proposed text. As a general observation it strikes me as very odd to see this RfC launched in an area of major interest when there is no obvious active dispute, by a fresh WP:SPA. I'm not convinced it is helpful to try and set text on this topic in stone now, in what is still an evolving field. Alexbrn (talk) 14:48, 5 October 2020 (UTC)
  • Comment I'm seeing one possible issue with the paragraph. The certainty of the word 'sometimes' with aerosols seems not to be scientific consensus, a more accurate word seems to be 'possibly' as far as broad consensus right now. Bakkster Man (talk) 16:22, 5 October 2020 (UTC)
Agree with replacing 'sometimes' with 'possibly'. comrade waddie96 (talk) 17:19, 5 October 2020 (UTC)
  • Comment per Alexbrn above, I see this topic as constantly evolving in the coming months and years and don't see it fit to agree on a set paragraph for now. In addition, there's no active dispute about the contents of the paragraph cited above. I would keep the current "airborne transmission" statement if that's what's in question here as it is supported by good evidence (Transmission of SARS-CoV-2: A Review of Viral, Host, and Environmental Factors, WHO, CDC, ECDC). For now I'd support the above quote until such time that good new evidence disapproves it. comrade waddie96 (talk) 17:19, 5 October 2020 (UTC)

CDC have updated their guidance to use sometimes aerosols [10] and it was never possibly Investigatory (talk) 20:57, 5 October 2020 (UTC)

The CDC’s reliability in taking so long to concur with the ECDC on this specific point calls their reliability as a source for COVID-19 into question. Investigatory (talk) 20:59, 5 October 2020 (UTC)

Also the current consensus list is out of date if this wording achieves consensus. It pretty much did due to virtual silence but if thats the case then the current consensus list above needs to be removed in regard to this. --Investigatory (talk) 08:36, 6 October 2020 (UTC)

Deterioration of this page

I pretty much gave up on monitoring this page due to exhaustion a while back. Checking back in on it, I'm disappointed to see that no one else seems to have picked up the baton. Right in the first paragraph, there's an WP:ANNOUNCED violation for the October 5 statistic and "more reliable indicator" language that's ill-fitting, plus a swap in the infobox gallery from the nice Philippines supplies photo to a bland Central Park one that doesn't display well at small scale and creates a U.S. tilt. And then, looking at the table of contents, there's "Urgent research in the potential vaccine" as a level two heading, with the excerpt moved from the previous vaccine level-3 heading which still exists. Ugh. Looking at the history, some of this seems to be mess created recently by Abbeequiy, but I can't even do a simple undo because of others who have edited in the meantime or done only partial reversions. I'm too tired maintaining this page to do more cleanup. {{u|Sdkb}}talk 09:39, 7 October 2020 (UTC)

The virus disease causing economic crisis, famine, cancellation of events, etc.? No: the disease causes sickness and some death, those other effects come after human political interventions.

At some point, the sentence, stating that:
"The pandemic has caused global social and economic disruption, including . . ."
came to stand in the top of this article. I don't doubt the good intentions of any of the editor(s) contributing to that statement, but I must contend that the mentioned statement is not clearly based on a ref source, and probably not correct.

A pandemic, as we know, is a "(rapid) spread of (a certain) disease" (see the starting line of this article and the wikilinked lemmas Pandemic and Epidemic); this article handles over the spreading of disease COVID-19. But, to my knowing, this virus disease can do only two, purely physical, things to man or mankind: 1. make people ill, or (in severe cases): 2. make people dead. If further 'social and economic disruption' then did occur during or after the pandemic—which is indeed clearly attested in this and other Wikipedia articles—it was the (unintended) effect of human (governmental) actions and decisions: that cause of those disruptions at least is clearly asserted in the ref source given in the article (and in further refs in for example the articles 'Social impact of the COVID-19 pandemic' and 'Economic impact of the COVID-19 pandemic').

The given ref source (IMFBlog, 14 April, 'The Great Lockdown…') speaks of "countries" implementing "quarantines and social distancing practices" (also named a "Great Lockdown") in reaction on the pandemic, leading to "collapse in activity" and a "crisis" with great "impact on people's lives … financial crisis … collapse in commodity prices", etc., etc., all together resulting in "the worst recession since the Great Depression". I think we can keep the summary of those effects as: 'social and economic disruption' (as was already used in the article), but in that IMFBlog ref source those effects are clearly stated as to be effects of actions of countries, thus effects of human reactions on the pandemic. Therefore, I've replaced that unsourced statement with this paraphrased summary of what the IMFBlog says:
"With the purpose to contain the pandemic, many countries have set up quarantines and imposed social distancing practices. These measures however led to socially and economicly disruptive side effects, including …" --Corriebertus (talk) 13:44, 7 October 2020 (UTC)

