Hacker News Reader

Comment by 01100011 | Hacker News Reader

COVID-19 makes ~20% seriously ill and 10% dead. Influenza kills about, what, 2 out of every 100,000? Don't get me wrong, the flu killed my aunt in her early 50s, but COVID-19 is much worse.

Beyond the immediate medical consequences, there is also the societal reaction and potential overreaction. The world economy has been poised for a pullback and this just might trigger the next global recession(my money is on that happening, even if we find a vaccine next week).

Like always, it's a good idea to have a disaster plan in place. Make sure you have a few weeks of critical medications and food on hand. Help those around you put the current events into perspective, help them stay calm, and help them prepare.

View on HN

>COVID-19 makes ~20% seriously ill and 10% dead

COVID-19 death rates in China are about 2-3% and significantly lower outside of China. (less than one percent). Probably due to the healthcare systems in the Hubei region being pushed to its limits.

Bad flu seasons in the US generally have a fatality rate of about 0.2% and infect about 30 million people annually, killing about 60000.

So even if COVID-19 cannot be contained and will linger around it will likely not be as deadly as influenza.

10% is dead / recovered. Don’t look at dead / infected, that’s skewed by an exponential infection rate.

Dead/recovered is also skewed because if someone is going to die, they will die before the illness has "run its course," whereas someone who is going to recover will have it for longer before they count for their statistic. As a result it is also skewed by the exponential growth, albeit in the opposite direction. I really feel like none of the statistics I am seeing are satisfying...

That's not clear. Many people are getting antivirals and clearing the disease in a few days.

Presumably there are also people who die abnormally early. Unfortunately I have not seen what we really need to see: a breakdown of dead/recovered by day since infection. Without it there is no way to accurately assess the deathrate in an environment where new people are quickly falling ill.

There is no evidence to date that anti-retrovirals are successful at treating this infection.

I'm sorry, but that's just plain wrong. The first US case at Providence Everett got well in a few days thanks to antivirals.

Citation?

https://www.nejm.org/doi/10.1056/NEJMoa2001191

Many people in China have been treated. There is an ongoing trial that is supposed to have results in a couple of weeks. Patients in the U.S., Korea, and Thailand have all been treated with antivirals and dramatically improved within a day or two.

This was released Thursday: https://www.thelancet.com/pb-assets/Lancet/pdfs/S22132600203...

This Chinese study used 28-day mortality rate.

https://www.thelancet.com/journals/lanres/article/PIIS2213-2...

The best measure will be something of this sort, with a sufficient duration to catch most of the fatalities.

It assumes we know the amount of infected people.

We have very accurate numbers for surprisingly large group due to the cruse ship. As of 20 February 634 infected including 328 asymptomatic cases. https://en.wikipedia.org/wiki/2020_coronavirus_outbreak_in_c...

Adjusting for the delay between infection and first symptoms a relatively small percentage of people avoided symptoms.

That's a sample population biased toward the elderly, though.

80% were age 60 or over. Normal is 11%.

People stuck on the same ship 24/7 is not very representative of actual daily life.

How are you doing this adjustment?

>Probably due to the healthcare systems in the Hubei region being pushed to its limits.

What happens when the Italian healthcare system gets pushed to its limits? With a conservative estimate of 15% hospitalization (which I can't vouch for, but offer for the sake of discussion), there may be no medical system in the world which is prepared for this.

I notice a lot of downvoting without responses here. It smacks of denial and motivated reasoning. Usually on HN, when you get down-voted, you get a counter-argument. I think it speaks volumes when there's none.

If the original commenter here is suggesting that 15% of Italy's population will be hospitalized...that is its own counter-argument. That's pretty clearly not going to happen.

> That's pretty clearly not going to happen.

Sure, if you mean that the capacity isn't there.

And sure, if you mean it won't be 15% of the total, but rather 15% of the 70% of the population who catch it, then ok.

If you mean that that level of care isn't required for the 15% of severe cases which was seen in the studies, then you'll have to refute the studies of people who know more about this than you, with some better arguments than that.

http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9...

>of the 70% of the population who catch it,

Sorry, but where in gods name is this number coming from? There are currently a few hundred cases documented in Italy,rate of new coronavirus cases worldwide has slowed down to about 500-1000 per day.

For reference, the US has about 1 million hospital visits for pneumonia every year. I couldn't find numbers for Italy but I assume it's in the ballpark of 200k relatively speaking. So a few hundred extra cases or even a few thousand aren't going to push the system anywhere.

Not sure about the 70% but 60%-80% was talked about a few days ago: https://www.theguardian.com/world/2020/feb/11/coronavirus-ex...

> Usually on HN, when you get down-voted, you get a counter-argument.

Not really.

When you say "15% hospitalization" are you suggesting that 15% of the population will be hospitalized?

There are some estimates that 15% of conavirus cases end up needing to go to the hospital. So, 15% of however many Italians catch it might end up needing medical services, plus the standard baseline that already need it. That's going to be pretty tough for the system to handle.

