Comment by ardit33 | Hacker News Reader

Comment by ardit33 | Hacker News Reader

1. I would not trust anything coming out of WHO at this point. Even Germany called it a pandemic, yet they are not willing to call it such (perhaps due to political influence/pressure, or just incompetence). This looks more like a 'panic containment' type of statement than the truth.

2. The R0 of seasonal flu, is about 1.5, Covid-19 has a R0 between 2.6 and 3.5*. (yet to be determined), which is much more contagious than normal flu. This article has no mention of it, hence has no credibility. By any account of any data, Covid-19 looks to be 2x more efficient to spread as the normal flu.

3. The major cases from the Diamond Princess, the cult in South Korea, and the Eldery Care facility in Seatle, are an indication that the virus is very easily spread in close quarters. That's not a normal flu type of virality, it is much worse.

4. We have many cases where people still tested positive even after 14 days of quarantine, hence it is not going to be easy to contain. But we don't know yet if a person is still contagious after testing positive after 14 days. No mention to this as well.

TLDR: Don't panic, yet 3.4% of people are going to die, or 10-15% of your parents/grandparents will perish earlier due to this virus.

I am sorry, but that's war-zone like statistics.... and this should be treat as such. (it needs a true war like mobilization to be combated, and talks like this to minimize the impact are just irresponsible).

The fatality rate may be 3.4% and the r0 may be 2.6 to 3.4 but it is unlikely that both are true at the same time.

It depends on your assumption of undiagnosed cases. We don’t know how many of those there are.

But suppose you assume that all the diagnosed cases are all the cases (impossible but for the sake of the statistical argument). That is to say we tested 100% of the sick people.

If that were true the fatality rate would shoot up to the high end of the estimate and the r0 would plummet. It hardly spread at all, but if a patient gets it, it is more fatal.

On the other hand assume that almost everyone has it but we only tested a tiny fraction. Now the r0 sky rockets and the fatality rate plummets.

Put another way, there is a trade off between the two and it is unlikely to be on the upper end of the estimates for both.

What this author is saying is that it hardly spreads at all but the fatality rate is high. I.e we tested many of the cases.

Pretty sure the fatality rate is based on the number of patients who present themselves to a doctor. I've seen estimates of influenza fatality rate of 0.2%, which corresponds with the ~61000 deaths over ~20700000 medical visits for the 2017-2018 influenza season documented here: https://www.cdc.gov/flu/about/burden/2017-2018.htm

The fatality rate would obviously decline with a larger denominator which includes total infected. But so would the rate for influenza. It still seems to remain the case that this virus is ~10x deadlier than the flu, unless it has a far greater r0. The possibility of variants (type-S and type-L) mentioned elsethread makes things more complicated, though.

> Pretty sure the fatality rate is based on the number of patients who present themselves to a doctor.

In an ideal world that would be true, however we know that in early Wuhan they were mostly only testing people who were already hospitalized with "pneumonia symptoms" due to having limited kits and staff. Pneumonia symptoms how the most serious cases advance after going through flu symptoms. I read one analysis of the Wuhan data that showed 91% of everyone they tested had pneumonia. This changed later but a lot of the stats we're looking at are from papers with data only through the end of Jan.

Almost every country has different criteria for testing a patient and you can't become a "case" until you have a positive test. The U.S. has changed testing policy three times in the last week.

> Pretty sure the fatality rate is based on the number of patients who present themselves to a doctor.

I don’t think this is right. I believe it’s based on an estimate. Your own numbers bear me out. The flu death rate is estimated to be around 0.1% and we can come to that number by a division here:

“ The overall burden of influenza for the 2017-2018 season was an estimated 45 million influenza illnesses, 21 million influenza-associated medical visits, 810,000 influenza-related hospitalizations, and 61,000 influenza-associated deaths”

So 61/45000 = .14%

Actually 21 million or 45 million does not make much difference. There will be still order of magnitude between influenza and covid-19 (CFR 0.2% vs 3.4%, and mind you, 3.4% is an early estimate and subject to change in the situation where new cases are still coming in and people are still dying, if you observed then CFR for covid-19 was around 2% when it was rapidly growing in China and did rise to current level when the new cases started to slow down; many people warned that it will be much higher actually but these people were hushed down; you have to use your own analytical mind to choose what is more closer to the truth).

Also, WHO just raised the death rate to 3.4% from the previous value of 2.3% ... [1]

Add to this, the fact that that the outbreak is still expanding, and new cases tend to drive this number downwards. But if we consider only the "closed" cases (recovered/dead), the current number is more like 6% [2].

And it could be worse from the previous experience with SARS [3]:

>> Finally, we shall remember that while the 2003 SARS epidemic was still ongoing, the World Health Organization (WHO) reported a fatality rate of 4% (or as low as 3%), whereas the final case fatality rate ended up being 9.6%.

Of course, this number could also go down, if there's a big number of unreported mild cases.... so the conclusion is that we only know that we have no idea... and that it does indeed sound like this is aimed to reduce panic (which is also a good thing).

[1] https://www.cnbc.com/2020/03/03/who-says-coronavirus-death-r...

[2] https://www.worldometers.info/coronavirus/

[3] https://www.worldometers.info/coronavirus/coronavirus-death-...

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PS: I'm giving the sources for the numbers I posted, so, instead of just downvoting, could you explain why you disagree? Thanks :)

I didn't downvote, but this question came immediately to my mind: why no source link from WHO itself?

For [1], you are right, and here you have it:

>> "Globally, about 3.4% of reported COVID-19 cases have died. By comparison, seasonal flu generally kills far fewer than 1% of those infected." https://www.who.int/dg/speeches/detail/who-director-general-...

For [2] I believe this page is making a good work at aggregating the data, and they have been linking their sources for the stuff they add, and for [3] in particular, they do link to WHO ([4][5]), but also summarize information from other sources.

[4] https://www.who.int/csr/sars/archive/2003_04_14/en/

[5] https://apps.who.int/iris/handle/10665/119464)

It's clear the WHO message is trying to present the bad news in the best possible light. The sentences about transmissibility are very obviously constructed extremely carefully. However, I do take away from the report that Governments should get serious about containing this, because the experience of China shows that this is possible, whereas with the flu it's known to be impossible.

I think that is the right message at the moment. Simply acquiescing to some undetermined percentage of the elderly and random people of all ages dying is not a good strategy, and I think that is what he is trying to communicate.

Thank you for this.

Something that confuses me is, why would governments minimize the risk and not take necessary steps to slow the virus? It seems obvious that the short-term economic gains resulting from such an approach are vastly outweighed by the negative consequences of an extended and prolonged outbreak. I'm missing something.

It is possible that people in relevant positions are clueless cowards or calculating psychopaths.

My initial impression leans towards the first option.

Taking measures needs courage. You have to take very disruptive steps in the environment where popular opinion still calls it not worse than flu and before that you have to be smarter than popular opinion.

https://markets.businessinsider.com/news/stocks/pandemic-bon...

> The [class a] bonds default if pandemic-related deaths reach 2,500 in a single nation with an additional 20 or more deaths confirmed in an overseas country, according to the bank's prospectus.

> The [class b] bonds pay 11.5% annually, but reach default after 250 deaths. The bonds' payout rate scales with the number of additional countries that experience than 20 confirmed deaths.

Well? Why are they dragging their feet? Even the official numbers have seen more than 2.5k die in China and more than 20 in Iran. The only question now is whether this is incompetence or maliciousness.

I don’t see it. Pandemics are objectively defined. The bonds’ principal pays for relief in the event of a pandemic, meaning a venal WHO would lean towards categorising non-pandemics as pandemics.

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