https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-d...
The worst flu season we saw in a decade killed (~80k / 300M) = .02% of the US population. NYC has seen ~14000 deaths, or .18% (~14k / ~8M) death rate for the entire population, and while the absolute worst may be over, people are still dying at a high rate in NYC.
The only way I can make sense of this is that you're somehow mixing figures relating to deaths in healthy populations (COVID) vs. overall death rates in flu (including older/unhealthy populations).
If people there stopped all preventative measures, yes it would get much worse than 3x.
On the other hand, there's one very specific way that considering NYC gives us data we can't (yet) get elsewhere. While it's possible that we're underestimating disease prevalence by 50x elsewhere, it's basically impossible in NYC (almost 2% of people already have tested positive, with less than 10% of the population being tested).
Depends on whether mortality rates can be variant on environmental conditions, such as viral load, population density, access to healthcare/ICUs, population socio-demographic profile, etc.
What I would still say is that it's reasonable to say "NYC has .18% of its population dead. It's extremely implausible that this disease is no more lethal than the flu is, when that's 10x the overall death rate from the flu. If you present me evidence suggesting that from elsewhere, it's going to have to be quite strong to overcome the evidence from NYC."
edit: it shouldn't be controversial to say that a thing that kills 30-80k per year with active measures of mitigation already something that would be more deadly without a vaccine. seriously reflect on that. the corona virus is something we need to take 100% seriously but also acknowledge that the flu is also very deadly... even more so without any mitigation (thankfully we have for the common flu)
The flu as-is causes 45,000,000 sicknesses every year in the US alone.
If we don't develop herd immunity ASAP, and instead pursue a course of lockdowns, as soon as we lift the lockdowns (either voluntarily or because people just walk out -- see the midwest), we'll immediately start playing rolling lockdown whack-a-mole as China is. The first contagious person who flies in from a foreign country (or domestically) without perfect lockdowns will re-ignite the wildfire.
We should do exactly what Sweden is doing and what the UK proposed: isolate and provide support services to those who are at risk, and let out those who aren't. I think it speaks volumes that Sweden's new infection rate stabilized at the same time as the rest of the world but without lockdowns.
It's really the only path forward. Is it perfect? Of course not. People will die. However, there's no world in which about 70% of the population won't get the disease before the vaccine arrives, so we need to control who gets it, when, and in what order, to minimize harm.
While I agree mostly with your assessment, it's worth mentioning that the lack of official lockdown in Sweden doesn't mean there isn't a lockdown. According to Google's mobility data for Sweden, their lockdown activity looks pretty similar to what we see in the US. People are voluntarily staying home.
Since Sweden doesn't have a lockdown, this statement is meaningless. A major objection to lockdowns is their involuntary nature. In general, there is a big difference between choosing to stay home, and being coerced (with the threat of force) to do so. One is "choosing to do what you believe is best", the other is "prison".
In the meantime, the coastal town that I live in is getting swarmed with out of town visitors every weekend. This is in violation of the shelter-in-place orders. Other towns have stepped up enforcement to combat this type of behavior, but our police department is small and does not have the resources. We shut down the parking lots, but now they just park in the neighborhoods. And to add insult to injury, we have a large senior housing complex at the entrance point to my neighborhood.
I have little faith that the US could achieve the type of distancing and isolation necessary on a voluntary basis. There is a sharp vein of individualism that runs through our society that works strongly against us in these types of situations.
It's by no means a "hope and pray it goes away" or a "lets wait it out until a vaccine" -- it's a "let's get everyone not in a risk category infected as fast as possible so long as the healthcare system retains some excess capacity."
> healthcare facilities remain un-saturated
You can't simply look at the current burden on the health care system to guide the process. The virus has a 2-3 week lag time between when an infection cluster breaks out, and when the health care system starts to feel the impact. Without wide scale testing, we are just going to end up back in a lock down once the infection numbers start climbing again. And I can't think of a worse scenario for our economy than having to shut things down every other month because our government is to incompetent to implement a tracing program that multiple countries already have up and running.
