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Your numbers aren’t matching other published statistics. For one, 81% of cases are considered mild. I don’t know how that is supposed to square with your statistic that 30% of patients need mechanical ventilation to survive.

I agree that the disease is something to take seriously, but pushing incorrect information to fear monger is just wrong.

These are the most common complications that leads to death. The clinical presentation is very different here. And yes, my source backs everything I said.

Also, the Lancet is one of the most respected medical journals in the world. I'm giving your primary literature that I took from the current medical guidelines from what's published. I'm a medical student and, although not a board certified physician, I'm going to be apart of the care team that is going to be diagnosing this.

What's with this dismissive attitude?

I think if I had said this in person it would have sounded a lot less dismissive, but the way I typed it up came off as mean which was not my intention.

The article is fine, but you're not reading it correctly.

> Here is the list of complications: -ARDS in 29% (Acute respiratory distress disease, this needs mechanical ventilation to survive) -acute cardiac injury in 12% (this potentially kills your heart tissue which leads to arrhythmia and then a heart attack) -secondary infection in 10%

Those percentages say how many out of 41 admitted hospital patients have those serious complications.

But of course they have serious complications, that's why they were admitted to the hospital.

Those percentages say nothing about the health risks to the average person who is infected.

Let me try to rephrase what you're saying just to understand where you're coming from. "these are cool numbers, but what's the chance that the average person is going to actually have any of these complications?". I don't have any cogent numbers on that, but the current deaths/(deaths+resolved) percentage is 8%.

> what's the chance that the average person is going to actually have any of these complications?

Yes, that's the question we'd all like to have the answer to.

But we don't know how many mild or asymptomatic cases have resolved, so the deaths/(deaths+resolved) calculation is a known divided by an unknown.

I didn't even think of how many people are asymptomatic carriers when I said that number. More data, like all science, is the answer here.

Honestly, someone I highly respect who is high up on the medicine food chain is very concerned that a lot of people are going to die and that's been making me very concerned.

If you are going to flex your (yet unearned) credentials, I will flex mine. I’m a statistician, and your source is a perfect example of an egregious statistical fallacy: sampling bias. Yes, it says 30% had ARDS, but it was based on the first 40 cases, all of whom were identified before January 2nd. It’s literally just a sample of the the cases that were so severe that they popped up on the radar before people were even aware that there was an epidemic of a novel virus occurring. Even now many of the mild cases may be being undercounted. Back at the beginning of January, all of the mild cases were being missed.

Being a medical student gives you no authoritative expertise, especially when it is clear you need to hit the books a little harder. That you will be part of a care team diagnosing the disease doesn’t make me trust you more, it makes me trust the competence of our medical professionals less.

Let me ask you a question: what is the intention of responding to me in a condescending way? What do you get out of it? My intention right now is for people not to down play how serious this will become and that this isn't just the flu.

This is the only data we have right now and it's saying this is really bad. You can talk selection bias here, faulty statistics, etc. but right now the death rate is 8% (deaths/(deaths+resolved) not deaths/total infections) and the list of complications is the check list for an intense ICU (no pun intended) visit.

I wasn’t condescending until you were. I initially questioned your claims, and you responded by asserting that you were correct and I was not because you are a medical student and I am not. It had nothing to do with the validity of what I was saying, it was an appeal to your own authority. If you do not wish to make an argument personal, then you should refrain from using your person as an argument.

Secondly, it isn’t the only data we have. The data in the sources you linked are dated. There has been weeks worth of data and tens of thousands of cases since January 2nd, so to rely on papers focusing on 40 cases from 2 months ago is inexplicable. And even our current estimates of the death rate are still very likely over estimated for the same reason: sampling bias. It appears that it takes longer to recover than it does to die from this disease, and so deaths / (deaths+resolved) will be biased high. It also fails to consider that mild cases are less likely to be detected and therefore won’t be included in the calculation, further skewing the death rate higher. And lastly, the overwhelming number of cases so far have been from a single province in China, overwhelming their capacity. Outside of that province, the death rate is far less. That isn’t to say that other provinces/nations can’t also become overwhelmed, but there is something to be said for the fact that having several months of preparation and notice will improve readiness remarkably compared to Hubei province, which only was able to react to the outbreak after it had been occurring for several weeks.

