Coronavirus: Largest study suggests elderly and sick are most at risk
bbc.com
bbc.com
What is more important to realize about the virus is that (1) a death rate of 2% (20 times that of flu) would still be considerable given its relatively high infectivity rate and long incubation period, and that (2) the fact that 20% of the cases require hospitalization would put a significant strain on even the best healthcare systems should it become widespread.
Separately, any data-based inferences are only as good as the underlying data, and there have been some doubts as to the completeness and veracity of data available. Even the WHO chief has effectively spoken to that effect.
The death rate in China is very likely exaggerated, because (as you say) the hospitals are overwhelmed with panicked locals (which tends to happen when you turn a city the size of New York into a police state!) leading to systematic under-reporting of minor cases. Anthony Faucci of NIAID was quoted in the Washington Post a day or two ago, saying that the death rate will likely drop to/below 1%:
” experts have said the coronavirus fatality rate is likely to decline substantially as they compile a more accurate count of the people who contract the virus and survive. At the Aspen Institute presentation, Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, said he hoped the rate could decline toward 1 percent.”
Also from that article:
“The fact that there are so many mild cases is a real hallmark of this disease and makes it so different from SARS,” said Jennifer Nuzzo, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health’s Center for Health Security. “It’s also really challenging. Most of our surveillance is oriented around finding people who require medical intervention.”
” For those who study viruses, the large number of mild cases is reason for optimism. “This looks to be a bad, heightened cold — I think that’s a rational way of thinking about it,” said Matthew Frieman, a virologist at the University of Maryland School of Medicine. “Not to diminish its importance — it’s in the middle between SARS and the common cold.”
” Many experts have said early phases of outbreaks like this one tend to have a large number of severe cases, as the sickest people flock to hospitals and come to doctors’ attention. And in Wuhan, where the health-care system is overwhelmed, people have complained they cannot find a hospital to test them for the virus, let alone to treat their symptoms. So patients with milder versions may be at home, uncounted, waiting out the epidemic.”
https://www.washingtonpost.com/health/most-coronavirus-cases...
Again and again, experts keep saying the same thing: the danger of this virus is being exaggerated. But folks like you continue to spread these exaggerated numbers, leading to panic and overreaction:
” Health experts question the timeliness and accuracy of China’s official data, saying the testing system captured only a fraction of the cases in China’s hospitals, particularly those that are poorly run.
Neil Ferguson, a professor of epidemiology at Imperial College London, said only the most severe infections were being diagnosed and as few as 10 per cent of cases were being properly detected, in a video released by the university.”
https://www.google.com/amp/s/amp.ft.com/content/bb73bd9c-4d9...
Wuhan is particularly intertesting in that 50% of males smoke. Additionally, the air is terribly polluted. We know from ordinary flu, both of those factors increase mortality significantly. More interestingly, it looks like smoking may increase ACE2 expression and make people more succeptable to the virus.
So there could be environmental factors endogenous to the region that may not hold globally that drive both infection rates and disease severity.
Since deaths are trailing the onset of symptoms by as much as 20 days, what we are seeing now are the outcomes of people who became sick in the end of January.
Even a death rate of "just" 1% (as you quoted) is still 10-20 times that of a particularly bad flu (0.1-0.2%), so by no means the two are equivalent.
Situation will become clearer as more data is available in the next couple of weeks but that is no reason to ignore what we know thus far. It's not about panic or overreaction but making an informed choice, for example for those of us who have scheduled travel to the region, and need to decide whether or not to postpone it.
These comments from Marc Lipsitch (Harvard epidemiologist) are quite informative: https://threadreaderapp.com/thread/1228373884027592704.html
Stop fear-mongering.
Statistical modeling of the case fatality rate using only cases and deaths reported from outside China was done by Christian L. Althaus (Institute of Social and Preventive Medicine, University of Bern), this estimates the CFR for COVID-19 at 2.1% although with a high uncertainty (95% confidence interval: 0.5%-5.4%). Data and R code for his modeling are available on Github: https://github.com/calthaus/ncov-cfr
A comment from Adam Kucharski (Associate Professor, London School of Hygiene & Tropical Medicine) on Twitter: https://twitter.com/AdamJKucharski/status/122970801348691148...
"... The upshot: the widely quoted 2% fatality for China is calculated incorrectly, because it's based on data that is under-reported and doesn't account for delays. But, confusingly, these errors may actually cancel out, leading to an estimate that is right for the wrong reasons ..."
The 1918 flu disproportionately killed healthy young adults. Why? Their immune systems reacted more strongly to the flu. But the immune reaction (fever and phlegm) was so strong that it ultimately ended up killing the patients before the pathogens.