It's a creative interpretation of the facts.
One important note: it's impossible that NYC is overestimating cases by 100x. Close to 2% of NYC has confirmed cases.
This has included a couple lf suicides of folks who had respiratory illness prior to death, and one person who got in an auto accident and died of head trauma -- but he had tested COVID-positive.
Yes, most people right now who get a respiratory illness and then die probably did have COVID -- and it is possible that some folks are dying of COVID and being uncounted to offset some of the overcounting -- but with death numbers counted so loosely, it is hard to know the real story, and impossible to do simple maths using rates from one place at one time to compute rates at other times or other places.
I tend to think that NYC must be approaching saturation, and that the true new-case numbers must be falling there, but it's impossible to answer with certainty using only the numbers we have here on the internets.
No, this isn't what's happening.
Doctors who are sure to the best of their knowledge and experience that the deceased had covid-19 will put covid-19 on the death certificate, and they will also say if they think it contributed to death.
That's not the same as "anyone who dies with covid-19 is being described as killed by covid-19".
In some countries they absolutely do count anyone who dies while in the possession of COVID as a COVID death, for instance Italy. " Italy’s death rate might also be higher because of how fatalities are recorded. In Italy, all those who die in hospitals with Coronavirus are included in the death counts."
“On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88% patients who have died have at least one pre-morbidity – many had two or three.” [1]
In New York they're counting speculative COVID deaths of anyone with respiratory illness even if they've never tested positive [2].
"A subtler issue is what to do when the patient has other serious medical conditions. If the person suffered from chronic lung disease, then became infected with the virus and died of pneumonia, the immediate or primary cause would be pneumonia as a result of COVID-19. The lung disease would be listed as a contributing condition, said Sally S. Aiken, president of the National Association of Medical Examiners." [3]
The CDC has guidance on this but it's fair to say its interpretation will vary from place to place. "COVID-19 should be reported on the death certificate for all decedents where the disease caused or is assumed to have caused or contributed to death" -- that's pretty broad. [4]
Sorry, Dan, this is looking like it's not the Ebola infection you're making it out to be.
[1] https://www.cebm.net/covid-19/global-covid-19-case-fatality-...
[2] https://www.cnbc.com/2020/04/15/coronavirus-new-york-city-st...
[3] https://www.inquirer.com/health/coronavirus/coronavirus-covi...
[4] https://www.cdc.gov/nchs/data/nvss/coronavirus/Alert-2-New-I...
The problem here is that you don't know what "COVID-19 should be reported on the death certificate for all decedents where the disease caused or is assumed to have caused or contributed to death" means.
Here's one for the UK: https://twitter.com/ONS/status/1252518098047041536
[1] https://fee.org/articles/sweden-s-top-epidemiologist-covid-1...
[2] https://aatishb.com/covidtrends/?location=Canada&location=Sw...
Absent the data from widespread testing, the spread of the disease was consistent with two epidemiological models -- low-contagion/high-mortality and high-contagion/low-mortality. In the latter model, there's not much to be done to stop the disease from infecting the population at large, and not that much that needs to be done, since the vast majority of people will emerge unscathed. But in the former model, it matters tremendously -- doing nothing will slowly but surely result in vast loss of life but quarantines can stop the disease dead in its tracks.
Therefore the most cautious course of action, from a public health perspective, was to assume the former and proceed with a regime of extreme social distancing. Unfortunately doing so had dire economic consequences.
- The way deaths are counted in each state
- Daily Temperature
- Comorbidity percentage difference for residents - https://covid19tracker.health.ny.gov/views/NYS-COVID19-Track...
it's been unseasonably cool in socal for the duration of this so i doubt it's that.
Sweden has about 23 active cases for each one recovered. The US is about 10:1, Europe overall is about 2:1, so is Italy, and Spain is close to 1:1. Asia as a whole is about 1:1.
[edit] I misread, disregard, but preserving for posterity.
