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Comment by vehementi | Hacker News Reader

A month? Wouldn't it be more like 1-2 weeks?

The problem we are going to have in the US is some states are responding better than others. NY looks bad right now because they are testing a lot. States like Florida, Louisiana and Georgia are already in double digit deaths each and don't have the positive cases to account for them. Going forward the rate of deaths will be far more indicative of what's happening than just the positive cases and that is going to continue to climb for at least 4 more weeks. Will we see a ban on interstate travel? What happens when one state gets the outbreak under control while another state's cases are still increasing? I'm extremely doubtful that any one state in the US will see a significant slowdown in cases in the next 4 weeks. No European country has yet...

Italy and Spain each had a record number of deaths today at 627 and 212 respectively. The next two weeks are going to be terrible in the US.

We get shocked when an airplane with 150-300 people falls: we spend months talking about it. Now we see multiple instances of these numbers daily: two airplanes in Italy, one in Spain, a small one in the US, but it still doesn't feel as terrifying as a real airplane crash to me.

I'm not saying I'm denying COVID or that the deaths are not horrible, just that for some unknown reason airplane crashes still seem so much more horrible: I'm talking about feelings, not facts. I don't know.

OTOH, thinking about the economic implications of this crisis prevents me from sleeping.

The one that bothers me is 9-11, how many trillions of dollars did the US spend after that on the Iraq and Afghanistan wars and the war against terror? We are likely to see several 9-11s worth of deaths in the US due to Covid-19, will we spend even a fraction of what we spent after 9-11 to be more prepared for the next pandemic?

Considering it’s been less than a month and there are already half trillion dollar plans to help Americans out being proposed, it seems like the answer is probably yes.

As you can see with WA, deaths is not a perfect metric either. Florida also has a lot of retirement homes and one getting hit will skew that metric a lot.

Yeah, I am very skeptical of extrapolation from deaths to get total cases. Just looking at China's numbers province by province reveals that the death rate varies quite a bit. Hubei has a very high mortality rate compared to the provinces surrounding it. Most provinces around Hubei had roughly 1 death per 1000 cases. But Henan, to the north had 22 deaths per thousand. There doesn't seem to be such a thing as a titular mortality rate for these viruses.

The virus progresses from infection to death in more like 3 weeks, depending on medical care. Any change in infections wouldn't be seen for about that time.

This is accurate. Also, most folks that do go to the Hospital with Covid-19 are staying much longer than people who have pneumonia. That means hospital beds that can't be recycled as quickly to get to the next wave of individuals.

This was apparent from the Chinese data, and sadly discounted by most Western countries.

Right - but it isn't completely clear yet.

From https://www.sciencedaily.com/releases/2020/03/200317175438.h... :

A new study calculates that the median incubation period for COVID-19 is just over 5 days and that 97.5% of people who develop symptoms will do so within 11.5 days of infection.

From https://de.wikipedia.org/wiki/COVID-19#Inkubationszeit :

...the incubation period can be up to 14 days. In addition, there are reports from Chinese researchers that extend the possible incubation period up to 24 days. An analysis of the first 425 cases reported in Wuhan shows an incubation period of 5.2 days on average and an average age of 59 years. ... A statistical analysis of several reports of infections in a household or in another narrow spatial limitation (so-called clusters) shows an incubation period of 5–6 days on average.

Anyway, as long as people don't keep distance between each other, the situation won't improve. Here in Switzerland the limit was shurunk within ~2 weeks from groups of people of max 1000 to 500 to 100 to 10 to 5 (today's new guidelines) => so far nothing improved.

The company I'm working for reacted early => many employees started staying at home (and working remotely) already 3 weeks ago, like myself => at the beginning it was ok for me, but now it's getting psychologically a bit "heavy". Luckily the government so far did not implement a total curfew, so from time to time we can still walk a bit in the parks/forests (but alone).

The progression to death is something like: (very rough, from memory)

Day 0: Infection

Day 5: First Symptoms

Day 11: Hospital admission/shortness of breath/oxygen

Day 14: Ventilator

Day 21: Death

If there's no ventilator on day 14, the process is tragically accelerated.

I wonder what percentage of people have been saved by ventilators vs. merely had their death delayed.

Mortality rate of people who get put on a ventilator is in the ballpark of 40%.

It appears 5-10% of people need ventilators, and "need a ventilator" basically means that you will die without one. So the difference between that 5-10% and the actual death rate of <1% should be your answer.

I guess it really comes down to whether or not someone actually needed it, which is a very difficult thing to determine.

Curious as well.

I find that in the US, we have an understandable but sometimes costly attachment to 'treat at all costs'.

I lost a family member to cancer last year - and was pushed by providers to pursue treatment that would have bankrupted me and my family, while adding (maybe) a few months of (low quality) life to someone already in pain and confined to a hospital bed.

I was made to feel callous about balancing the collective 80+ years of my family's life going forward, against the 80 days or less of an elderly relative.

If we can't break out of that mindset, then the coming coronavirus storm is going to provide some very painful choices on us, as it already has in other countries such as Italy.

I’m sorry to hear that but you are spot on. Some decisions require cold-blood and we can only hope we chose the lesser evil.

Here are some stats about Italy: https://public.flourish.studio/visualisation/1593946/embed (extracted from here: https://lab24.ilsole24ore.com/coronavirus/ )

("Morti giornalieri = daily deaths | "Terapia intensiva" = total amount of people in intensive care on that day)

As people who need a ventilator are in intensive care (but I admit that that includes as well people that have other types of complications who might not need/be using a ventilator), an idea of that can maybe be extrapolated by comparing that number vs. the number of deaths (daily? total?)?

Thinking more about it, another complication with these numbers is that there are probably already now not enough ventilators, therefore the deaths might include people that died because of the lack of a ventilator... .

China took about 18 days to get from from the number of cases the US currently has, to the peak of infected cases. But they had a pretty different approach to controlling it than the US did.

The numbers you see on dashboards have A LOT of lag from the moment of infection. There's incubation. There's "nah, this is just a regular cold". There's calling the doctor. There's looking for a test kit. There's processing the test. There's reporting. Then the numbers show up on the dash.

Plus, there will be a lag between the moment the order is issued and the moment you see material changes in patterns of social interaction.

It's definitely not 1 week, and even 2 seems a little sunny side up.

We'll see an acceleration of cases, due to accelerated testing. Additionally, there's a 2-3 week period between infection and death for the worst cases, so barring spectacular new treatments, even a reduction in cases will take a few weeks to impact the death rate.

There is also family to take into account. If you shut everything down today, you will see cases like this

1. X incubates for a week

2. X gets symptoms and infects spouse

3. X's spouse incubates for a week

4. X's spouse worsens for a few weeks

5. X's spouse dies

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