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Comment by sciinfo | Hacker News Reader

Most severe cases require trained medical staff. Since ~20% of infections requires hospitalization, no healthcare system is prepared for an exponential rise in SARS-CoV-2 infections.

Most fatalities are from pneumonia. Lots of details are available all over. You may want to read up.

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The numbers out of Korea are nowhere near 20%. About 0.9% of cases are considered severe, according to the most recent statements from the KCDC:

https://m.yna.co.kr/view/AKR20200307046000017?fbclid=IwAR0tl...

Someone is exaggerating, or something is fundamentally inadequate about the Italian response.

> The numbers out of Korea are nowhere near 20%. About 0.8% of cases are considered severe.

0.7% have died, and even that's gone up in the last few days as more cases progress. I don't know the specific stats of how many were severe/critical but it's probably much higher than the mortality rate. If you take a look at the age breakdown of the infected it seems they've been good about keeping it away from the elderly, <2000 out of 7000+ cases have been 60+ years old: https://en.wikipedia.org/wiki/2020_coronavirus_outbreak_in_S...

There’s a link, right there in my post, with more recent and relevant data than you’re citing, and it is directly from the Korean health services: 59 / 6767 confirmed cases were severe or critical in Korea at the time of the report. That’s a rate of 0.89%

The error bars on that estimate certainly encompass 1-2%, but they don’t span to 20%. Either Korea is doing something fundamentally different, or the 20% number is wrong.

I strongly suspect that OP simply took the “80% of cases are minor” stat, subtracted from 100%, and concluded that 20% are therefore hospitalized. This method is wrong.

Google translate says:

> "23 people in severe stage and 36 people in serious stage".

Which is a current snapshot, not a total of the cases that have been severe/serious. It seems like they've done pretty well at keeping it away from the elderely where the fatality rate increases dramatically: https://en.wikipedia.org/wiki/2020_coronavirus_outbreak_in_S...

The numbers part is where people are confused. Becase the baseline is scetchy, depends on testing (so you risk measruing your tsting at least as much as the spreading itself) and moving. Add to that a methodology that requires a lot of domain knowledge to properly understand these numbers, and this reaction is kind of expected. Which is basically the only point I have to call the WHO, CDC and other, similar bodies out on. Explain what you are doing, why and how these things work! Especially the numbers part, I have the impression most of the panic comes from not understanding the nmbers and less the disease itself. Then people toy around with incomplete sets of these figures, usually out of date as well, and come up with stuff like 20%.

South Korea has been administering way more tests than anyone else: https://www.worldometers.info/coronavirus/covid-19-testing/

There is plenty of evidence that many cases are asymptomatic or mild which means the true infection numbers for most countries are likely understated. So the true number of infected individuals in Italy is likely much higher than the reported number of cases.

The other thing to consider, is that with more comprehensive testing, quarantines become more targeted and effective. So South Korea might be having better success in keeping the virus away from at risk populations.

>South Korea has been administering way more tests than anyone else

Also, the last time I checked, something like 75% of patients were part of the Shinjonji "religion" whose members skew very young demographically.

98% of cases in S Korea are classified as "no outcome" at this stage - that is, it's too early to make a call. It takes 11 days on average for the disease to get really severe, so we won't see the deaths for a while. With exponential growth the pct will consistently under report the severity.

Note also that S Korea has 3x the beds of the US, and covid-19 requires very high hospitalization rates and oxygen for weeks.

Tldr: don't expect US or Europe final stats to look anything like S Korea"s current stats.

Lots more detail, and responses to common misunderstandings, here: https://www.fast.ai/2020/03/09/coronavirus/

SK have tested 5 times more people than anywhere else so are picking up more mild cases that other countries are not detecting. So I'm hoping the SK numbers are closer to 'real'

The SK death rate of 0.7% assumes that all 98% of the cases with outcome currently classified as "unknown" will recover. That isn't rational! You need to do proper survival analysis to account for the growth in cases.

Here's a brief analysis of the current numbers from SK: https://twitter.com/jeremyphoward/status/1237324005108924417

I think the real takeaway is from all this is that death rate is a pointless metric. It is highly dependent on the local demographics, it requires precise information which is rarely available, it is biased by the level of care available, it has numerous ways to estimate it all of which are hard to explain and not actual estimates but upper or lower bounds, it tends to naturally decrease over time, etc.

The death rate is lower in China than Italy, but the death rate is lower within each age group in Italy vs China. Most people are too innumerate to understand this statement.

As an aside, I REALLY hate how this guy on twitter says “it could be 5.0%, look at this spreadsheet that assumes 5.0%!” Then refers to a paper as a good analysis which claims 1.6% and a set of facts which differ greatly from all of his assumptions.

My point is that medical staff are trained to respond to many things. Training newbies to respond to one thing would probably be easy and fast. Especially if most people just need fluids, oxygen, and aspirin. Burning out doctors to maximize survival rates up front is... bad

If all you needed is something that a person with no training could handle they’d send you home and have a family member care for you.

well it’s a good thing I didn’t suggest that

Aspirin isn't an effective treatment.

what is the treatment then?

Same treatments as usual for pneumonia, acute respiratory distress syndrome, and sepsis.

It isn’t that easy to train someone to handle medical emergencies. They don’t typically fall into the same “path”.

As well there’s a technical skill component that takes a while to master due to variations in person-to-person anatomy. Took me about 8-10 real live intubations in life or death emergency situations (not training where I had all the time in the world) to feel comfortable enough to be unsupervised.

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