Doesn't that depend entirely on how many Italians end up catching it?

It does, but in an average flu season, how many escape unscathed? Now factor in that the transmission rates may be significantly higher for this virus (R0 below 2 versus anywhere from 1.4-6.6).

What you're missing is the multiplier. It seems to be substantially more contagious.

edit: To put a finer point on it, the estimates of the R nought range from the same as the Spanish Flu, to double the Spanish Flu.

I’ve seen C19 rates of 20% seriously ill (hospitalization) and 5% critical care (ICU). Almost no country has the capability for this, even in large cities.

There are vaccines for flu; none for C19 for 18 months at the earliest. Also, C19 is contagious when victims are asymptomatic. It aerosolizes so it can spread across rooms and potentially through ventilation systems.

Many C19 healthcare workers are becoming infected, some dying. This is unheard of with the flu.

And C19 is uncontained, unlike SARS. It meets the definition of pandemic now (2+ continents and community spread). The WHO will finally recognize this any day now.

To equate C19 with the flu is inaccurate and dangerous.

Watch this video from CNBC last Friday.[1] It’s excellent, and features experts who do not mince words.

[1] https://youtu.be/8A9BT3lAGHU

Curious why you say 18 months at the earliest for a vaccine. Is this a standard vaccine timeline? Are we guaranteed to be able to make a vaccine for this virus? I am not at all educated on how vaccines are developed.

I'm not understanding your conclusion at all. In an environment not taking precautions above normal flu season, the r0 for covid-19 is significantly higher than flu (2.6 vs 1.6) - in part because we have partially working flu vaccines. If it can't be contained, it'll be far worse.

Now I suppose measures China style will drop its transmission rate below flu, but at the minimum that's a heavy economic cost to be concerned with.

Actually what the data says is the older you get the more deadly it is and below certain ages it's less than 2.

There are actually 5 episodes on "this week in virology". These people are virology professors in the US.

This episode an interesting look at the percentages.

http://www.microbe.tv/twiv/twiv-588/

EDIT: two other interesting aspects, over 80% of the cases were mild and over 50% of chinese males smoke.

I think it would help people understand this is is worse than the flu if we start calling it sars 2.0. Because that’s what it is, sars. https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndr...

People had the same dismissive attitude towards SARS which turned out to be much less deadly than the seasonal flu. I am a betting man and say that this year Coronavirus won't become as big as the flu this year.

SARS had a mortality rate of 10 %. The flu is 0.1 %

Yes, though factor in how many get it.

In this case say 100 people got SAR - 10 people die Now Flu - 1000 people get that and - same net result.

Lets face it, how many got SARS in total - less than 10k How many people catch the flu each year? - millions litterly millions.

But as with most of these - it is overall health and underlying preexisting conditions that can and do skew statistics and not all countries log things to the same standard.

You are forgetting that highly aggressive measures are put in place to fight SARS.

If you did what China is doing now to deal with flu, you'd drastically cut transmission rates.

We got lucky last time. Does it seem logical to you that China would put half the country, 750 million people, on lockdown and crash the economy if it was just some flu equivalent? China’s actions speak for itself.

How many people you know ever got Sars? Now how many people you know ever got the flu? That is literally the major difference betweena killer that makes headlines and a silent killer that no one notices.

You need to factor in the fear-factor and as fear spreads much more effectively than any virus known to man, then the net effect I'd bet will be bigger.

Remember - there are still people who believe the earth is flat - when you're up against that basic ilk of intellect, the World becomes a strange place very easily when you push a few variables.

Even sadder is, most people will think of this CV as the flu of the year and with that, many statistics will become entwined.

If it doesn't become as big as the flu, it's because people are more afraid of it and some governments are taking steps to control it.

If HIV had the same response as this year's coronavirus is getting, it would've been stopped dead in its tracks. Meanwhile people around the world would say governments overstepped their bounds, fear ran rampant, and it really wasn't that dangerous--the common cold kills more in absolute numbers.

We really don't know much about the disease yet. SARS had a huge fatality rate, but it was well contained. If it weren't and absolutely nobody panicked or worried, it would've decimated some urban centers. Sometimes it's fine to be extra careful in the beginning and easing up only after you're certain that it's not that bad, and unknown diseases are one of those times. Taking a more carefree approach doesn't look so good if deaths start tallying up.

my understanding is 2% dead (think that number is being borne out in both italy and s korea), which is still much more lethal than the flu

Your probably both right 10% if you get put in a big room on a bed with just basic med care and 2% with the best hospital care we are currently able to provide (antiviral pumped oxygen ect).

It is 2% dead if you assume that all today infected will recover in the end. It is much more pessimistic when you do not have such assumption but project current dead to number of infected about 2-3 weeks ago.

It's more like 3% dead, according to Johns Hopkins: https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h...

Reply on news.ycombinator.com