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Comment by easytiger | Hacker News Reader

The WHO predicted that 150 million people would be killed by avian flu

https://www.google.com/amp/s/amp.theguardian.com/world/2005/...

Using the same logic that had lead to the severe predictions for cv19.

For swine flu they promoted and stood by a CFR of 60%. Again turned out to be nonsense; nonsense known at the time to others

https://jech.bmj.com/content/62/6/555.abstract

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When it comes to these estimates, the WHO seem to be really bad at their job.

But the reality now is that no matter what the estimated CFR is, Covid-19 guarantees that without containment there will be significantly more people in need of hospital care than there will be beds and support staff. And that will affect the final mortality rate, and push it higher than a normal flu season.

> and push it higher than a normal flu season.

last major flu season in Italy killed 24k people. We didn't immolate the global economy as a result

Why didn’t the hospital system collapse because of the flu?

It is because of the consequences of covid-19 on the lungs of some people, which needs intensive care and specialized equipment to cure them, that is rare (ventilators etc.).

People are conditioned by experience to not present to hospital with mild respiratory symptoms. As they get older it gets more common and you still apply the same rules. Often too late by then to do anything other than ventilate.

People forget that ventilator means not only the machine itself, but you also need couple of doctors - anesthesiologist in the least and nurses that have to keep watch. Person on the ventilator needs to be partly paralyzed to not interfere with the machine. I do not know how many staff on average is needed per patient but it is a significant number.

Also the length of time that people stay on it, with covid-19 it seems to be 2-3 week so bed and staff turnover is slow, which meant you need many more people that are available.

ICU "bed" is a virtual term, it not only means the physical availability of ventilator, but also staff.

Just a nitpick but a regular ventilator doctor that isn’t necessarily qualified to administer anesthesia is a Pulmonary specialist. They are generally the doctors prescribing the ventilation therapy. Below them are Respiratory Therapists who have a core of general knowledge and training for ventilation therapy. The RT is the person who administers the therapy and manages the equipment in the day to day. You don’t need to have run anesthesia ventilators to run regular ventilators. Anesthesia delivery is generally considered a different animal.

Based on the CDC's numbers for the US[1], less than 2% of seasonal flu cases require hospitalization at all. This disease is at about 20% (based on detected infections). Even if 75% of infections are really undetected and asymptomatic, we're still looking at about 3 times the number of hospitalizations as seasonal flu.

[1] https://www.cdc.gov/flu/about/burden/preliminary-in-season-e...

This doesn't make sense.

The flu figures are statistically derived. The cv2 figure is derived from literally actual test cases only, which represent a tiny tiny tiny subset.

They cannot surely be compared, unless I'm missing something

Because the health care system is built with those estimates in mind.

It's the same with electricity infrastructure on climatologically hot days. The infrastructure is only built to handle a certain normal peak load. COVID-19 like a heat wave, is abnormal.

And COVID-19 is on track to kill way more than that in less time. So what's your point?

If we wait for new pandemics to kill more people than the flu to take them seriously, then it's too late to act.

At this rate in Italy alone it will kill more than 100k people. And the rate is increasing.

It won't

https://twitter.com/jeremycyoung/status/1239975682643357696?...

The rate is decreasing, not increasing

Note enough data to say that, the past 3 days were all twice as high as the 3 days before that, and those days looked like it was decreasing.

How would you accurately attribute that to the risk of the disease being overestimated, rather than the measures taken being effective?

Because it's becoming obvious the disease is vastly more widespread and far further ahead than the official numbers based on death rate/testing data show.

Death is usually around 20 days after first symptoms

Overestimates of the severity of the threat have much less harmful consequences than underestimates. For a start, actual casualty statistics are not independent from mitigation actions taken.

> Overestimates of the severity of the threat have much less harmful consequences than underestimates.

We didn't take the estimates for SARS and h1n1 as "seriously" as now, and they are just as if not worse than this.And look what happened.

I think Asian countries took the estimates pretty seriously. I think both would have been worse if they didn't, especially SARS.

SARS was more lethal and more infectious than COVID-19. It was however easier to contain because there wasn't much asymptomatic transmission, and the incubation period was short. Those two things are what makes COVID-19 more dangerous in practice.

Definitely agree, but at a certain point, WHO is going to be seen as crying wolf. They've already taken a large credibility hit in this crisis. They can't afford to ignore their perception in the age of populism and social media.

Don't underestimate the number of people whose lives will ultimately be shortened by the economic harm being done in panic over the virus.

The thing is, there's what happens if you don't contain something and what happens when you do.

Humans are a monoculture across the planet at this point. In many ways it's surprising that there aren't more pandemics.

The estimates in that first article seem oddly cavalier:

> “Around 40 million people died in 1918 Spanish flu outbreak," said Prof [of mathematical biology at ICL] Ferguson. "There are six times more people on the planet now so you could scale it up to around 200 million people probably."

As of 2014 the number of deaths is <500, although the Wikipedia article [1] is written as if bird flu is something that may yet turn much worse.

[1] https://en.m.wikipedia.org/wiki/Influenza_A_virus_subtype_H5...

Both links are for H5N1 avian flu

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