I think your edits have, in general, been on the right track. The economic and social impacts are primarily the human response, not directly caused by the disease. That said, this is the article about the pandemic rather than the disease alone, so this discussion is certainly appropriate for the article. The one place I think we should be careful without solid citations is that not every impact is necessarily due to political action (ie. government mandates). Some impacts are simply individual reactions en-masse (ie. choosing to postpone large purchases and avoid travel), as well as the direct affects of the virus at a smaller scale (ie. being out of work for two or more weeks, medical debt, etc). Unless there's a solid source distinguishing the root cause, I think we should be cautious before labeling them solely political.
Let me take a look at proofreading and cleaning up your edits. Bakkster Man (talk) 16:09, 7 October 2020 (UTC)
Another user combined the two paragraphs, so preventative response and the side-effects are together, which I like. I refined the sentence to say "Preventative measures have contributed to..." these effects. I feel like this is reasonable language, indicating the effects are not solely caused by COVID or politics and without attempting to determine the proportional significance of any contributing factor (ie. 'most' or 'some'). My reasoning:
  • The UN source on famine indicates that while COVID was likely to contribute, it was not the sole cause of famine this year: "even before the COVID-19 outbreak, 2020 was on track to see the worst humanitarian crisis since the Second World War amid wars in Syria and Yemen, a deepening crisis in South Sudan, locust swarms in Africa, more frequent natural disasters, and economic crisis in Lebanon".
  • Just as the start of the paragraph mentions both recommendations and mandates, this doesn't attempt to separate the two sources and ascribe specific effects to either. The multiple sub articles on the topics (particularly national ones for political impacts, see South Korea for an example where economic growth slowed but didn't recede) seem like the more appropriate places to describe these, rather than the lede.
  • It avoids having to directly address whether the impacts are larger or smaller than the impacts of an unmitigated pandemic, something we're unlikely to know for a significant time.
I'm open to other tweaks. Any opinion on whether changing "preventative measures have contributed..." to "responses to the pandemic have contributed..." would improve this section? Particularly since it would leave things a little bit more broad referring to everything from private to government actions, including the possibility of lack of mitigation contributing to the effects. Bakkster Man (talk) 17:01, 7 October 2020 (UTC)
Thank you for calling attention to this. This is not good... "Preventative measures have contributed to social and economic disruption, including the largest global recession since the Great Depression." I'd suggest "The pandemic and response measures have..." To test the statement, assume that there was no response. Would a pandemic hospitalizing and killing millions of people unabated contribute to all of the above? - Wikmoz (talk) 17:40, 7 October 2020 (UTC)
I like that wording, and made the update. Bakkster Man (talk) 20:12, 7 October 2020 (UTC)

ref errors with {{excerpt}}

Ref multiplication: I noticed the ref "ECDCQA" (entitled "Q & A on COVID-19: Basic facts") was duplicated. It happens because this ref appears in the lead and in the Transmission section (via {{excerpt}}). I was trying to solve this duplication but no success. Does anyone know how to fix this?

Ref mix up: Another error that happens is when different refs are defined with the same name across the calling article and source article (via {{excerpt}}). I fixed this in the case of the Transmission source article by renaming every single ref there that was named ":1" ":2" ":3"... I did not do this renaming here in Pandemic, but, please, refrain from using such naming (if this is not result of an automated process)... in my opinion it's not good practice even if this error did not occur.

Feelthhis (talk) 20:13, 8 October 2020 (UTC)

It is automated - I believe if I remember correctly, it's the visual editor which automatically gives those names when the editor doesn't choose one themselves. It sucks, for exactly this reason. Also, it provides no useful naming to us in the edit window - if I see <ref name=":1" /> I have absolutely no clue whether that's a valid reference for that section... then I have to go find the reference with CTRL-F or stop what I'm doing to look for it... yeah, I agree, but it's not something that's likely to change. The only solution is for people like you to come along and fix individual articles. I'm also not seeing any actual reference errors, when you say duplicated do you just mean it appears in the reference section twice, under two different numbers? If so, there's not much we can do - it's appearing because of the excerpt and using the same name for both the "local" and "except" copies of the reference would result in a multi-defined ref error, but could also result in problems if ever either article is changed. So... yeah, no good solutions here, but hopefully I provided some info on the :1 style ref names. -bɜ:ʳkənhɪmez (User/say hi!) 20:17, 8 October 2020 (UTC)
Yes no actual errors in red, just 'undesirable behavior'. There is another one related to using {{r}} and {{excerpt}} but this is getting out of scope of this Talk. That was real quick answer, thanks. Feelthhis (talk) 20:24, 8 October 2020 (UTC)
Sophivorus is the go-to editor for excerpts, and might be able to help with this. {{u|Sdkb}}talk 06:56, 9 October 2020 (UTC)
The Excerpt template and its modules silently add a prefix to the transcluded reference names to avoid conficts, so if the transcluding article and the transcluded article both have a reference named ":1", that shouldn't cause a conflict (the prefix is the title of the transcluded article, plus an empty space). As to having two references with the same content, I can maybe think of a solution or two, but really they are so ugly and complicated, that I'd rather not. Kind regards, Sophivorus (talk) 11:19, 9 October 2020 (UTC)
@Sdkb and Sophivorus: Thanks. What I saw happening (ref with same name) was that the transcluding article (Pandemic) loaded up his own reference instead of the intended one from the transcluded article (Transmission). After I renamed the ref in the Transmission article the correct ref was invoked (but duplicated in Pandemic). Using {{r}} in the Transmission article was a bit more problematic as it raised a red colour error in Pandemic. PS: if you change your mind, I don't mind the ugliness of the solution :) Feelthhis (talk) 19:51, 9 October 2020 (UTC)

Incosistent chart caption

The chart with caption 'Semi-log plot of weekly deaths due to COVID-19 in the world' links to a picture which states it is per day. Which is correct? Osram (talk) 17:35, 14 October 2020 (UTC)

Osram, I assume you are talking about File:Covid-19 daily deaths in top 5 countries and the world.png. The description reads:

This data is sourced from the European Centre for Disease Prevention and Control where the date is that of publication rather than the end of the day before. This is now the weekly total rather than a 7 day rolling average. The top 5 countries are chosen by the geometric average of new cases and deaths over the preceding month in order to keep this relevant.

Emphasis mine. —Tenryuu 🐲 ( 💬 • 📝 ) 22:27, 14 October 2020 (UTC)

Concept of a 'Second Wave'

The term Second Wave is used frequently in media about the virus and tends to focus on regionally specific waves (or ebbs and flows) of viral spread. I left a message on the talk page for the disambiguation for Second Wave hoping to encourage discussion. The only mention in terms of virology relates to deadly second wave of the Spanish Flu. I am simply wondering if said concept relating to COVID-19 should be mentioned on the disambiguation and/or the larger article. I understand that the virus is still relatively new, and second waves are popping up randomly around the world, if at all, while some countries are still firmly in their first wave.

