Hacker News Reader

Comment by fortani | Hacker News Reader

The scary thing about this virus, isn't the mortality rate, but the high R0 value and the potentially high proportion of infected people who are classified as severe cases.

Assuming that 20% of the US population (330 million) gets it, we're looking at about 13.2 million (20%x20%x330 million) patients who require admission to an ICU ward. Needless to say, that is enough to overwhelm the healthcare system and hospitals, and increase the overall mortality rate, when people who requires ICU are turned away due to lack of beds or equipment.

As it is, the best option would be to delay the spread as much as possible, so that the number would be spread across a time-span for as long as possible.

View on HN

> The scary thing about this virus, isn't the mortality rate, but the high R0 value and the potentially high proportion of infected people who are classified as severe cases.

This is kinda where I'm at right now. The true mortality rate is almost certainly well below the 3% being reported now due to a high number of mild unreported cases. That said, the speed with which it is spreading combined with the potential severity is cause for concern.

If we compare this to the previous SARS and MERS events the trajectory is worrying. The SARS epidemic lasted 19 months and resulted in 8400 confirmed cases. The MERS epidemic has been ongoing since 2012 (very few cases after 2015 though) and resulted in 2500 confirmed cases. The current Coronavirus epidemic has only been going for a little over 2 months and we're already over 80,000 confirmed cases with no indication of a slowdown.

As a counterpoint though, from October through December of last year, there were 3.7 million cases of the flu in the US alone.

Never mind that, far before you get to 20% the billing issues will destroy the system: https://www.miamiherald.com/news/health-care/article24047680...

If you charge $1,400 to each suspected person then either the testing will bankrupt the population or people are going to hide from testing. If coronavirus arrives in bulk in the US, then it's either going to be "Medicare for coughs for everyone" or a pandemic.

This is something insurance will cover, and 90% of the American population are already covered under health insurance.

https://www.cbo.gov/publication/55085

Are you sure? I couldn’t say with certainty whether any emergency service is covered by my insurance. There are no blanket statements and a relatively high co-insurance to ER services. Most policies have over $10,000 in co-insurance so stating that 90% are technically covered doesn’t actually respond to the parent’s claim. You’d have to know intimate details for how the service is billed which is apparently impossible before receiving service. If you don’t believe me call your hospital or your physician or your insurance company and ask what your out-of-pocket would be. Nobody can tell you.

What percentage of that insurance doesn't involve arcane rules about what's covered? My parents recently learned, following my dad's heart attack, that our town's ambulance was considered "out of network" and told they should have shopped around first. I had the pleasure of overhearing this conversation. Combined with the fact that many rural and suburban folk can't afford a $20 copay for a regular checkup let alone thousands of dollars for their deductibles, I put little confidence in that 90% coverage.

The article explicitly says that (a) he has insurance (b) this is out of pocket after insurance and (c) the insurance is disputing whether to cover this at all:

> Hospital officials at Jackson told the Miami Herald that, based on his insurance, Azcue would only be responsible for $1,400 of that bill, but Azcue said he heard from his insurer that he would also have to provide additional documentation: three years of medical records to prove that the flu he got didn’t relate to a preexisting condition.

Also for the irony:

> Azcue said he earns about $55,000 a year working for a medical device company that does not offer health insurance

Another thing to consider is that more public facing jobs like the Starbuck's barista, is also part of the population that fears doctor/hospital bills the most.

I don't think that number is accurate because so many people are not tested. Only people with severe infections are tested or those who have been in contact with known infected people.

With the deaths in Italy it is now also unclear if one person actually died from COVID-19 or if it was the late stage cancer they had.

Reply on news.ycombinator.com