Coronavirus may have spread undetected in US for weeks | Hacker News Reader

Coronavirus may have spread undetected in US for weeks

thehill.com

35 pointsdevy26 comments

I heard that China tests literally everyone who shows up a a doctor's office with symptoms of a common cold. Why isn't the US testing more people?

That's likely false information. China had a severe limitation on testing kits through most of the upward surge in the virus outbreak.

They have 20, 50, 100, 500 million test kits? No they do not. They're testing everyone? No they are not.

Why isn't the US testing everyone? There are nowhere near enough test kits to do it. There are not enough test kits to go around anywhere on the planet, not even remotely close.

Right now China can test 1.6 million a week, and now that they've gotten that capacity they barely need it. 1.6 million a week wouldn't be enough to screen everybody with a sniffle in the US, but it would get us most of the way.

I dont know where you heard that number. It doesn't seem reasonably accurate.

This article gives that number:

https://www.sciencemag.org/news/2020/02/united-states-badly-...

They f*ed up. But I don't understand why they refused to use the testing kits provided by WHO.

https://www.axios.com/cdc-lab-coronavirus-contaminated-6dc97...

Because CDC didn't authorized the local/state to perform typical RT-PCR testing[1] for COVID-19 until a few days ago and their guideline for testing COVID-19 super strict probably due to funding and they have been bottlenecked in delivering results. We know it is very expensive in the U.S. for such testings (so it's likely related the fundings are not ready, given that Trump just recently announced budget with significant cuts to CDC and WHO) and U.S. is obviously NOT prepared.[2][3]

However, CT scans are a much better, cheaper and economical way in clinical settings to confirm COVID-19[1]. Results come out in minutes and in negligible costs vs. thousands of dollars for RT-PCR testing. Chinese government's website has the most comprehensive guidelines and treatments recommendations on their official website.[4]

Washington State today is like the early January of Wuhan, where infections aren't officially confirmed even though it's been outbreak for weeks.

[1]: https://www.sciencedaily.com/releases/2020/02/200226151951.h...

[2]: https://www.wired.com/story/covid-19-will-mark-the-end-of-af...

[3]: https://www.nytimes.com/2020/02/29/health/coronavirus-prepar...

[4]: http://www.gov.cn/zhengce/2020-02/19/content_5480958.htm

> However, CT scans are a much better, cheaper and economical way in clinical settings to confirm COVID-19[1].

Unfortunately CT scans have their own risk for the patient that traditional blood tests don't have.

> (so it's likely related the fundings are not ready, given that Trump just recently announced budget with significant cuts to CDC and WHO)

Announcing funding cuts isn't the same as actually cutting them. The CDC budget won't be reduced until congress approves it. [1]

1. https://www.snopes.com/fact-check/trump-cut-cdc-budget/

https://www.theguardian.com/world/2020/feb/28/coronavirus-ma...

Doesn't the fact that so many people have it, and the vast majority of them don't even get sick enough to request medical care -- or to make it obvious in retrospect who they got the virus from -- suggest that the virus is much less deadly than originally feared?

No. Based on the cases so far, we have a decent idea of the mortality rate. 2-3% is a reasonable figure.

That's anywhere from - roughly - 30 to 60 times higher than the common flu depending on the year you source.

It might suggest that not very many people are multiple weeks into having it; possibly that not very many older people have it yet (drastically higher mortality rate for people over ~50-60 years of age); and or a combination of the two.

If 3,000 people have it in the US right now, undetected (some may be at home, sick, in the second week of having it, thinking it's the common flu; or the symptoms may be mild enough to not alarm in most cases), they may be in the first week or two of having it. If 300 of those people have had it long enough to die from it, and 2-3% of those people do die from it, you're only talking about maybe 6-10 people (point being, it'd be a small number).

2-3% is not a reasonable estimate. It keeps getting lowered, especially in a western context with better medical care. 2% was an early estimate in a Chinese context, but even there it's going down as more cases are identified.