I am a frequent editor for COVID-19 pandemic in Canada, COVID-19 pandemic in Ontario and COVID-19 pandemic in Toronto. I have seen frequent mention of the concept amongst Canadian media (as well as American media) and the Prime Minister of Canada Justin Trudeau announced Canada was already in a "Second Wave" [11]. In any case, I wonder how I use the terminology when there seems to be a loose definition of what a "Second Wave" is in the first place.

CaffeinAddict (talk) 21:59, 29 September 2020 (UTC)

Anyone know if "second wave" is a common term used in epidemiology? —Tenryuu 🐲 ( 💬 • 📝 ) 22:28, 29 September 2020 (UTC)
Yes, here's CEBM discussing the topic including a study in The Lancet on modeling a second wave in COVID. There seems to be no strict definition of what makes a wave a wave, but the term seems to come from the late 19th century. Bakkster Man (talk) 13:57, 30 September 2020 (UTC)
Interesting background, but in real life it's one of those too commodious terms which gets batted around in the media until we're thoroughly sick of it. I would use it with caution, or at least caveats. kencf0618 (talk) 21:38, 1 October 2020 (UTC)
Yes - it has become a buzzword to the media like "quarantine"... where most of the western world isn't actually in a strict quarantine... CaffeinAddict (talk) 03:24, 2 October 2020 (UTC)
While I think people would understand what a "second wave" is, the looseness of its definition makes it hard to have its own article. A definition exists over at wikt:wave, under the "Noun" subheading of "Etymology 2", though. —Tenryuu 🐲 ( 💬 • 📝 ) 21:57, 3 October 2020 (UTC)

I would like to make a suggestion that a "second wave" section or even separate article be created. It is now a given for many countries, including all of Europe and at least Canada, where authorities have acknowledged it. I believe a new article would be the better approach in terms of not further bloating the current page, for proper organization, cleaner history and in preparation of it eventually turning into a very big article like we have now, which is going to be pain to extract into its own page later on. 2804:431:C7CF:6C43:2945:2B18:1C29:8F26 (talk) 19:22, 5 October 2020 (UTC)

The idea has merit. I'm thinking of potential problems for doing so:
  • Creating its own section on this article: it could potentially set a precedent for any hypothetical subsequent waves to be included in their own sections, contributing to bloat.
  • Creating its own page: it would only be for nations that have reported it as a "second wave". Might be a case of "too early"? This page might have to be renamed "First wave of the COVID-19 pandemic" or another page would have to be created with that title, with content from here getting shunted over.
An idea I have would be to mention when nations have declared that they are in a second wave of the pandemic in the "COVID-19 pandemic in <month> <year>" articles and in the affected countries' articles. It would be less attention grabbing, but it would also escape the problem of bloating any one particular page or doing any renaming. —Tenryuu 🐲 ( 💬 • 📝 ) 03:43, 6 October 2020 (UTC)
For the new article approach, I think the simplest way would be to change the "History" section of this page from 2019/2020 to First Wave/Second Wave and then for the Second Wave sub-section provide a brief overview and use Template:Main to redirect to the actual new page. The First Wave sub-section could then remain as-is or extracted to its own article as well, if necessary, later. I would suggest against renaming the article but instead adding a Wikipedia:Redirect link that redirects from "First wave of the COVID-19 pandemic" to the proper heading inside this page. As for, "too early", I believe a Second Wave article more than promptly satisfies Wikipedia:Notability guidelines. 2804:431:C7CF:6C43:AFA8:187D:B439:D706 (talk) 17:36, 6 October 2020 (UTC)
I think it's reasonable to compare to the Spanish flu#Timeline section for precedent. I think it's clear that a second wave section could make sense, but I think there's a reasonable argument not to try to include one until later in the pandemic, when there's a general consensus about the overall timeline (the 1918 flu timeline given spans 24 months, we're not even halfway through that for COVID-19). I'd lean towards right now any second waves as they come should go in the national/regional articles, since the pandemic has been so diffuse around the world with no defined single peak across multiple nations. Bakkster Man (talk) 19:23, 6 October 2020 (UTC)
How is there no consensus on a worldwide Second Wave? Can you provide at least one source that actively argues against or denies that a second wave is currently happening? If we were going by "let's wait until we understand it better" mentality, none of this article would have been written yet. "Perfect understanding" is not an actual requirement in any of the Wikipedia guidelines I'm familiar with nor should it be. 2804:431:C7CF:6C43:8C44:56A8:218D:D99A (talk) 21:11, 6 October 2020 (UTC)
If an article for "Second wave" in epidemiology is to be created, the primary focus should be the concept of a second wave in general, with some instances of this pandemic as examples (Europe has some very distinct second waves as of the last month). Another example could be the 1917 pandemic, which I believe also had a very distinct second infection wave. BlackholeWA (talk) 08:23, 7 October 2020 (UTC)
Second wave (epidemiology) does feel like an article that should exist regardless on consensus as to the global progression of this pandemic, especially if it's an established term in expert sources as suggested above. BlackholeWA (talk) 08:28, 7 October 2020 (UTC)
This seems like a good plan of action and would help to put into context the Spanish Flu, the Black Death, COVID-19 and Cholera outbreaks and pandemics in general. I've found some other interesting sources on the topic here: [12] [13] [14] CaffeinAddict (talk) 04:14, 9 October 2020 (UTC)
A "second wave" section may be welcome on the Epidemic and/or Pandemic articles - I would suggest this is not the place to discuss it though, rather those articles' particular talk pages. A Second Wave sub-section or new article for the COVID-19 pandemic is necessary to represent its historical progression. — Preceding unsigned comment added by 2804:431:C7CF:6C43:B6F9:F604:9D0A:725E (talk) 20:10, 7 October 2020 (UTC)
The context of bringing the whole thing up was in relation to COVID-19. So I think this is an appropriate place to discuss it. It doesn't come up very often. It's not like we were writing wikipedia articles about the 1918 flu pandemic back in... 1918. CaffeinAddict (talk) 04:52, 10 October 2020 (UTC)
I respectfully disagree, for the same reasons stated prior, which were not disqualified nor disputed thus far. 2804:431:C7CF:3683:D8B2:2BAB:EF9D:82D8 (talk) 23:39, 14 October 2020 (UTC)

