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Comment by mikekij | Hacker News Reader

Tl;dr: It looks like ~4.2% of Los Angeles residents may have already been affected.

Current stats from [https://covid-19.direct/county/CA/Los%20Angeles]: Confirmed cases: 12,349 Deaths: 601 Population: 4M Implied fatality rate: 4.87%

If this study is correct (~4.2% prevalence): Cases: 167,580 Deaths: 601 Implied fatality rate: 0.36%

There is massive difference between the appropriate response to an illness with a 5% fatality rate and an illness with a 0.36% fatality rate.

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Certainly, but I don't think anyone was assuming 5% fatality rate. There were concerns about it being 1-3% fatality, but even those would be worst cases.

Worth noting that .36 is roughly 3x as deadly as the flu.

3x as deadly as the flu, in a population of people who have already been exposed to the flu (and some even taking flu vaccines constantly).

The evidence will continue to build that this virus is pretty benign compared to all of the fear mongering has been suggesting. Of course, HN downvoted me when I suggested this last time https://news.ycombinator.com/item?id=22685457

I don't know how you can say that when hospitals have already hit the breaking point. It's not like our health care professionals have been sitting around twiddling their thumbs.

Only a few hospitals in the very worst hotspots have hit the breaking point. I don't mean to say that we could have or should have done nothing, but the idea that there's been some widespread breakdown in medical care is just not accurate.

That's not what you'd believe if you watched cable news ;)

How can you interpret many countries across the globe facing hospital and ICU bed shortages and not call that widespread?

I'd definitely call it widespread. In many places across the world, hospitals faced bed and ICU shortages and had to go to heroic efforts to prevent them. But most of them were successful, remediating their shortages before anyone had to be denied care.

A shortage means a denial of care took place.

Sure, that's a reasonable definition, in which case it's untrue that more than a handful of places around the world have had a shortage.

Wrong. They were more successful if they had proper supplies of masks, citizens cooperative with lockdowns, enough testing capacity, and so on. Otherwise, no, they were having triage when they normally would be able to treat everyone.

And many more hospitals were only 1-2 doubling periods away from faring as bad or worse. Doubling periods that were avoided because the surrounding regions took the actions they did.

Closer to 4x and only between 10M and 40M people in the US get the flu every year. Coronavirus could be >4x more deadly and have >10x more people infected.

Lets ballpark and say it's 3x more deadly and only 3x more people get it than the flu, 40M * 3x * .0003 == 36k deaths. However, we've blown past that many deaths already, and we have nowhere near 120M infected people so far, so the math just doesn't work. It's far more than 3x more deadly than the flu, or we have far more infections than we can account for in any study.

Also keep in mind that the death statistics have largely only counted people with positive tests who died in a hospital, so it's going to be strictly under counting.

New York, Italy and Wuhan are all the evidence you need. The virus is perfectly capable of overwhelming local health care systems, at which point shut downs are the only responsible option.

In high density areas or with a substantial older population, yes.

Sweden didn't shut down and their health system isn't at the point of any of those locations. [They have a lot of people dying though - so that's not to say not shutting down is a good idea].

It's also pretty unclear from Seattle's trajectory pre-lockdown it was every going to be overwhelmed if it didn't shut down.

People should downvote confident assertions like this that lack supporting data, along with the dismissiveness that people are fearmongering.

There's a chance you're right, and people want this to be true, but when you're wrong you're very wrong and people die.

What is the relevance of people having immunity to the flu or taking flu vaccines?

Of course there isn't any. Sure, it would matter if this were a buzzfeed listicle about "most dangerous viruses of all time". The flu might be higher in that list. But the actual question is "given this virus, which we don't have acquired immunity to, and don't have a vaccine for, how many people will it kill, and what are reasonable steps to lower that number"?

Just listened to an interview [1] with a doctor that claimed we probably over-estimate the risk associated with the seasonal flu.

[1]: https://reason.com/podcast/we-make-the-weather-why-voluntary...

You need to factor in that some of the currently infected are going to die.

I think your math is a bit off. From the paper 221,000 to 442,000 adults are believed to be infected. This makes the IFR ~0.13-0.27%. Source: http://www.publichealth.lacounty.gov/phcommon/public/media/m...

Note that the death counts we're measuring correspond to what happens when there is sufficient treatment / health care capacity. We have to assume it would be higher if hospitals were overwhelmed and patients who needed ICU beds were not given it.

The study is for Los Angeles County, not LA, so the population is 10m.

You'll want to keep in mind that the death rate spikes if the medical system is overwhelmed and there are medical shortages, which has not been the case in Los Angeles. There is plenty of examples globally and in NY that this virus is capable of overwhelming metropolitan areas.

A lot of this is besides the point because what matters is hospitalization rate, and we've already reached the point where some hospital systems are stressed. Beyond that point, people die that otherwise wouldn't. So I'm not sure there's a big difference in appropriate response.

we've already reached the point where some hospital systems are stressed.

Only NYC has gotten anywhere near their capacity, and even there (as far as I know) nobody has been denied care due to insufficient resources. Many hospitals in other areas are mostly empty and even cutting shifts, e.g. https://www.insidesources.com/unexpected-consequence-of-covi...

you don't take into consideration how contagious it is, it's not only important the percentage but the absolute number and also the time (due to resources constrains)

>> There is massive difference between the appropriate response to an illness with a 5% fatality rate and an illness with a 0.36% fatality rate.

Is there? What is the appropriate response to 0.36%? The flu has a mortality rate of 0.1%, which seems comparable, except we all have some immunity from having the flu multiple times in the past. Flu shots are available for vulnerable people. So while people on average have a 1 in 1000 chance of dying if they get the flu, they also only have a 1/40 to a 1/7 chance of getting the flu at all. The probability of getting corona virus appears to be much, much higher for people exposed to it, and we have no idea what the rate of infection could get to if we let it run free and behaved normally.

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