This is all to say that, yes the virus is concerning, and yes people should prepare themselves, but it is also incredibly irresponsible and dangerous to spread immaculate and misleading information based on long outdated studies and statistical malpractice, and then do further damage by stamping it with unearned medical expertise.

> something to be said for the fact that having several months of preparation and notice will improve readiness remarkably compared to Hubei province

Do note though that the system is already getting strained in some parts of Italy, and it sounds like Iran is in very serious trouble. Despite what seems like a pretty aggressive response, South Korea has had very rapid spread through a cult church.

Elsewhere in China the virus has been largely contained, but the Chinese have imposed extreme quarantine measures at unprecedented scale, which are just now easing a bit (hopefully without a regression in virus spread).

Developing countries are going to have a really bad time with this virus, and even in the US and Western Europe it seems plausible that healthcare systems could be overwhelmed, since to date in many places the carefulness of quarantines, the level of testing, the extent of contact tracing, etc. has been quite limited in comparison to e.g. Singapore or South Korea.

The US response seems disorganized, and anecdotally healthcare workers I have talked to have received little guidance or training so far.

Supply chain disruptions and spikes in demand are having a substantial effect on the availability of personal protective gear and some pharmaceuticals (e.g. antibiotics used for treating secondary bacterial infections in viral pneumonia patients).

Yearly flu season already strains the medical system. This virus seems from available evidence to be both substantially more contagious and substantially more dangerous (higher rates of severe symptoms) compared to the typical flu. When it reaches epidemic scale in a particular place it could make every other kind of medical emergency quite a bit riskier. In Wuhan there are many stories of people with e.g. cancer or heart problems being unable to obtain medical care, because medical resources were fully devoted to coronavirus patients.

As stated elsewhere, I lacked tact towards the person who I was condescending towards and it was not my intention. But my behavior towards someone else does not mean it's ok for you to now treat me poorly.

I'm not going to argue with you any more because this doesn't seem worth it, and justifying bad behavior is just not something I'm into. This looks like SARS 2002-2004's cousin. The virus is actually called SARS-CoV-2, the disease is COVID-19. The transmission rate is astounding, the fatality rate is also looking like SARS 2002-2004 [1]; this is something you should take very seriously. And no, I don't need a medical degree to recognize a pattern. But I'm guessing you're not immunosuppressed or elderly so it's not a big deal for you. Do whatever you want, bud, because your actions will only get the people around you killed.

I just want to say it's making me laugh to myself how ignorant people are as to what my education actually entails and the nuances between every step of the medical education hierarchy. Like how in a few months I'm going to magically know what I'm doing because I have a piece of paper.

[1]https://www.medrxiv.org/content/10.1101/2020.02.17.20023630v...

> Do whatever you want, bud, because your actions will only get the people around you killed.

So you say you lacked tact, I shouldn't treat you poorly, and then a paragraph later say this?

> The transmission rate is astounding, the fatality rate is also looking like SARS 2002-2004

The fatality rate is not looking like SARS 2002-2004, its looking far less. Again, you are spouting incorrect information.

> this is something you should take very seriously

I am taking it seriously. Part of taking something seriously is relying on accurate information.

> And no, I don't need a medical degree to recognize a pattern

And what pattern is this that you are recognizing? So far you've only cited dated medical papers and interpreted them incorrectly.

> I just want to say it's making me laugh to myself how ignorant people are as to what my education actually entails and the nuances between every step of the medical education hierarchy. Like how in a few months I'm going to magically know what I'm doing because I have a piece of paper.