Background, history, China

"Background:"

  • On 31/12/2019, the WHO received reports of a cluster of pneumonia in WUH. Investigation just launched on Jan 2020.
  • WHO called it a PHEIC.
  • Probably from the Huanan market.
  • Caused by coronavirus.
  • Unknown patient zero, however SCMP suggested an old woman.
  • WHO called it a pandemic.

"History:"

  • Unknown patient zero, however some made theories.
  • Probably from the Huanan market.
  • Initially identified as cluster of pneumonia.
  • Started in WUH.
  • WHO called it PHEIC, then a pandemic.

"China:"

  • Initially identified as cluster of pneumonia in Dec 2019, from WUH.
  • Unknown patient zero, however some made theories.
  • Probably from the Huanan market.
  • Caused by coronavirus.

These are repeated information in one single article. I am confused as to the Background and History section, both seem so relevant. Perhaps the "History" section could talk about a different kind of history, not the epidemiology. And what about "China"? I'm confused here, that's why I took to this talk. Anyone? GeraldWL 13:11, 15 October 2020 (UTC)

I think an article about the early history would be highly interesting. Definitely 2019, and maybe including January 2020. A place for whatever is known about cases during that time period. Adoring nanny (talk) 02:38, 16 October 2020 (UTC)
Adoring nanny, Timeline of the COVID-19 pandemic, that is. Perhaps the "History" section can be merged with "Epidemiology." And perhaps the China section can just feature infos haven't mentioned. Thoughts? GeraldWL 16:47, 16 October 2020 (UTC)

Pictures

I don't know how to describe. The pictures in the infobox are just too much, is how I can put it. Sdkb, opinions? GeraldWL 13:31, 17 October 2020 (UTC)

Gerald Waldo Luis, 90% of maintaining the photos for this page seems to be removing the constant attempts to add a gazillion boring photos of people queuing and empty shelves (probably since those photos are super plentiful); I just removed the latest attempt, restoring the status quo infobox gallery.
I'm pretty satisfied with those five photos: they're from diverse locations (U.S., Taiwan, Philippines, Iran, and Italy), are all visually compelling, and each represent a different aspect of the pandemic. Going clockwise from top, they cover the medical aspect, the changes in everyday life, the logistical/economic aspect, the human tragedy, and the political aspect, respectively. {{u|Sdkb}}talk 18:23, 17 October 2020 (UTC)
Sdkb, thanks for the status quo revert. I also see no problem in the photos representing the pandemic. I'm sure it might have to change as the pandemic progresses to refurbish this article itself to not be outdated, so might as well prepare for that. GeraldWL 03:02, 18 October 2020 (UTC)

Link to wiki page discussing increase in domestic violence

There is a wiki article discussing how the pandemic has led to an increase in domestic violence worldwide. It links to this page. Can we link to it from this page? Segoldberg (talk) 12:36, 19 October 2020 (UTC)

Segoldberg, there are a lot of these "Impact of COVID-19 on blablabla" pages. It is all covered in the "Impact of COVID-19 pandemic" article, so we don't need to link more shit, excerpt more shit, see-also more shit. It's all there :) GeraldWL 15:22, 19 October 2020 (UTC)
Gerald Waldo Luis Indeed, I did not realize there were so many of these pages. Out of curiosity, is there a tool that measures the amount of wiki content related to different topics? Perhaps we should start an article titled "Impact of COVID-19 on amount and distribution of wikipedia content" :) Segoldberg (talk) 18:39, 19 October 2020 (UTC)
Segoldberg, well there is a page titled Wikipedia's response to the COVID-19 pandemic. GeraldWL 01:03, 20 October 2020 (UTC)

CFR, IFR in lead

Gerald Waldo Luis removed a para on case fatality ratio and infection fatality ratio with the comment frankly a vague paragraph for a lead, not a good addition. consider moving relevant info to the cases subsection.. The text is anything but 'vague'; in fact it is more specific than any other pandemic page. The IFR is the salient statistic during an epidemic, particularly when so many of the infected have mild or no symptoms. No other pandemic page even provides the CFR. Humanengr (talk) 20:05, 19 October 2020 (UTC)