Now, 11/100 blood givers in Stockholm who has not been sick in the last two weeks have antibodies according to researchers.
That gives you a naive mortality rate of 0,4% per infection, assuming the spread among bloodgivers is the same as the population in general and just dividing the death count by 11% of the population. It is a high eastimate as I guess many wont get traceable antobodies and mostly asymptotic people give blood.
[1] (Swedish) https://www.folkhalsomyndigheten.se/publicerat-material/publ...
So no.
Just because a majority of people do sensible things doesn't matter. The actions of the irresponsible and sociopathic minority still create the epidemic.
The coronavirus bans on public gathering are fairly clearly permissible under SCOTUS precedent.
No, it isn't. In the time period in which the Second Amendment was passed, privately owned warships of similar capability to the ones in national navies were common enough to play a pivotal role in two wars (the American Revolution and the War of 1812).
However, the colloquial use at the time of the phrase "arms" almost certainly referred to small arms, but would have included knives and swords (State v. Kessler 1980[1]) which are paradoxically much more heavily regulated than firearms in most states. See also "To Bear Arms"[2], by which the modifier "to bear" suggests arms that could be carried.
Perhaps one counter argument to this point was the desire by the framers to include a conscientious objector clause obviating military service for people who had specific objections, which may support the view that "arms" was anything in use by the military of the day, but the clause was stricken from the constitution for fear that the second amendment may be interpreted by later generations as a right that could not be enjoyed by the people and was intended to encompass military service.
There is also the argument that the framers opposed the idea of a standing army, which would support your viewpoint, and there is an excellent essay[3] that makes a fair and reasonable argument to this end.
My personal opinion is that this isn't clear, but it is obvious that--at a minimum--the interpretation of "to bear arms" would suggest that the 1986 ban is unconstitutional, as is the 1934 NFA tax act that required registration. I'm not convinced "to bear arms" includes other weapons that could not be "beared," such as warships, but perhaps this will clarify my thought process for you.
[1] https://law.justia.com/cases/oregon/supreme-court/1980/289-o...
[2] https://guncite.com/gc2ndmea.html
[3] https://tenthamendmentcenter.com/2016/06/30/what-does-the-wo...
Perhaps it did, but whether it did or not, I don't think its use in the Constitution can be reasonably described as "colloquial". Since no specific restrictions were set out by the framers, I think they intended a broad right, not one restricted to small arms. Of course my opinion is an extreme outlier given current jurisprudence on this topic, to say the least. :-)
> it is obvious that--at a minimum--the interpretation of "to bear arms" would suggest that the 1986 ban is unconstitutional, as is the 1934 NFA tax act that required registration.
I agree.
> I'm not convinced "to bear arms" includes other weapons that could not be "beared," such as warships
Currently that question is moot in a practical sense, since nobody appears to be in the market for privately owned warships. And I will cheerfully admit that if we could get to a point where it was generally accepted that people had a right to bear small arms, and the arguments were over other categories, I think that in itself would be huge progress from where we are today. If that happened, I wouldn't spend a lot of time complaining that everyone recognized my right to keep and bear an AR-15 but I was being given grief about wanting to buy an aircraft carrier or a nuclear submarine. :-)
"Arms" was used in colloquial speech and legal use at the time which converged on approximately the same definition. It's late, but there are some resources on guncite that support this argument. They're all worth reading beyond this reason, mind you, and there are plenty of arguments there that disagree with mine.
Either way, it makes for good reading should you find a topic there you're not already familiar with, and even if you are, there are some interesting twists. I don't necessarily agree with all of them.
> Of course my opinion is an extreme outlier given current jurisprudence on this topic, to say the least.
Suffice it to say that I understand where you're coming from, but in my definition a broad application of "military small arms" is probably more accurate according to my understanding of what was intended. The problem is that I don't know, nor will we ever know for certain, since the militia (rather, the people) were to act as the nascent US' standing army. I rather wish this point were discussed in civics classes, but it's not. So, the younger generations are woefully unaware of history, much to no one's surprise...
