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Comment by JPKab | Hacker News Reader

It needs to be emphasized here:

This virus is much more transmissible than the viruses we usually deal with in humans.

If a virus has a low fatality rate, but is extremely contagious and prevalent, hospitals will get overwhelmed. A small percentage of a big enough number is itself a big number.

The subway and high-utilization of buses are likely factors in NYC vs. LA. LA is much more representative of the typical US city.

Frankly, I'm not sure why so many on HN are surprised by this. The scientific data on asymptomatic carriers coming out of Italy, Germany, South Korea, and Iceland has been very clear on a majority asymptomatic frame for this virus. I think that maybe authorities and responsible people are concerned that this information could lead to people flouting lockdowns more.

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I mean NYC publishes the number of positive tests each day and it’s dropped from 60% to 30%. So majority of people proactively getting a test because they are symptomatic are showing up negative. Hard to believe a very high percentage of all people have had Covid, then. https://twitter.com/natesilver538/status/1252317247785271297...

Isn't that the virus test, not the anti-body test? Maybe a fairly low percentage have the virus but a high percentage have been exposed and have the anti-body.

The optimistic take on this is: that means soon enough will be exposed that their immunity will stop the spread.

The pessimistic take on this is: we also don't have strong evidence that the previously exposed are immune, ie, have a strong enough immune response to stop the virus.

Those 30% numbers are still very high, the similar rate in Italy has dropped bellow 10% for 2 weeks now (it's the line-chart on this page [1] bellow "Tamponi giornalieri e contagiati"), with the latest week's figures somewhere between 5% and 7%.

[1] https://lab24.ilsole24ore.com/coronavirus/

Norway's number of positive tests was 5% at the current peak of the epidemic, for reference. Testing and isolation measures have been very effective here, so we have not had an overwhelming wave of infections (yet, knock on wood).

You are conflating a test for active virus versus an antibody test. my suspicion is that a very large percentage of people in certain neighborhoods of New York City are going to show up having been exposed and never presented symptoms. I just don't compute how else you can explain this with a virus that is so transmissible. we should also keep in mind that the number of deaths isn't necessarily indicative by itself of number of infections since deaths can be caused by hospitals being overrun.

This only tells if you are sick not if you were sick

Already 0.1% of NYC's population has died from COVID-19 - 10k deaths of 8.54 million people. That's... quite a bit higher than LA's current 576 of 10 million.

So either everyone in New York City was infected, or most probably 200-400k infected in LA is an order of magnitude of wishful thinking (e.g. ~2% false positive test rate.)

There's the theory of Vitamin-D deficiency. It would make some sense given NYC's climate and time of year. In LA, people likely are exposed to the sun year round. It would be interesting to see if other respiratory illnesses exhibit a similar pattern between these two cities, as I understand Vitamin-D levels have an affect those as well.

But also, NYC is considerably more dense, so diseases spread far more rapidly. Especially so considering heavy public transit use versus, what I would say is, extreme overuse of personal vehicles.

Another option: A bunch of people will die in a few weeks.

So like the fact that most of NYC, like most of Italy, and Spain is infected because they are a more dense city than LA is lying about the data because this is backed up by data in other countries like Korea, Germany and everywhere else with similar data.

Could some of the discrepancy in regional death rates be explained by a mutation in the virus?

Honestly, it seems more likely that California's much maligned car culture has served us well in this case - ensuring many of us maintain social distance which is impossible on NYC's subway and bus system. All the positive press about governor Cuomo's leadership and handling of the crisis seems a little weird given his failure to shut-down the subways (or at least curtail a but the absolutely most urgent ridership).

> Honestly, it seems more likely that California's much maligned car culture has served us well in this case - ensuring many of us maintain social distance which is impossible on NYC's subway and bus system.

California local and state government being ahead of NY in issuing shelter-in-place orders even though NY was being harder hit even before the divergent response also makes a difference. But, yeah, the hyperdensity of the NYC metro area is a big factor.

It could.

Previous studies suggested that the strain circulating in NYC is of European origin, whereas the California strain, arriving earlier, was of Asian origin.

It's always possible that the NYC one is more fatal. We don't have data, but it is possible.

Thing is, though, at the peak, NYC was seeing a 60% positive rate on tests and is still seeing something near 30%. That pretty much guaranteed that the vast, vast majority of NY cases were not detected, and still probably are not.

(Italy is back around 5-6% again, for example)

It must be the case that a dramatic percentage of NYC is infected. Certainly not more than 100% as some oversimplified maths suggest, and likely not 80%+ that would be very comforting -- but quite likely between 30% and 45%, given the Stanford and LA studies, and the NYC testing data.

Not from, with. Also, gov’t pays a hospital out $70k for every covid death.

This "with, not from" stuff collapses when you look at 5 year averages.

EG this from UK https://twitter.com/ONS/status/1252518098047041536

Seems so obvious that this was the flu but far more contagious from the beginning because of the lack of herd immunity and vaccines. We are just getting verification.

"so obvious".

I love it when people have strong opinions about a complex, constantly changing piece of difficult science.

It's not opinion is the logical conclusion from literally every random sampling study. Pretty much consistently 50x as many people have been infected that we thought. And if we made the current strategy with limited data why aren't we updating what we are doing with more data.

Even the Diamond Princess showed a 50+% asymptomatic rate and that group skewed way, way older than average -- you know, people who take cruises.

