2009 flu pandemic in the United States
en.wikipedia.org
en.wikipedia.org
https://nymag.com/intelligencer/2020/03/cdcs-worst-case-coro...
Mortality rates for Covid19/SARS2 are estimated to be closer to 3.5% by the WHO, a 35x jump. At 214 million infected, the worst case scenario should be at least 7.5 million. But I believe the 3.5% estimate also assumes that hospitals are able to provide intensive care for all critical patients.
The US only has 100k ICU beds, and SARS2 has an ICU rate about 10%. SARS2 patients typically need 2-4 weeks, meaning that the entire US healthcare system can only handle about 2 million SARS2 infections per month. In order to keep a mortality rate of 3.5%, the US would need to spread out those 214 million infections over 9 years.
Conclusion: The CDC's worst case estimate of 1.7 million deaths is completely incongruent with their worst case estimate of 214 million infections.
"The case-fatality risks, when adjusted for a 13-day lag time from reporting to death, were 3.5% in China; 0.8% in China, excluding Hubei Province; 4.2% in the group of 82 countries, territories, and areas; and 0.6% for the cruise ship (Table). Our result for China, excluding Hubei Province, is similar to a previous estimate of 0.9% (95% CI 0.6% - 1.3%) by using a time-delay adjusted case-fatality risk for the same area"
This is the only research data I could find. Do have other data? I have multiple sources citing the WHO estimating 3.5%, but I was unable to find any first hand material from the WHO that said 3.5%.
The information above - from the CDC, which I consider to be biased and underplaying the situation - has 0.6% as the lowest number, and 4.2% as the highest number.
But honestly none of the data I just went digging through felt comfortable.
Another thing to remember is that the case-fatality-rates we are seeing in most areas are because the hospital infrastructure can keep up with the number of infections. If the US gets over 1 million infections, the hospitals will not be able to keep up and mortality rates will spike significantly.
Case numbers (and thus CFR as well) aren't comparable between countries, period. It's not as simple as "testing people" or "not testing people", each country has a different regime. Most countries won't test random asymptomatic people without a reason to do so. Heck, many countries won't even test symptomatic people unless there is a known link to a case.
https://youtu.be/VNqfElehhKc?t=1765 29:25
Obviously very uncertain numbers no matter who you ask.
* even in Germany you are (at least till very recently) only tested if you show symptoms AND have been in contact with an infected person or have been to a heavily hit region).
2) Why choose a number like 6% when it's currently at 3.8%?
3) Why are we experiencing so much more panic over this virus?
Italy's CFR is over 7%. They've implemented triage in Lombardy where they won't even consider someone over the age of 65, because they're out of beds and ventilators and want to ensure patients with the best chances for survival make it.
Amongst those with symptoms, this virus has an 80% hospitalization rate.
This virus is a test, and we're going to be found severely unprepared.
Give me a moment and I'll go dig up my citations.
Edit: I was wrong about the hospitalization rate. It appears to be 20% [1]
One source cites a CFR of 5% in Italy as of two days ago. [2]
[1] https://www.nbcnews.com/health/health-news/people-have-been-...
[2] https://www.livescience.com/why-italy-coronavirus-deaths-so-...
Or perhaps the 80% figure was patients within a certain age range.
I read that there is some triage but this seems a lot more extreme than I imagined.
3. Because it's much worse than the 2009 flu on almost every metric. If we treat them the same, there will be two orders of magnitude more deaths.
GP appears to be using 2% mortality rate
Corona has higher mortality rate in most age groups, including in young people. People who do need ICU stay there for weeks. Unknown number of people have reduced lung capacity after for long.
Now if we run out of hospital beds and we have to pick/choose who lives/dies including car wrecks, and other emergencies the deaths could double or triple.
Let's assume that the current coronavirus has an R0 of just 2 (estimates vary, most higher than this). Perhaps it is less, but for the sake of argument lets say it's 2.
1.6^10 = ~110
2^10 = 1024 (so ~9x higher)
That's with just 10 steps of transmission. So assuming the R0 of 2 is correct this will spread much faster.
Now consider that people do not seem to show symptoms until at least 5 days after they've been exposed (by some estimates, even longer, like 9+ days). Assuming they are contagious at least part of that time, they are unknowingly spreading this.
As others have mentioned add into it the fact that people who have been exposed to various flu viruses can have some immunity to new ones.
Ignoring all that, just look what's actually happening on the ground in Italy and China.
I'm shocked there are so many people treating covid-19 as if it's just the flu. Our medical system is going to be strained to the breaking point. It's a big fucking deal.
There's a dog park with booze just outside my window, and it's packed to the brim with hipsters day after day. None of them care. The bars are overflowing with the St. Patrick's Day crowd.
Insane.
Why are so many people nonchalant? Can't they imagine how this situation plays out?
Here is something I posted a week ago about the social landscape that still holds true unfortunately:
Twitter: oh shit
Instagram: what virus
Facebook: you’re overreacting
In person: toilet paper!!!!
I couldn't get my parents to get a flu vaccine, but now they are doing self quarantine and taking it.seriously.
As long as people are scared enough, they are relatively safe compared to other diseases.