Now people are estimating 1.5%, 1%, or even less.

https://www.nejm.org/doi/full/10.1056/NEJMe2002387

2-3% wasn't an early estimate for China. It's the figure. It's based on the reported total cases and reported deaths. We have no other figures to go on out of China other than what they've officially reported (anything else is pointless speculation, we could each claim anything). The death rate there is in that 2-3% range so far.

I do agree, generally, with your point that highly developed healthcare systems should be able to get the mortality rate under whatever the figures are in China. That might only mean 1.5% to 2% though, given China's reported mortality figure is closer to the high 3% area.

It's the figure of deaths in china / verified cases -- and we know that the verified cases is low. In any case, I'll just go with The New England Journal of Medicine on this one, not some online spook.

https://www.nejm.org/doi/full/10.1056/NEJMe2002387

So far China has around ~3,000 deaths on ~80,000 cases.

3.75%

What are you trying to refute about that exactly? Those are China's reported numbers. Online spook? I have no idea what you're talking about.

Your only alternative is to say, flat out, that China's figures are wrong / a lie (Which figures though - deaths? Cases? Both? Is the mortality rate even higher?). And once you do that, we can all just start making up numbers at will.

Here's an amateur rejoinder: It's possible, if not probable, that the infections have actually spread far more widely than what has currently been detected. Those wider cases may have been almost entirely silent, and resolved without significant incident.

If that's true, then the actual rate of fatalities (or even serious cases) might be a lot lower than first thought.

The truth, of course, is that currently no one really knows at present. Right now we have educated guesses at best.

Wouldn't this also only assume that we don't tax the current system? Since, you can still be 'critical' need a ventilator/icu, but not die, would mean that if there aren't available beds/equipment, the mortality rate goes up, am I right? Being as we have around 96,000 ICU beds, and 64,000 ventilators.

Could that drive up the mortality to 4-8% simply due to unpreparedness?

Correct. What we know so far is 80% of those infected show mild to no symptoms. 20% of those infected require hospitalization. Of that 20%, roughly 15% perish. The problem is we can't tell who that 15% are. So we treat everybody equally. To your point, IF there were a massive outbreak in the United States far more than 3% would be expected to die due to our medical resources being depleted. This is one of the reasons the flu of 1918 was so deadly - medical resources were depleted. There's a good documentary about it (the 1918 flu) on Netflix.

K, my logical brain + google, sort of came to this conclusion. Just kind of scary the implications.

I'm also curious what this is going to have on the state of politics in America, I mean --the boomers might speed up their rate of decline being the target demo for the virus, giving a lift to the gen-x, xennials, millenials, etc...

Seems very much like an overestimate to me. The best data point is the Diamond Princess cruise ship as there we see all infections within a population, not just the ones severe enough that they end up getting tested. And what we have so far there is 5 fatalities from 800 infections (and that in a population that definitely skews on the older side, it being a cruise ship).

If the mortality rate was 2-3% we would expect to see 16-24 deaths - in fact probably significantly more than that given the age of the passengers.

I saw an article also, stating this may be genetically disposed to affecting asian/chinese genomes more drastically, than caucasian or african american, can't be certain, but that could cause differing results. Can't remember the link, or how accurate that was.

Can anyone explain to me why in Asia the authorities seem to be going all in with extraordinary containment measures and testing larger groups of people, whilst in Europe and North America the authorities are responding very different? Almost no lock downs, very limited testing etc. In one country a single patient is enough to lock thousands in a hotel or on a cruise ship for days, while in e.g. the Netherlands everyone is assumed to be corona free. You can only get a test if you have a fever, are coughing and have been in contact with a known patient.

Either China is hugely overreacting, or we in Europe/US are in deep trouble. There is not a chance the virus can be contained here I think. In the last week he Netherlands has gone from 0 known patients to about ten, which each have probably infected multiple others. E.g. one was in the ICU (not in isolation) for a week just before diagnosed.

Imagine the type of reaction if the US decided to lock down a major city, compared to an authoritarian regime with full control over movement.

China thought this was more like SARS.

SARS kills 10% of people infected.

Now we know that COVID-19 is much, much less deadly than SARS.

But China didn't know that when the virus was first spreading.

Dupe.

Earlier submission and more commentary here: https://news.ycombinator.com/item?id=22461301

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