The Coronavirus Isn't Going Away – Interview with Harvard Epidemiologist | Hacker News Reader

The Coronavirus Isn't Going Away – Interview with Harvard Epidemiologist

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33 pointsronyeh15 comments

We literally need to rethink our blase attitude to public infection control. Self isolation for cold and flu like symptoms should be mandatory.

With a 2% death rate, 40-70% of the world population is huge. That would mean 80 million dead I think.

I really do hope we can stop it or slow it down enough to find a cure. On the other hand, the world has been through worse: the 14th century Black Plague famously killed a third of the population of Europe. I hope we won't get something like that again, but if we do, it's still not going to be the end of the world. It'll suck, but we'll recover.

Except that it is doubtful that it actually has a 2% death rate. Some huge number of coronavirus infections are not being counted because they are asymptomatic or presenting minimal symptoms[1], and thus those people aren't being tested. In fact, probably even a lot of people with fairly serious symptoms aren't being tested[2]. Only those being tested can test positive and only those testing positive are getting counted, inflating the presumed mortality rate massively. On top of that it seems the tests being used may be giving a lot of false negatives, for example in people who have "recovered" and test negative but then later test positive again, so they may have still been infectious all along.

Bottom line; when you really look at all the facts, it seems that perhaps Covid-19 is no more lethal than any more severe flu.

[1] https://www.nytimes.com/2020/02/27/world/asia/coronavirus-tr...

[2] https://www.reddit.com/r/nyc/comments/fayko1/my_covid19_stor...

This is something I always find strange when people make these basic extrapolations with insane numbers for deaths.

Someone who never presents to hospital or gets tested can very much be infected and would never get counted in this estimated mortality rate.

Our flu numbers aren't the same. Epidemiologists estimate infection rates. They don't test 700 million people a year to see if they have the flu.

Flu is still a far bigger health concern but virtually everyone shrugs it off as a fact of life.

> Flu is still a far bigger health concern but virtually everyone shrugs it off as a fact of life.

Because it has been a fact of life for the entirety of everyone living's life.

nCoV is a new threat that can kill, of course people will worry about it, it's instinctual.

We also don't have a vaccine for it yet, and an estimated 30% of infected people need hospital treatment, which is surely more than the usual flu, and requires more specialised & cautious care since less about it's known.

As the US' CDC says in the other nCoV post on the home page:

> The complete clinical picture with regard to COVID-19 is not fully understood.

It might just blow over and be fine, sure, but I don't think the response or caution surrounding it is irrational.

> an estimated 30% of infected people need hospital treatment, which is surely more than the usual flu

That sounds like an extraordinarily high estimate. How could we have an accurate estimate of hospitalisation proportions without even knowing how many infections are out in the community?

It seems very, very likely that we are missing the vast majority of cases given the tests are pretty inaccurate, and we only bother administering them to people who are either extremely sick already, or who have been in an "affected region" (realistically, every region is "affected" at this point).

I have no idea; it's not a job I envy.

But what I read in the UK was that looking increasingly like 'about 50%' would be infected, 'but only 30%' of those would actually need medical attention. Something similar came from the US with '40-70%' instead of 'about 50'.

But yes, a large part of the concern, particularly for government bodies coming out with these figures is preparedness; so they probably are erring on the side of 'more resources needed' in these estimates. But why not? Better over-prepared than under, not that that's looking likely.

The latest discussions going around are that there appears to be a neurological aspect that causes/triggers apnea, hence the need for mechanical breathing assistance. Possibly the reason why people are also seeming to just be dropping in the streets.

This is where the medical system is most limited in how much equipment they have on hand.

We are missing a lot of cases because they had been limiting testing to individuals coming from infected areas and those who directly contact them, which is why we are now seeing it appear in the general community.

It's going to be bad. Not societal collapse bad, but simply that if you think of 100 people you know, a few of them (particularly those that are elderly, immune suppressed or sick) are likely to die if they get infected. I think the path forward has to be protecting the vulnerable, like strictly quarantining aged-care facilities, cancer wards, etc to protect the residents.

That seems correct. When swine flu was in the UK (around 2010), I had really bad flu. I went to the doctor for blood tests etc. I recovered in around a week without intervention but was weak for quite a while afterwards. In the end I seem to remember them saying that I probably had swine flu but there was not point testing now, so I wouldn't have been included in the statistics.

So sketchy! As they say in this podcast, hard to wrap your head around

Think of this way,,,

AIDs while changes genetics fast evading immune system its hard to catch and takes decades to show up. It took us 35 years to come up with a vaccine and that was due to our degree of knowledge of the immune system works at the time.

Now, we have something easier to catch than the flu that requires hospitalization to treat. Or in short words, myopic Trump is wrong; pushing for a World-Wide vaccination effort funded by the US is not only securing USa but securing the world.

This is the first case where we will have to pull together to vaccinate 7 billion people. Its not optional.

Any idea how many tons of steel to get 7 Billion new needles? It might be 5 million tons. That is about 5% US production or about less than 2% China production. But, the real costs is not in the needles. Its the logistic costs of trained medical personnel to deliver the vaccine.

Well, 5 million / 7 billion is 0.000714, or 714 grams. I doubt it takes anywhere near that much to make a needle.

> AIDs while changes genetics fast evading immune system its hard to catch and takes decades to show up. It took us 35 years to come up with a vaccine and that was due to our degree of knowledge of the immune system works at the time.

There's an AIDs vaccine?

I wouldn't be surprised if billions of new needles are manufactured every day.

https://www.theguardian.com/world/2011/jul/11/cia-fake-vacci... There's gonna be a lot of people refusing to get a vaccination, I suspect

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