1. It seems like people are severely underrating the flu and always have been. Remember when we closed all restaurants and bars and suspended all sports events when the flu killed an estimated 1 million people in 1968-1969? No you don’t because society seemed to have shrugged that one off. Ditto for many years when the flu kills upwards of 600k worldwide [1] 2. The reported CFR (Case Fatality Rates) across different countries is all over the place causing a lot of panic and overstated mortality rates. Countries like Italy report almost 7% whereas in Germany and South Korea, the CFR makes Covid-19 look like no big deal (Closer to 0.1%). I suspect that’s because Italy is well under counting the true denominator, while countries like SK have tested thousands of people per day making their data much more comprehensive.
There’s something unique about this year’s outbreak that seems to resonate deeply with more people. Ultimately it’s definitely not “just the flu” but it’s closer to that then a guaranteed death sentence.
We may see more damage from the secondary effects (people losing jobs, runs on medicine and supplies causing people to die) than from the virus itself.
[1] https://en.m.wikipedia.org/wiki/Influenza_A_virus_subtype_H3... [2] https://en.m.wikipedia.org/wiki/Template:2019%E2%80%9320_cor...
https://www.bloomberg.com/opinion/articles/2020-03-10/how-co...
For example: Why was H1N1 allowed to spread around the world more or less unchecked, while countries are going to far greater lengths to try to halt Covid-19? Why did the WHO call H1N1 a pandemic but not Covid-19? Isn’t 12,469 deaths a lot worse than the 26 that have been attributed to Covid-19 in the U.S. so far?
That last one is the simplest to answer: Covid-19 is near the beginning of its spread in the U.S., and thus cannot be compared with H1N1’s effect over a full year. If the U.S. death toll from Covid-19 is only 12,469 a year from now, that will likely be counted as a great success. The legitimate worry is that it could be many, many times higher, because Covid-19 is so much deadlier for those who get it than the 2009 H1N1 influenza was.
How much deadlier is still unknown, but of the cases reported to the WHO so far 3.4% have resulted in fatalities. That’s probably misleadingly high because there are so many unreported cases, and in South Korea, which has done the best job of keeping up with the spread of the virus through testing, the fatality rate so far is about 0.7%. But even that is 35 times worse than H1N1 in 2009 and 2010. Multiply 12,469 by 35 and you get 436,415 — which would amount to the biggest U.S. infectious-disease death toll since the 1918 flu. Hospitalization rates are also many times higher for Covid-19, meaning that if it spread as widely as H1N1 it would overwhelm the U.S. health-care system.
That’s one very important reason governments (and stock markets) around the world have reacted so much more strongly to Covid-19 than to the 2009 H1N1 pandemic. Another reason is somewhat more hope-inspiring. It’s that public health experts generally don’t think influenza can be controlled once it starts spreading, other than with a vaccine, whereas several Asian countries seem to have successfully turned back the coronavirus tide, for now at least.
Influenza can’t be controlled because as much as half the transmission of the disease occurs before symptoms appear. With Covid-19 that proportion seems to be lower, meaning that even though it’s more contagious than influenza once symptoms appear, it may be possible to control by testing widely and quickly isolating those who have the disease.
That’s the biggest unknown about the new coronavirus disease for me: how ill am I actually going to get? Flu seems so unpredictable.
It seems the reason for this is to downplay covid-19. As if that outcome is what the whole world is freaking out over.
If anything you should see those numbers and ask yourself. What if it were exponentially worse?
That is also under the assumption that hospitals will not overrun. Which they will.
Don't plan on having any injuries this year.
And currently a large part of the public thinks it is a regular flu. So showing them an example of something else that was scary that didn't amount to anything (compared to what we are risking now) is helping exactly how?
No one is disputing the higher death rates but somehow has this feeling that this won't be as bad as other flu incidents?
I felt this was a good reminder that what many fear is going to be true. That 60-70% of population is likely going to be infected. Because that is what happened in the past. It's not going to go away in a few weeks.
"See, told you, just a bad flu." would be the expected response.
Even a milder flu like in 2009 could reach 59 million and COVID-19 can be exponentially worse. That is really the only take away. We need to discuss this in the open to bring that truth to light. I agree with some of the folks here who said many could see it another way and take light view of the situation. What exactly can make them see it differently though?
If you are scared shitless and panicking - you should be. Protect yourself and your loved ones. Stay home.
It is precisely a variant of coronavirus flu. Why do you think otherwise?
Coronaviruses are in a family that typically causes what we call the common cold. Flu is caused by influenza virus, which is a completely separate family of viruses.
https://twitter.com/atomicanalyst/status/994696175575068672?...
“When the next pandemic occurs (and make no mistake, it will) and the federal government is unable to respond in a coordinated and effective fashion to protect the lives of US citizens and others, this decision by John Bolton and Donald Trump will be why.”
And he links to the following article.
The tweet is creepily prescient.
Fortunately, the CFR is considerably lower than in the previous pandemic, with 0.1-0.5% of cases resulting in death. 18,500 of these deaths were laboratory-confirmed, but estimates are as high as 151,700-575,400 globally.
50-80% of severe cases were found in people who had underlying conditions such as pregnancy, asthma, diabetes, and cardiovascular disorders.
Compared to swine flu, coronavirus:
- is less widespread - has caused fewer deaths - has a higher CFR - has a longer incubation period - affects young people less
https://about.futurelearn.com/blog/covid-19-how-does-coronav...