You are right, at this point it seems safe to assume that even if you receive your medical degree you won't actually know what you are doing. Pity for your future patients.

I am an ex physicist and how statistics are handled by people who do not have the right expertise is exhausting.

He (or she, I do not know) wanted to show you that numbers you base your conclusion on must be carefully vetted.

I was once a reviewer of a PhD thesis in biology. The statistics part was dreadful, from someone who was otherwise a very serious student. She just would not know how to properly handle her data. After a review of the methodology the conclusions were different.

So do not get upset, being challenged by someone knowledgeable is fantastic and does not happen often.

Good luck with your degree.

I was in the wrong here and could have worded this more tactfully. I do appreciate your insight.

If most people don't care to prevent infection, the hospitals and medical resources will soon be overwhelmed, the death rate will surge from 0.5-4% (no exact figure at the moment) to 10-20% like earlier in Wuhan. When viral load in the environment becomes sufficiently high, some young people will be taken away by it too, as in the case of several Wuhan doctors who sacrificed themselves under that circumstance.

Among the ~16-19% who are hospitalized and recover, you may suffer through weeks of pneumonia and your lungs could be damaged long-term.

Even if you're lucky to be among the 80% who survive without hospitalization, you could still be the vector who directly or indirectly infect someone you care about.

^This is exactly why we should take this seriously. Even if this "isn't a big deal" that attitude will get people you love and care about sick potentially leading to their death. I'm advocating that people be mindful and try to take this very seriously.

Very true, the low end stats are for regions with few infections. If say, 1 million ppl get in NYC, expect a lot higher rates, as the health system cannot do much with that many people.

>the death rate will surge from 0.5-4% (no exact figure at the moment) to 10-20% like earlier in Wuhan

Those percentages come from different samples altogether and cannot be compared. 10-20% is heavily biased toward people who were admitted before there were even reliable tests for the virus or a recognition that it's novel and serious. Now you're comparing that to 0.5-4% which includes a bunch (though by no means close to all) of mild cases who got picked up by the tests but may not have required a hospital visit at all. What's the point of mentioning two numbers that aren't just unreliable and biased, but unreliable and biased in different ways?

Yes, I think I might have mixed up stats of different kinds (Posting too late at night, sorry).

However, the point stands that fatality rates will likely go up a lot if medical resources are overwhelmed. Long-term lung damage is also another risk for younger people and its rate will also go up.

Panicking is also dangerous and has real costs.

How about we agree to be diligent but also not overreact.

Right now the Deaths/(Deaths+resolved) is 8%, which is on par with SARS in 2002-2004. This affects most demographics, but mostly the elderly. I'm not here to advocate for panic, but we need to take this very seriously now while the outbreak is still young. The more we can slow this the less dangerous the virus will become.

Just to be clear, the percentage of those infected with the virus who will have ARDS is far, far lower than 29%. This is a percentage of those who were admitted in this one case study, in one hospital in Wuhan before January 2.

> This is dangerous.

How? He is not advocating to take things likely. He is not promoting dangerous practices nor a cavalier attitude.

This is just some person sharing his first hand experience.

"Hey it's not as bad as people making it out" will make people complacent. People need to self quarantine if we want this to be well contained. We need people to understand that if they don't take this seriously people will die, people they care about.

I, personally, appreciated the words of warning a lot. I'm a reasonable enough person to not panic and will stay pragmatic about it (I'm not going to go into quarantine now, obviously) but it's very nice to see and hear people in the know are taking it seriously to prevent the spread of a horrible disease and many unnecessary deaths.

Thank you for the warning signs, I will keep an open eye. :)

Is it more appropriate to say that Covid-19 is dangerous if you are elderly or have pre-existing conditions?

https://www.worldometers.info/coronavirus/coronavirus-age-se...

Median age of admitted patients in the article above was 49. That’s not elderly. Also, only half of them had pre-existing conditions.