Hacker News Reader

Comment by fspeech | Hacker News Reader

15% of all confirmed cases in China were serious at some stage and require some kind of oxygen assistance. This is the one number we need to focus our minds on. Death rate is entirely dependent on the availability of resources. If we don't slow down the spread we will face disastrous consequences.

There are thousands in Wuhan who have been on life support for weeks if not months. Even if they do survive they will face diminished lives and this is with China sending all available resources (doctors, nurses, ventilators) of the nation there. Death rate itself is worthless to argue over unless one names the context: sporadic outbreaks here and there or tidal waves?

View on HN

>15% of all confirmed cases in China were serious at some stage and require some kind of oxygen assistance.

the death rate in the hubei region itself is also several times higher than in most western countries so it's fair to assume that the rate of undetected cases in China is simply very large.

What we know from well controlled cases like the cruiseship with 600 infected people appears to suggest that about 20% of people develop more serious conditions like pneumonia and a fraction of those require intensive care.

> the death rate in the hubei region itself is also several times higher than in most western countries

Italy now has a higher case fatality than Hubei, and getting close to Wuhan.

Italy is there at the top with Japan in terms of median population age. This might play a role in the statistics.

And Germany has a CFR of 0%. People need to stop quoting CFR like it’s applicable to the general population. It is not.

They have 670 cases so that's quite interesting. A lot of these cases are relatively new. I wonder what's the hospitalization rate.

And many of those cases are new. How many of them have recovered, and how many are still battling it out?

CFR can change tomorrow for a given population. Another reason it’s such an elusive number.

When the infection spread is increasing, more new cases are coming in today than yesterday, and so the CFR contains a good portion of people who are still early in the illness lifecycle. Just because some haven’t died yet doesn’t mean they won’t. Meanwhile, as the spread continues, the healthcare infrastructure may reach a tipping point where it can’t treat people as effectively.

You use the word "pneumonia" to describe seriousness, but this IS a viral pneumonia. The virus infects the lung first. Detection is through the sputum coughed up from the lung. If you test positive you basically have pneumonia. China's definition of a serious case is blood oxygenation less than 93% without assistance.

To be precise, the COVID-19 virus is not “viral pneumonia”. Viral pneumonia is a symptom (pneumonia caused by a virus) which results from COVID-19 in the minority of cases.

Studies of the number of known cases which resulted in viral pneumonia find, for example;

“A total of 81% of cases in the JAMA study were classified as mild, meaning they did not result in pneumonia or resulted in only mild pneumonia.”

That is not to say that 20% of all cases are severe, but 20% of the cases in that study were.

Pneumonia is the inflammation of the lung. You will find covid patients more reliably through lung CT than nucleotide tests of swabs.

People are confused about what "mild" means:

https://www.nytimes.com/2020/03/04/health/coronavirus-china-...

What were mild, severe and critical? We think of “mild” as like a minor cold.

No. “Mild” was a positive test, fever, cough — maybe even pneumonia, but not needing oxygen. “Severe” was breathing rate up and oxygen saturation down, so needing oxygen or a ventilator. “Critical” was respiratory failure or multi-organ failure.

So saying 80 percent of all cases are mild doesn’t mean what we thought.

I’m Canadian. This is the Wayne Gretzky of viruses — people didn’t think it was big enough or fast enough to have the impact it does.

the virus does not cause pneumonia in the majority of cases. A pneumonia is an infection of the lower respiratory tract (which is a quite serious condition leading to significant symptoms).

In the majority of patients this virus causes an infection of the upper respiratory tract, which causes symptoms comparable to a common cold.

The virus infects the cells through ACE2 receptors, which are highly expressed in some lung cells but not the upper respiratory tract. High fever and dry cough are the most common symptoms while runny nose is rare. So no the symptoms are not comparable to a common cold.

I don't know that you are wrong, but Toni Fauci seems to say otherwise (around 2:50 in this video): https://www.nbcnews.com/video/dr-fauci-explains-how-coronavi...

The majority of cases do not have pneumonia. They have a dry cough and fever. In a minority of cases this develops into pneumonia.

The part about the upper respiratory tract is wrong though, cold-like symptoms are not a normal feature of COVID-19.

Could you provide a source for the 15% statistic (that need oxygen assistance)?

Also, is it not possible to provide this oxygen assistance/therapy at home without hospital intervention?

Reply on news.ycombinator.com