Humanengr, I never said the fact itself is vague. I said they are not worth a mention in the lead, because it is randomly just there without clarification of what it is, and it only interests a particular audience, also for the fact that it is in the lead. The lead just gives some basic summary, not an entire info about CFR. You don't need every info in the article to be in the lead. There's no need for it to be there. The sentences would feel home at their respective section, not in a lead. GeraldWL 01:01, 20 October 2020 (UTC)
Gerald Waldo Luis, It is not randomly there. Most if not all of the pandemic pages have death statistics in the lead §, sometimes in the lede para. The particular audience it interests is everybody — on a personal level because they want to know their risk of dying if infected; and on a global level as that statistic plays a major role in policy making. During a live epidemic where a large fraction of infected show no or only mild symptoms, it's now acknowledged that the IFR is the key metric of interest. Early on in this epidemic the focus was on CFR; the CDC only adopted IFR as a measure in July. All that is lead-worthy. Re 'clarification', it's currently in temporal order; I'll put some thought into alternative ordering to see if that further clarifies. Humanengr (talk) 03:51, 20 October 2020 (UTC)
Humanengr, I agree with Gerald Waldo Luis's reversion of your addition to the lead. We have a ton of information to get through in the lead, and spending an entire paragraph on the case fatality ratio is wildly WP:UNDUE. For the article on the disease, a sentence or so on the fatality rate is probably appropriate in the lead, but for the pandemic page here, what we want is the infection/death numbers, and we already have those in the first paragraph. {{u|Sdkb}}talk 07:38, 20 October 2020 (UTC)
@Gerald Waldo Luis and Sdkb: Would it work for you if, instead of that para, we append to the last sentence of the lede (see italics): As of 10 March 2023, more than 676 million cases have been confirmed, with more than 6.88 million deaths attributed to COVID-19.[1] and a "best estimate … that about 10% of the global population may have been infected by this virus".[2] That is, ~0.15% of those infected have died, with risk of fatality strongly dependent on age (0.03–0.04% for <70 years).[3]
Humanengr (talk) 08:25, 20 October 2020 (UTC)
Humanengr, see above for discussion on the 10% estimate, which I could see making its way into the lead for this page. I don't see the same for the second sentence; you could bring it up at Talk:Coronavirus disease 2019, though. {{u|Sdkb}}talk 08:37, 20 October 2020 (UTC)
Humanengr, I would support doing that, although I would trim it down a bit to make it less technical. GeraldWL 09:05, 20 October 2020 (UTC)
How about we go with appending the one sentence as I suggested; and move the remainder to a footnote which would read These estimates of correspond to an infection fatality ratio (the percentage of infected people who die) of ~0.15%, with a strong dependence on age (0.03–0.04% for <70 years).[4] Humanengr (talk) 09:23, 20 October 2020 (UTC)
I don't think the European Journal of Clinical Investigation source meets WP:MEDRS. Per the WHO (a WP:MEDRS compliant secondary source which indicates consensus) citing three studies to state "estimates of IFR converging at approximately 0.5 - 1%". Otherwise I agree on the general structure for this information in the lede being roughly two sentences rather than a full paragraph: confirmed cases and deaths, estimated infections, estimated IFR (0.5-1.0% unless someone has a yet better source than the WHO). Bakkster Man (talk) 15:34, 20 October 2020 (UTC)
Humanengr, I would rather have it described briefly, combined with the As Of sentence. The age thingy... I don't think it would blend well with the sentence. Would support the WHO estimate by saying "[insert number]; true numbers are likely higher." GeraldWL 09:28, 21 October 2020 (UTC)

After further consideration, I’m now thinking we should wait until WHO or some other MEDRS writes up something formal before adding this to the lead. Humanengr (talk) 12:25, 21 October 2020 (UTC)

I think it's worth considering what it'll take to put these numbers in this article. Especially since it appears they'll vary a lot depending on how early in the pandemic, where in the world they happened, and, ethnicity, and possibly more. At what point does the number get so broad that it's not worth including (at least in the lede)? For comparison, the 2009 swine flu pandemic article does not put IFR in the lede, but in three places later in the article. Seems like a good strategy here: final determination of IFR, early estimates which affected later decisions, and a comparison table to other pandemics (which might make sense in the long run to split into its own article). Bakkster Man (talk) 22:15, 22 October 2020 (UTC)

References

  1. ^ "COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU)". ArcGIS. Johns Hopkins University. Retrieved 10 March 2023.
  2. ^ Keaten, Jamey (2020-10-05). "WHO: 10% of world's people may have been infected with virus". AP NEWS. Retrieved 2020-10-20.{{cite web}}: CS1 maint: url-status (link)
  3. ^ Ioannidis, John P. A. (October 7, 2020). "Global perspective of COVID-19 epidemiology for a full-cycle pandemic". European Journal of Clinical Investigation: e13421. doi:10.1111/eci.13423. ISSN 1365-2362. PMID 33026101. S2CID 222183928.
  4. ^ Ioannidis, John P. A. (October 7, 2020). "Global perspective of COVID-19 epidemiology for a full-cycle pandemic". European Journal of Clinical Investigation: e13421. doi:10.1111/eci.13423. ISSN 1365-2362. PMID 33026101. S2CID 222183928.

Last sentence of the lead

Resolved
 – -sche Sdkb made the change. —Tenryuu 🐲 ( 💬 • 📝 ) (amended 06:06, 23 October 2020 (UTC)

The last sentence of the lead reads

There have also been many related misinformation, as well as incidents of xenophobia and racism against Chinese people and against those perceived as being Chinese or as being from areas with high infection rates.

The first clause of this is grammatically confusing and I think it is incorrect, though I don't know whether this falls into British English differences with plurals. Can someone clarify? Ovinus (talk) 01:24, 22 October 2020 (UTC)