Anyway, while I also wish we could undo some of the impingement on our rights by legal challenges made in the 20th century, I'm afraid that would be an uphill battle (as you also allude) given how panicked the general public is on loosening firearms restrictions thanks in large part to the unnecessarily excessive coverage of mass shootings that seem focused primarily on stoking fear.
But, if you allowed me, I'd probably rant all night about this subject which wouldn't do either of us much good by the sounds of it, other than reaching continued agreement and probably upsetting other readers.
> since nobody appears to be in the market for privately owned warships
...admittedly a shame!
> I think that in itself would be huge progress from where we are today.
Agreed. Somewhat surprised to have this conversation on HN of all places, TBH.
> ...that everyone recognized my right to keep and bear an AR-15
I live in an open carry state and sometimes exercise that right, particularly since I live in an area sometimes subject to wild animals. But while I would love to do the same with an AR, I suspect that would probably get me called in to the local sheriff's office. Not that they would care, but I would be disappointed if someone thought it apropos to waste their time.
Biological and nuclear weapons should not fall in the scope of the 2nd amendment. They're useless for guaranteeing your liberties against a tyrannical government, and the consequences for storing them improperly are severe.
Depends on who's attacking and what might deter them.
> They're useless for guaranteeing your liberties against a tyrannical government
Which is only part of "the security of a free State", not all of it. The militia was also for repelling foreign invasions.
Given our current modern world, I would agree that weapons of mass destruction (nuclear, biological, and chemical) shouldn't be available to anyone who wants them; but the correct legal way to make that happen in the U.S. would be to amend the Constitution to explicitly add that exception to the Second Amendment. As the Second Amendment is currently written, it does not admit of any exceptions. As I noted in another comment upthread, privately owned warships were significant at the time the Second Amendment was passed, and the framers of the Amendment did not exempt them from the category of "arms".
The First Amendment very clearly binds only Congress in its literal reading: it begins "Congress shall make no law..." And there is no literal text in any subsequent amendment that might cause incorporation to the states--the Fourteenth Amendment only literally incorporates the Fifth Amendment, and that by literal repetition of the text.
That's a whole lot of people left out of your number. A quick google suggests that 1/3 of Americans have hypertension and 9% have diabetes. It seems like probably the majority of the US has at least one of these underlying illnesses.
And this report relies on figures that diverge dramatically from the COVID death tolls. It lists the current total report as around 15k, when we're close to 3x.
Here's some more data. What I'm saying (that it's approximately the same as the flu for the young, with some early evidence pointing to it being better) isn't particularly controversial and well supported by evidence [1] (also older, April 14th). CDC as of late March "... no ICU admissions or deaths were reported among persons aged ≤19 years. Similar to reports from other countries, this finding suggests that the risk for serious disease and death from COVID-19 is higher in older age groups." [2] In Italy nobody under 30 died, and only 5 people between 30 and 39, as of April 19th -- yes in spite of a CFR of what, 13.22%? [3, 4]
More data as of April 20th from Oxford [4]. Scroll through all the data the world has to offer, I'm not wrong on this. I repeat, the facts you're arguing with me over, without citing data to support your case are not controversial. Surprising maybe, but not controvercial.
Especially when you consider (an albeit bad flu): the overall case fatality rate as of 16 July 2009 (10 weeks after the first international alert) with pandemic H1N1 influenza varied from 0.1% to 5.1% depending on the country. [4] The flu can absolutely be very bad is the take away there. And yeah this is worse than the flu, by around 3X on both ends of that range. Not bad, not great.
> It lists the current total report as around 15k, when we're close to 3x.
They actually address that critique, that it takes a few weeks for case data to be finalized and reported upwards, so the CDC data can be up to a few weeks behind. It's not divergent, it's delayed. This is a live list updated and maintained by the CDC. Make of that what you will.
[1] https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-d...
[2] https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm
[3] https://www.bloomberg.com/news/articles/2020-03-18/99-of-tho...