50? Just initially, but in a week or two more of these developed symptoms, so more recent number was just 18%:

https://www.cebm.net/covid-19/covid-19-what-proportion-are-a...

"Setting: Diamond Princess cruise ship, Yokohama, Japan (n=-634 tested positive).

Proportion: 18%"

Also:

"23 Residents of a Long-Term Care Nursing Facility King County, Washington

10 (43%) had symptoms, and 13 (57%) were asymptomatic."

But then:

"Seven days after testing, 10 of 13 asymptomatics developed symptoms"

That means that just 3 of 23 remained asymptomatic there too, i.e. 13%.

It is estimated that the people mostly spread this virus exactly in the phase where they still haven't developed symptoms, and the virus can be detected. But that doesn't mean they will remain without the symptoms.

Thanks, I actually didn't realize the number drifted so much over time. Good to know! I'm curious how many of them were actually seriously afflicted vs. a stuffy nose. I'd argue almost 20% actually asymptomatic is still huge in context.

Especially as we know the disease affects these demographics up to 100X more than the young.

For instance consider: "Emerging evidence suggests many more people are infected than tested. In Vo Italy, at the time the first symptomatic case was diagnosed, about 3%, had already been infected – most were completely asymptomatic." [1]

[1] https://www.cebm.net/covid-19/global-covid-19-case-fatality-...

> a stuffy nose.

Not a covid-19 symptom.

EDIT: I'm wrong, sorry. Thank you to kgwgk for the correction.

https://www.who.int/news-room/q-a-detail/q-a-coronaviruses

The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some patients may have aches and pains, NASAL CONGESTION, runny nose, sore throat or diarrhea.

I suspect most people notice a bit of a cold or "allergies"

Like you said, probably only 10% to 15% truly asymptomatic.

there's a really big pro-density crowd online which is working hard to undermine this argument in order to satisfy its agenda.

>Frankly, I'm not sure why so many on HN are surprised by this. The scientific data on asymptomatic carriers coming out of Italy, Germany, South Korea, and Iceland has been very clear on a majority asymptomatic frame for this virus. I think that maybe authorities and responsible people are concerned that this information could lead to people flouting lockdowns more.

Because people on here panicked without thinking and don't want to admit it.

No one wants to say "Oh yeah, I ignored second year calculus and never bothered plotting logistic growth curves with the full spread of expected fatalities. Because of this I supported legislation that's started the next Great Depression. But I meant well!"

We don't know that the fatality rate is off, we just suspect and hope it. Measurements of this kind are how we'll find out.

Are you claiming that everything is normal and would benefit from a complete reopen? Are you also claiming that the economy is in otherwise healthy shape regardless of the interest rate levels and global buyback programs that have been ongoing prior to the outbreak?

A complete reopen, no - crowded stadiums and amusement parks probably shouldn't happen. Things would never have been normal right now, and there's no silver bullet to make them normal again.

I can't speak for the original commenter, but I think the evidence increasingly suggests that we would benefit from allowing people to visit small groups of friends and run non-essential businesses.

It's rough because it's simultaneously very mild in the vast majority of people, but a horrific, suffocating death in a tiny minority, and highly contagious.

I don't know if there is a "right" policy answer on what to do with something like that.

As someone else said, the lockdowns are probably illegal, you can't just throw away freedom of association over the flu. But if we didn't have them, we might have seen another 100k dead..

". . . the lockdowns are probably illegal, you can't just throw away freedom of association over the flu."

Where did you study constutional law? Rights granted in the constitution are subject to many restrictions. There is no explicit "freedom of association" in the Constitution, although it has been held to be implicit in freedom of speech. Free speech doctrine includes a "time, place, and manner" test that's applied to restrictions on speech when the government has a "significant interest" in the restriction[1] (e.g., national emergency for a viral pandemic). I don't know how the lockdowns (which are mostly not full lockdowns) would fare if Supreme Court were to apply the time, place, manner test, but I wouldn't presume to offer an offhand opinion that they're "probably illegal".

[1] https://en.wikipedia.org/wiki/Freedom_of_speech_in_the_Unite...

Not op. I am not a lawyer and I’ve not studied constitutional law. What I recall from high school is that anything not expressly stated as illegal is legal for citizens and any power not expressly given to a state or federal government is unavailable to them.

A law has to exist that gives states and the federal government the ability to do what they are doing and that law needs to not violate special protections built into the Bill of Rights.

With a state of emergency declared, some things can temporarily be enacted that under normal circumstances would not be legal.

I don’t know if all the lock down rules are legal, but I wouldn’t be surprised to find out that governments have overstepped their bounds.

You may be remembering something, but you seem to be remembering it almost exactly backwards. It sounds like you are remembering something about the 10th Amendment, which reserves to the states any power that is not granted to the federal government in the constitution: https://en.wikipedia.org/wiki/Tenth_Amendment_to_the_United_...

What part is backwards? I'll state what I did in reverse (ie, what I believe to be incorrect)

A) Everything is illegal for a citizen unless granted as legal by a state or federal govt.

B) The fed govt. can do anything it wants. The only things it cannot do are things that are expressly forbidden.

C) A state can do anything it wants unless a law prevents it.

D) A state of emergency does not expand the powers of the the state or fed govt.

Those are the reverse of what I said I remember and none of those sound right.

(for C/D, ignoring the supremacy clause)

It is C that is pretty close to true. Laws don't give states their powers. It is in fact the states that make their own laws, subject to some restrictions from the U.S. Constitution.

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