Ovinus Real, it's a weird construction: it's uncountable, but referred to in the singular. An easy way to resolve this is:
There have also been many pieces of related misinformation [...]
Emphasis added for inserted suggestion. —Tenryuu 🐲 ( 💬 • 📝 ) 01:45, 22 October 2020 (UTC)
Indeed! Or even simpler, There has also been much related misinformation. Not a big fan of "as well as", but since that is part of the consensus I won't argue about it. Ovinus (talk) 01:59, 22 October 2020 (UTC)
I changed it to "has also been much". Thanks for catching the grammatical error. -sche (talk) 04:24, 22 October 2020 (UTC)
@Ovinus Real, Tenryuu, and -sche: we're suffering from short memory here; the changes that introduced the bad grammar were introduced less than 24hr ago; we don't need to rewrite so much as revert to the better version that was present before.
That version was Misinformation about the virus has circulated globally., which I like better than what was developed here, since it doesn't use passive voice. The version that was present farther back, Misinformation about the virus has circulated through social media and mass media., I like even better, since it offers a better characterization of how misinformation is operating. I'm going to revert to something similar to that, but changing about the virus to about the pandemic, per the point Gerald Waldo Luis made.
Something that's been going back and forth is whether the misinformation clause should be a separate sentence from the xenophobia clause or not. I think it could go either way, since the xenophobia is a fairly closely related concept.Any thoughts on that? {{u|Sdkb}}talk 07:47, 22 October 2020 (UTC)
Yeah that's definitely better Sdkb, thanks! I got confused because the invisible comment indicated the sentence had consensus. Also, I think keeping them in one sentence makes sense because they are similar phenomena with similar causes. Ovinus (talk) 08:04, 22 October 2020 (UTC)
Sdkb, that's what I get for not digging into the article's history. :P
Normally, I'd say "yes" to merging the misinformation and xenophobia clauses together, but there's also other misinformation (conspiracy theories and "cures", for example) that also deserve to be mentioned. To give them more equal prevalence, I'd say mention them all together. —Tenryuu 🐲 ( 💬 • 📝 ) 15:40, 22 October 2020 (UTC)

Semi-protected edit request on 25 October 2020

https://en.wikipedia.org/wiki/COVID-19_pandemic#Education (edit out the dot in: "School closures impact not only students, teachers, and families. but have far-reaching economic and societal consequences." A11oy man (talk) 14:50, 25 October 2020 (UTC)

 Done - removed the inadvertent period :) -bɜ:ʳkənhɪmez (User/say hi!) 14:54, 25 October 2020 (UTC)

Confirmed vs. suspected deaths

A discrepancy has emerged between this article and Coronavirus disease 2019: here, the last part of the intro reads As of 16 October 2020, more than 39.1 million cases have been confirmed, with more than 1.1 million deaths attributed to COVID-19. There, it reads As of 16 October 2020, 39.1 million cases have been reported across 189 countries and territories, but the WHO estimates that around 800 million people in total may have been infected.[10] The disease has killed 1.1 million people; more than 26.9 million have recovered. The discrepancy between confirmed and suspected cases is pretty shocking, but the estimates are sourced to [15], which looks solid to me. I'd like to hear from editors with medical expertise: is the 800 million number a carefully determined estimate that we should include at the top here, too, or is it just the WHO throwing out a figure without much basis? {{u|Sdkb}}talk 20:32, 16 October 2020 (UTC)

Sdkb, not someone with medical expertise, however just wanna comment. Wikmoz once said that the recovery and active case numbers in the "Cases in the COVID-19 pandemic" template are "disgustingly inaccurate"-- something like that. So I'm not sure that the COVID-19 article should include it, if that's the case.
Cannot really comment on suspected cases though. But in my view, there's no way WHO can estimate 800M other than using logic, i.e. demographics, time, transportation (mostly aviation), etc. WHO able to estimate 800M is just shocking for me. I don't claim to be correct here, just throwing an opinion. GeraldWL 04:58, 17 October 2020 (UTC)
In any outbreak, including annual influenza, we never know the actual number. A few billion people around the round don't have reliable water, electricity, food. Reporting illness to their local health departments, even if they had the capacity to accurately diagnose a specific illness, is likely one of the last things on their minds. Nothing surprising or unusual to me when put in perspective with the flu. Here is better detail from the original source of the news report, Dr Ryan of the WHO addressing an executive session. "Ryan did not elaborate on the estimate. Dr. Margaret Harris, a WHO spokeswoman, said it was based on an average of antibody studies conducted around the world." MartinezMD (talk) 16:52, 17 October 2020 (UTC)
I understand that the real numbers are higher, since current numbers as we know it are just those reported. However to note the claim of 800M-- I don't think it is of an encyclopedia's interest. Just saying "although the real numbers could be higher" would suffice in my humble opinion. As quoted, Ryan did not elaborate further on it. I also don't see how "Average of antibody studies conducted around the world" would hint a light of truth on that claim. Anyone can just make a number estimate by doing average of antibody studies conducted around the world. GeraldWL 17:08, 17 October 2020 (UTC)
Reliable source, reliable statement, specifies that it's an estimate, meets WP policy. I don't see the problem. You don't like it. That's this issue in a nutshell. No offense is intended. MartinezMD (talk) 17:26, 17 October 2020 (UTC)
It could be emphasised that it is just an estimate, I'm perfectly okay with that. Also, this mentions WHO's estimate of "10% world infected with COVID-19," also estimated by Ryan. GeraldWL 17:35, 17 October 2020 (UTC)
I think it would be fair to emphasize the actual uncertainty in the estimate, that it was "about 10% of the global population" and 800 million is rounded up to the nearest hundred million from that already possibly rounded up estimate. I'd propose better wording would be "but the WHO estimates that about 10% of the world's population (760 million people) may have been infected". Bakkster Man (talk) 13:19, 19 October 2020 (UTC)
I called the recovery and active case numbers grossly (extremely) inaccurate because recoveries are undercounted. The 800M estimate is unrelated. I'm not familiar with it but it could certainly be modeleled based on available country-level deaths and serology data. 10% of the world population is not 800M, it's closer to 780M. I'd be interested to see how the 10% estimate was calculated because it does sound very high. - Wikmoz (talk) 18:45, 17 October 2020 (UTC)
780 is 97.5% of 800. lets stick to the main topic. MartinezMD (talk) 19:13, 17 October 2020 (UTC)
Same team. The accuracy of the number is the topic. I'd suggest keeping the WHO's estimate in a relevant section and NOT in the intro. Would also change the source to one that pins the number at 760M. I'm sure the WHO has a more robust calculation but one could roughly ballpark it from the 1.1 million confirmed deaths. If you assume 50% of deaths have gone uncounted then it's really 2.2 million. Apply the WHO's previously-mentioned IFR estimate of .65%, you get to 340 million infected people. - Wikmoz (talk) 04:25, 18 October 2020 (UTC)
A few things to bear in mind here: we can't use this as anything more than a reasonableness check (WP:OR), the WHO IFR estimate ranges from 0.5-1.0%, and the result we get would be the number of concluded infections (recovered or dead) not all infections ever. That gets us somewhere between 220 and 440 million infections where the conclusion is known, assuming an undercount on deaths of 2x and a consistent IFR worldwide and across ages. I think there's plenty of wiggle room to say that it's not worth second-guessing the WHO's serology estimate. Bakkster Man (talk) 13:19, 19 October 2020 (UTC)
Oh, yes. 100%. That's all it was meant to be. - Wikmoz (talk) 03:40, 20 October 2020 (UTC)
Also note that the WHO 0.5–1.0% figure only referenced estimates from 3 cities in Europe; and it was published two months prior to the 'about 10%' infected number. Humanengr (talk) 09:02, 20 October 2020 (UTC)

