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Comment by big_chungus | Hacker News Reader

> At the same time you shouldn't assume experts, the media, etc. are somehow mass conspiring against your health/safety. Assessments are probably reasonable to follow.

True, but it's also not their job to work for my personal benefit. Mine is. Their job is to do the greatest good for the greatest number, but what is good for the most people is not always good for me. My job is to keep myself and my family safe, and I don't trust bureaucrats enough to make the call that I have to lose out for the "greater good".

All that aside, at least according to China, the mortality rates aren't all that high (a few percent). We'll see what happens elsewhere, but I don't think there's reason to panic yet.

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> the mortality rates aren't all that high (a few percent)

That's about the same mortality rate as the pandemic flu of 1918, which wasn't exactly a walk in the park.

Tricky to compare, because health care is better these days so mortality would be expected to be lower (unless the system is overwhelmed, of course).

Uh, they don't calculate the mortality rate of the virus by guessing how many people would have died in 1900's care. The mortality rate is that high because that's the percentage of people currently dying.

Mortality rates are easy to compare - they are numbers that take healthcare and disease intensity into account because they are statistics from observation.

If anything, the numbers suggest that had the covid-19 struck in 1918, the mortality rate would have been higher.

...in 1918. When we didn’t have things like antibiotics or mechanical ventilators (or even a solid grasp on germ theory).

Non-adjusted comparisons to medical outcomes in 1918 are useless.

(pre-empting the criticism: antibiotics absolutely matter for a viral outbreak like this. Many people who die from respiratory illness actually die from secondary bacterial pneumonia.)

The observed mortality rate already accounts for advances in medicine that are actively being used, no? Mortality rates are easy to compare: x% died back then and y% die now. Those numbers take into account the various characteristics of the disease and health care.

People aren't saying this acts like the 1918 disease so it should have the same mortality rate. People are saying the observed mortality rate is the same. That's in spite of medical advances.

You’re making a lot of assumptions. Sure, if the reported death rate is correct (it isn’t; it’s going to end up much lower), and the medical system in Wuhan is up to first-world standards (it isn’t; they’ve had to scramble to build halfway adequate infrastructure for the population), and the distribution of victims is the same as the 1918 flu (it isn’t; this virus kills mainly old, sick people), then sure, you can just compare mortality rates.

But since none of those things are true, you can’t. It’s not like these parameters are fixed; they’re dramatically affected by the time and context in which they’re measured.

They're hardly useless, and if the current virus is killing the same percentage of people as the 1918 flu despite all of our medical advances, that's a strong indicator the current virus is significantly more potent, which makes the blithe assertion that "the mortality rates aren't all that high" even more dubious.

We don't actually know mortality. By the numbers, 2,470 deaths, 23,419 recoveries, and 53,105 undecided cases.

10% of all settled cases resulted in death. That is far higher than the 3% of Spanish Flu and reasonably close to SARS. Median time to death is around 12 days which is similar to time to recovery meaning the 10% seems likely to be an accurate metric.

https://www.cdc.gov/coronavirus/mers/clinical-features.html

The most interesting part is the ages of cases. Last I checked, there were ZERO deaths of children 9 and under. Mortality rates hover at around 0.2 to 0.3% until over 50.

The really big unknown for me is the weird SARS antibody Antibody-dependent enhancement (ADE) effect. Basically, if the antibody levels get too low and reinfection occurs, the disease becomes much more lethal than if no antibodies are present at all. This effect is now known to be the reason mortality rates for a second case of Dengue fever are so high. In SARS, the disease disappeared before reinfection was an issue. In the case of a pandemic, a second, more lethal wave could be disastrous (if this is also possible with COVID-19). This could also complicate naive vaccines that don't account for possible secondary, enhanced infections.

https://www.sciencedirect.com/science/article/pii/S0006291X1...

All that said, I'm not super-worried.

Thank you for calling out the actual numbers:

> By the numbers, 2,470 deaths, 23,419 recoveries, and 53,105 undecided cases. 10% of all settled cases resulted in death.

The mistakenly low estimates of mortality rate are likely due to use of the wrong denominator. As Worldometer [1] explains correctly in their summary of Ghani et al. [2]:

> Once an epidemic has ended, it is calculated with the formula: deaths / cases. But while an epidemic is still ongoing, as it is the case with the current novel coronavirus outbreak, this formula is at the very least “naïve” and can be “misleading if, at the time of analysis, the outcome is unknown for a non negligible proportion of patients.”

[1]: https://www.worldometers.info/coronavirus/coronavirus-death-... "Worldometer Coronovirus Mortality Rate"

[2]: https://doi.org/10.1093/aje/kwi230 "American Journal of Epidemiology Volume 162, Issue 5, Pages 479–486"

As the parent calls out, a better estimate of mortality rate for an ongoing epidemic is deaths / settled cases where settled cases is the sum of deaths and recoveries.

I'm seeing current numbers show 41,490 active and 45,112 resolved. Between your numbers and mine, the number of deaths increased by 507 and the number of recoveries increased by 21,693. This means the fatality rate for this set of resolutions is still lower, 2.2%. This trend is fairly pronounced downward as the WHO report on the matter calls out, we've learned a lot about the disease and are identifying a lot of totally asymptomatic cases [1]

[1] https://www.who.int/docs/default-source/coronaviruse/who-chi...

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