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Comment by jamesrcole | Hacker News Reader

CFR, whatever it is, isn’t the most significant detail. What is “terrifying” is its high contagiousness combined with its high hospitalisation and ICU rates.

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Yeah,and the high hospitalization and ICU rates become high case fatality rates once medical infrastructure is saturated, as well as increasing the case fatality rate for every other condition that creates a critical need for inpatient care.

That's where Italy definitely is, and where it seems Iran is evn moreso (though they are less public about it.)

What no one is talking about is how much social distancing/isolation is needed to avoid hospital saturation.

I ran the numbers for Canada, and it looks like we'd need isolation measures for 2+ years.

I don't see how that's a feasible solution long-term.

The numbers I ran for the UK put it at 12 years:

No. People in UK: ~66,000,000

Est. proportion of people who will get sick: 80%

Est. proportion of sick people who require intensive care: 5% (in Italy it's 10%)

So that's 60,000,0000.80.05 = 2,640,000

Number of ICU beds in the UK: ~4100 (90% occupied, but let's ignore that for now)

Length of time ICU required: at least 1 week (probably longer, but let's ignore that too)

So that's 2,640,000 / 4100 = 644 weeks or 12 years that we would need to spread the cases over in order to have enough capacity.

I did a similar calculation but came back more optimistically (although still on scale of a year to two).

You only need count over 18s as very few cases in this group. It is believed by the UK experts to have a lower fatality rate of 1% and likely lower admission rate due to asymptomatic infections (estimates at 16-75%). Ventilator capacity can increase with stopping surgery and CPAP/other measures can be used in some cases. Treatments developed later should improve efficiency of treatment. Extra ventilators should be manufactured and help ease burden. I think 80% is too high, likely more 60% given an R0 of 2-3. Finally, the chronically unwel elderly are unlikely to benefit from ITU care significantly and would never qualify. With these exceptions it gets down to 1-2 years depending on assumptions.

Around 18 months (until sufficient quantities of vaccine) is this group of experts’ estimate

https://www.imperial.ac.uk/media/imperial-college/medicine/s...

Around 18 months (until sufficient quantities of vaccine) is this group of experts’ estimate

https://www.imperial.ac.uk/media/imperial-college/medicine/s...

It's likely that we'll have a vaccine or at least some kind of treatment by the end of the year, so this should improve the prospects quite a bit.

So, wild speculation aside, what numbers did you use to base your model on, and what is your qualification to do anything like that?

I'd like to see more discussion around this point. I don't care where you got the numbers from. It's been clear from a glance that 3 weeks of cancelled school isn't going to do anything. So now we're looking at 8 weeks. Umm.... According to what? Which is more likely, 8 weeks or 2 years? I don't know, but I'm guessing 8 weeks isn't nearly long enough.

Around 18 months (until sufficient quantities of vaccine) is this group of experts’ estimate

https://www.imperial.ac.uk/media/imperial-college/medicine/s...

> What no one is talking about is how much social distancing/isolation is needed to avoid hospital saturation.

https://www.imperial.ac.uk/media/imperial-college/medicine/s...

People are talking about it, that talk is driving policy, and the answer is “with some local adjustments possible based on caseload, until there is an effective vaccine developed and deployed, which will probably be 18+ months”, and the alternative is a truly catastrophic number of fatalities.

Did you factor in an asymptomatic rate?

Around 18 months (until sufficient quantities of vaccine) is this group of experts’ estimate

https://www.imperial.ac.uk/media/imperial-college/medicine/s...

But, like CFR, we don’t know how high the rates are if we have no idea how many people have or had it.

Here’s a few first hand accounts of what the illness was like. These folks aren’t even that young and they describe it as being quite mild:

https://www.nbcnews.com/video/coronavirus-patient-from-diamo...

https://www.adn.com/opinions/national-opinions/2020/03/01/i-...

https://www.msn.com/en-us/news/us/don-t-panic-says-us-woman-...

"But, like CFR, we don’t know how high the rates are if we have no idea how many people have or had it."

While it's true that the hospitalization / ICU / mortality rates may be lower because we don't know the full number of cases, it still seems to be an immediate and acute problem.

Regardless of the rates, the absolute number of people being hospitalized in Italy was enough over overrun their healthcare system. The same situation looks to be on track in many European countries (Spain, France, UK).

So, the worst-case scenario may be less bad than predicted (let's certainly hope this is the case!), the number of case's we're identifying and having to deal with is still dangerously high.

> These folks aren’t even that young and they describe it as being quite mild...

Take that with a grain of salt. The people for whom it's not mild aren't going to be giving interviews.

It’s literally survivorship bias.

Whatever they are, they’re high enough to be causing major problems for hospital systems in places like Italy. They seem high enough that many countries desperately need to slow the spread of the virus or they will face dire consequences.

Anecdotes are not sufficient data

They are when there's little quantitative data to work with.

A lot of people's biggest questions are what the hell "COVID-19 symptoms" and apparently it means just about anything.

I'm suspicious of the 2 week long illness my family has just gotten over. Hit each of us differently. Predominantly nasal mucus, but the kids had some chest congestion, wife had a fever, and I had what felt like a sinus infection and a bit of a dry cough.

None of it particularly severe. Likely not COVID-19, but given the scattershot presentation of the disease in non-critical cases, I'm not ruling it out.

No, the symptoms are pretty clear:

Fever, dry cough, fatigue, sputum production, shortness of breath (dyspnoe), muscle/joint pain.

https://ourworldindata.org/coronavirus#the-symptoms-of-covid...

We don’t have sufficient data because we are, in our infinite wisdom, not testing every person with a pulse. Or at least testing from as random of a population subset as we can manage. At least in the US. Other countries mileage may vary.

But even then it is my understanding that there currently is no way to test if you already had it.

Technically, the hospitalization rates and ICU rates would also be greatly overestimated due to the number of unidentified asymptomatic cases.

But from a perspective of absolute numbers of patients hospitalized and admitted to ICU, your point stands.

Those high rates are also dependant upon the fraction of cases detected.

We are currently seeing about a 9% hospitalization rate based on detected cases.

If we are really missing 75% of cases, then true hospitalization is only about 2.3%

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