@Sdbk: These are not ‘suspected cases’. As you wrote in your initial post, the WHO was talking about ‘infections’. Should be changed throughout. Humanengr (talk) 06:38, 23 October 2020 (UTC)

@Bakkster Man and Wikmoz: Can someone with permissions to do this please add this field to the template. Thx, Humanengr (talk) 22:01, 24 October 2020 (UTC)

Infoxbox box ‘suspected cases’

As this is not tracked for COVID–19, I propose modifying the text to

As COVID-19 has many mild and non-symptomatic infections that are not classified as ‘cases’, the WHO estimated in October 2020 that ‘% infected’ was around 10% of the global population (c. 770 million).[1]

Humanengr (talk) 03:00, 25 October 2020 (UTC)

Seemed to be too many qualifiers so I shortened it. There is the attached citation for people to read more if they want additional information about it. MartinezMD (talk) 17:52, 25 October 2020 (UTC)
Strange that the infobox says 'suspected cases' rather than infections, which as best I can tell is the standard epidemiological term, but whatever. I further shortened the wording. The suspected cases is "approximately 10% of global population", no need to explain who estimated it in an infobox (that's what the citation is for). Bakkster Man (talk) 18:58, 26 October 2020 (UTC)

Specific death rates by age

Kudos to all who have worked on making this an impressive resource article. I am particularly interested in one aspect of this pandemic — the death rate by age. It is well-known that the rate is markedly different for older versus younger people, but I don't see this shown graphically. My apologies if it exist and I just haven't found it.

I note that the Spanish flu article had such a graphic:

That graphic was attempting to point out how the Spanish flu differed from typical flu, but I think that graph would be a good vehicle for showing the Covid curve. My impression is that Covid, Spanish flu and regular flu all have high death rates for people over 65, with Covid being even higher than the strains of flu, but I believe the rates for the very young is significantly lower for Covid then for flu. I think it would be worth showing such a graph. --S Philbrick(Talk) 17:37, 26 October 2020 (UTC)

That info is currently at Coronavirus disease 2019 under the Prognosis section. Because of the large size of this article, there's generally been an attempt to keep it focused on the pandemic aspect--topics specifically about how it has spread around the world. The CFR is briefly discussed here but the article on the disease has more specific data and charts. 76.81.196.244 (talk) 18:25, 26 October 2020 (UTC)
I see some bar charts for four countries, and a hidden table with more countries (curiously the US is by state and doesn't have the entire country) well that's a step in the right direction it doesn't Clearly answer the question of how COVIT compares to flu or Spanish flu.
Someone reported recently that for some age groups, death rates for flu exceed death rates for Covid. I'm interested in knowing at what age the graphs crossover. I'd also be interested in knowing whether actions taken to reduce Covid have also reduced flu. It sounds logical but I'm interested in seeing the graph not simply an assertion. I know there's lots to cover but the death rates by age for China are from February. That's hardly recent data. We don't expect we have even September data but I would think we would have some data through August by now. S Philbrick(Talk) 19:28, 26 October 2020 (UTC)
Most of the questions you're asking are moving fast enough that CDC aren't really putting rates per 100,000 population (different from CFR/IFR) like in your graph, which may not be directly applicable (since the 1918 flu season is over, and the COVID pandemic is not; before asking what the rates per 100,000 are for modern flu seasons). But the CDC do publish enough data to calculate it and comparable data from recent flu seasons. Generally, flu deaths increase again among children, but have not done so for COVID. The mortality rates for 1918 and earlier flu are higher across the board than COVID to date, while COVID is higher than recent flu seasons for all but children (specific crossover age depends on the year). The last two flu seasons, mortality among 50-64 year olds was similar to COVID mortality among 35-44 year olds.
Per the IP comment above, this data should go into the Coronavirus disease 2019 article or COVID-19 pandemic in the United States, not this one. Bakkster Man (talk) 20:34, 26 October 2020 (UTC)

National Responses ( Africa )

Requesting for 3 or 4 African countries' responses to the pandemic to be added to the National responses section. They could include; COVID-19 pandemic in Ghana , COVID-19 pandemic in South Africa,COVID-19 pandemic in Ethiopia , and COVID-19 pandemic in Nigeria. They could later include others like Egypt, Rwanda, etc. But for now, there isn't even a single African country on the list.

