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Comment by patrec | Hacker News Reader

Death of thousands or more???

You are living in some pleasant fantasy!

Back in reality, the UK wants to infect about a cool 40M people (for the herd immunity!). Last I heard they expect 50% (20M) to get it in a 3 week interval. Meanwhile they have about 4k ICU beds, which are at close to capacity already. Assuming cocooning works so great that only 3% of people need urgent care (rather than a more likely 5-10%) and only for one week on average (again, unlikely!), that's 200k people for 4k beds for a period of 3 weeks. Surely the fatality rate for those 3% is going to be way over 60%. At which point you have close to half a million dead in those 3 weeks alone.

I'd like to see numbers for a realistic scenario where this strategy does not result in something in the millions of deaths.

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I guess we'll see, won't we. I mean for all the panic about Wuhan, fewer than 3.2K people died there so far, and when it all winds down, the death toll will likely be below 5K people. Probably fewer than died of flu complications in the same time frame. Given that the vast majority of the cases are not acute, probably most of their metro population was exposed to the virus, which is tens of millions of people.

I know that extreme measures were taken to stop the spread (and such actions are infeasible in the West), but they did contain it: there are very few new cases or deaths.

So no, there won't be "millions of deaths" or anything close to that, especially if older people are isolated.

I think you kinda missed the part where the UK is trying very hard to infect the majority of the population and China is trying very hard to stop more infections from taking place. Successfully it seems.

> So no, there won't be "millions of deaths" or anything close to that

I showed you some simple arithmetic, based on official figures from the UK government. Can you come up with better numbers or point out an obvious flaw in my calculation?

There are no reliable estimates of overall fatality of the virus. Only the estimates of how many people _who required treatment_ have died, which the press deliberately misinterprets as the overall fatality rates most of the time, because higher numbers drive more clicks. Watch epidemiologists speak about this: they will go out of their way to point out that we don't know these percentages, and we won't know them for quite some time. Your "numbers" are bogus. You can easily see this if you look at the _initial_ estimates of H1N1, SARS and MERS. While COVID19 does appear to be deadlier, _nobody_ knows what the fatality rates will look like population-wide. Anyone who claims otherwise is full of shit. What we do know is that the numbers we currently have are the very uppermost bound of what's possible.

Nope, SARS and MERS are way deadlier than Covid-19, not just in initial estimates. South Korea tested hundreds of thousands of people and we have the Diamond Princess. That makes it unlikely that we are overestimating CFR by an order of magnitude due to uncounted mild cases. If you have someone reputable who thinks true CFR could be as low as 0.1%, please share! As far as I can tell no one believes it can be significantly below 1% for a country with similar demographics as the UK.

The reason why Covid-19 is scarier than SARS is precisely because it has a lower fatality rate, allowing it to spread instead of killing its host before they can spread it.

Not true. These estimates are of overall fatality based on number of people diagnoised. Not based on those who required intensive treatment. That means we have crude estimate on death rate for people showing some symptoms. Crude in a way not everyone in the pool is recovered, or dead for that matter, so it's not possible to be that accurate yet, but it will only be higher not lower.

Wouldn’t we only have a crude estimate on the death rate for people diagnosed with the virus? If we find that many people are not getting tested for the virus and just recover by themselves, then it’s possible for the fatality rate to be lower.

Well, those asymptom case can also infect others. In all likeliness they will infect others, multiple others. So if epidemiological root trauce is done right, we would find those asymptom carrier.

This doesn't mean those cases are "asymptomatic". Most people who get the disease fare about as they would with a flu. I'd also venture to guess that most people do not go to the hospital unless things are really bad (e.g. they can't breathe on their own). Furthermore, because not everyone at the hospital gets tested, I'd also guess that there's a number of cases where deaths are misattributed to plain old flu, too, since it's the flu season still, and some of those who are dying "of coronavirus" would have died regardless.

Well. How is common flu any different? Most people don't get tested and they just recover, if any, a lot more don't. So seeing those two numbers on the same page should mean something, even if you doubt the accuracy based on the assumption a large quantity of people aren't tested.

Wuhan disagrees with your argument much more than it supports it. The Chinese response in Wuhan -- after the failure of the initial attempts to suppress any news of the virus -- were swift, draconian, and competent. They locked everything down, heavily restricted travel, erected 16 temporary hospitals (just for that region alone), and pumped a ton of medical supplies in to it.

So the argument that follows from that is, "these are the measures required to achieve fewer than 3200 deaths."

... Only when you enact it at 400 cases (January 23rd) for a city of 15m or region of 55m (couple days later).

Germany and France are at 4000 cases, so even draconian lock-down of the entire country might end up with 32.000 deaths each.

Which is something I explicitly pointed out. Shit like this isn't going to fly even in the UK, let alone in the US, so they seem to be acknowledging this simple fact and thinking of what they realistically can do in the absence of such "draconian" lockdown abilities. Which I think is smart. Especially if you consider that _any_ lockdown can't last for very long for economic reasons. A month or two at most, after which you start over. Lather, rinse, repeat, until you build up herd immunity.

Of course the death toll in Wuhan/China has been relatively limited BECAUSE they took drastic measures.

When people start to say "all this panic for that..." it means that the measures taken have worked, not that they were unnecessary.

Yup.

The best case scenario is that restrictions are introduced, and they work so well that people complain that they were unnecessary.

And remember folks, when it comes to exponential growth, the best time to act was yesterday.

The issue with that approach though is how do you effectively prevent reinfection of the region when all counter measures are suspended? Another carrier could reinfect the region again and all that previous work came to nothing.

It's never "nothing". For all we know (or don't), the virus might (or not) slow down spread during the warmer months in Europe and the US.

Perhaps it could be effective enough to have multiple 2-week lockdown periods (eg. separated by 2 or 4 weeks non-locked-down periods), just to slow down the spread so health care systems can keep up?

There is so many variables at play, and no simple model could come up with "the best" solution, if there ever is one.

By contact tracing, quarantine of people who are suspect, and social distancing.

Look at taiwan , singapore, hong kong, macau. You can totally slow it down to a reasonable number of new cases daily such that the hospitals can handle. Just don't start like wuhan, iran, italy...

Reverse Tinkerbell Effect

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