Also, alphabetically the country list at the national responses section is wrong. If the list is arranged alphabetically then why is Africa all the way at " O " with Oceania. It should start with " A" Asia. Kwesi Yema (talk) 18:04, 25 October 2020 (UTC)

Kwesi Yema, sorry but we can't include all countries. There's not much significance in either countries that would be deemed noteworthy in this article. And it is not alphabetical, it's Asia--Europe-Americas-Africa-Oceania. GeraldWL 09:39, 26 October 2020 (UTC)

Gerald Waldo Luis No problem at all for I do not even want all African countries included as there isn't much space for it. However, there were significant responses from COVID-19 pandemic in South Africa and COVID-19 pandemic in Ghana that are worthy of getting penned in the article. Please do consider because they have enough that can be summarized in the responses section just like summaries of COVID-19 pandemic in British, US and Iran. Kwesi Yema (talk) 12:52, 26 October 2020 (UTC)

I think the time for Sdkb's cleanup to-do issue may be approaching soon. —Tenryuu 🐲 ( 💬 • 📝 ) 21:19, 26 October 2020 (UTC)

Changed "racism" to "discrimination" against Chinese people

Never knew Chinese were a race

SweetMilkTea13 (talk) 18:30, 23 October 2020 (UTC)

This seems reasonable. {{u|Sdkb}}talk 21:09, 24 October 2020 (UTC)
@Sdkb: If that wasn't meant flippantly, we are dealing with a high schooler here, as can be seen by the blatant WP:IDONTLIKEIT-style "justification". CaradhrasAiguo (leave language) 22:04, 24 October 2020 (UTC)
I care about the edit, not the editor. Race/ethnicity/etc. are incredibly complex, but I think it's reasonable to say that the race would be East Asian, and "Chinese" is something else. "Discrimination" works just as well as "racism" and allows us to avoid the question, so I'm fine with it.
Yes, the edit was technically against the current consensus list and should have been discussed first, but WP:DRNC. {{u|Sdkb}}talk 23:00, 24 October 2020 (UTC)
CaradhrasAiguo, "we are dealing with a high schooler"? What is the relevance? I think the edit does make sense-- Chinese is not a race, but a culture. If you're talking about race, then it's "Asian." Frankly I can't see any connection between that good-faith and good edit with WP:IDONTLIKEIT. GeraldWL 05:53, 25 October 2020 (UTC)
Numerous racist incidents have been targeted at non-Chinese East Asians because of their supposed Chinese appearance: the OP is trying to deny or whitewash the outright racism of the offenders there. CaradhrasAiguo (leave language) 06:25, 25 October 2020 (UTC)
Then change it to "East Asian." Simple. (Although it's not just East-Asians). GeraldWL 06:34, 25 October 2020 (UTC)
Despite the OP's incredulity, it's hardly uncommon that Chinese people (generally meaning Han Chinese or something similar although sometimes including other people from China especially if they "look similar") are considered a race. Indeed Anti-Chinese sentiment discusses racism or other racial issues, and there are other articles which are similar. E.g. May 1998 riots of Indonesia mentions a "racial nature" and Indonesian mass killings of 1965–66 mentions racism 3 times and 13 May incident mentions race (or derived words e.g. racism, racial) many times. Meanwhile Chinese Canadians similar has a number of mentions of race or derived words as does Chinese Exclusion Act. Then there's Plessy v. Ferguson which mentions John Marshall Harlan infamous "a race so different from our own that we do not permit those belonging to it to become citizens of the United States. Persons belonging to it are, with few exceptions, absolutely excluded from our country. I allude to the Chinese race." Of course plenty of people reject the concept of a Chinese race as well. Meanwhile, the idea that Asian is a "race" effectively lumping various South Asians, Arabs, Han Chinese, Andamanese, Batek people, etc together is something rejected in a lot of places. I think it's entirely reasonable to mention racism and xenophobia. I make no comment of racism and xenophobia against who. Nil Einne (talk) 12:31, 26 October 2020 (UTC)
I think the big question is less whether or not it can be considered racism specifically, and more whether "xenophobia and discrimination" covers it sufficiently. On one hand, do we need anything more than 'discrimination against Chinese people and those perceived as...'? Particularly in a lede, that's broad enough to cover racism, xenophobia, and multiple other categorizations of incident motivations. On the other hand, I think it's likely at least some of the incidents were attributed to race (can we cite this?) and if so there's no reason the sentence can't say 'xenophobia, racism, and discrimination'. Bakkster Man (talk) 14:52, 26 October 2020 (UTC)
There are many incidents of xenophobia, not just Sinophobia. So it can't be covered a lot in the lead. Furthermore, we want the lead to be short. (But the stupid consensus...) GeraldWL 15:01, 26 October 2020 (UTC)
Note-- the Indonesian articles mentioned "racism" because it is assumed in Indonesia that if you're white, you're surely Chinese. I'm not aware that the many Sinophobias due to the COVID-19 pandemic were of similar story. GeraldWL 13:11, 26 October 2020 (UTC)
[I]t is assumed in Indonesia that if you're white, you're surely Chinese. Am I reading this wrong? —Tenryuu 🐲 ( 💬 • 📝 ) 13:03, 27 October 2020 (UTC)
Tenryuu, you ain't reading nothing wrong. In Indonesia, brown's like white in America; black and white's like blacks in America. I think this is because white skins (not Caucasian) are associated with Buddism, and Buddism is associated with China. GeraldWL 13:50, 27 October 2020 (UTC)
Gerald Waldo Luis, ah, you're referring to lighter skin tones. —Tenryuu 🐲 ( 💬 • 📝 ) 13:54, 27 October 2020 (UTC)

@CaradhrasAiguo: You seem ageist. SweetMilkTea13 (talk) 19:46, 25 October 2020 (UTC)