[4] https://www.cebm.net/covid-19/global-covid-19-case-fatality-...
There are 400 covid-19 deaths reported so far in the 18-44 age group in NYC. There are 3.5 mn people in that age group in NYC. That's over 11 per 100'000.
The mortality per 100'000 for the 18-49 group in the US estimated by the CDC was in the last nine flu seasons: 1.8, 2, 1, 1.2, 0.7, 2.5, 1.5, 0.5, 3.9.
It's a stretch to say they are approximately the same and definitely 11 is not better than 0.5-3.9.
Not to mention, flu deaths are attenuated by flu shots, and pre-existing immunity. It's totally plausible that there are many more COVID cases than flu cases in that age group -- and of course those flu deaths will happen year after year while COVID is a very stable virus, and if you get it once, you probably won't get it again.
Certainly not enough data to conclude it's way out of line with the flu for this age group, in this season let alone if you factor in a few seasons end on end.
Lastly, with H1N1, the numbers are quite different, too.
The infection fatality rate for seasonal flu [edit: in the slightly older 18-49 group] is around 0.2% considering symptomatic cases, and probably there are as many asymptomatic cases which give 0.1%.
So yes, it's not impossible for the infection fatality rate to be similar. With some strong assumptions including that it's five times as contagious. So yes, it's not impossible for the acumulated lethality over five years to be similar. And if you extend the period the common flu will be much more dangerous, specially as this young people became older.
7 under 30 and 40 between 30 and 39. One order of magnitude more.
https://www.epicentro.iss.it/en/coronavirus/bollettino/Repor...
I wonder if you can back that up with a reference.
"The way in which we code deaths in our country is very generous in the sense that all the people who die in hospitals with the coronavirus are deemed to be dying of the coronavirus.
"On re-evaluation by the National Institute of Health, only 12 per cent of death certificates have shown a direct causality from coronavirus, while 88 per cent of patients who have died have at least one pre-morbidity – many had two or three," he says.
"Other experts have also expressed scepticism about the available data."
"Report from the Italian National Institute of Health: analysed 355 fatalities and found only three patients (0.8%) had no prior medical conditions. See Table 1 in the paper; (99% who died had one pre-existing health condition): 49% had three or more health conditions; 26% had two other ‘pathologies’, and 25% had one." [2]
(For what it's worth in my reply I called it out as "[4] from the parent post" which is [1] here -- sorry for the confusion -- all I meant was that the Italian data skews very high, both because it's the oldest region [Lombardy] in the oldest country in Europe [Italy] -- and because they were very generous in how they ascribed cause of death).
[1] https://www.cebm.net/covid-19/global-covid-19-case-fatality-...
[2] https://www.stuff.co.nz/national/health/coronavirus/12044372...
Actually the official number is grossly under-reporting COVID-19 deaths:
"We estimate that the number of COVID-19 deaths in Italy is 52,000 ± 2000 as of April 18 2020, more than a factor of 2 higher than the official number."
https://www.medrxiv.org/content/10.1101/2020.04.15.20067074v...
Less than 9000 COVID-19 deaths were reported in Lombardia by that time. If you think they are too generous classifying deaths as being caused by the infection, what would you say that caused the death of more than twice the usual number of people during the period?
So it seems like there should be no possible way to frame it as less severe than the flu, even only comparing to when the flu is at its worst and even assuming 100% of the population has covid or whatever other extreme things you want.
If we compare this with complete shutdown of all public activity on the other end of the spectrum, we can see there are things we could be doing that are on neither ends. Maybe distancing but not shutdown, or avoiding some mass gathering but still being ok with individual meetings, or having places like restaurants operating at reduced capacity to ensure people aren't too close to each other, or ask people to wear masks when they enter stores, etc. And strict lockdown for places like nursing homes, but more relaxed for places like college, or having people of high-risk groups to work from home, but people with lower risk be allowed to work in the office. I'm not saying it's the right way to do right now, but it's a possibility, there are options.
So if this is e.g. 50 times worse than the flu, then trying any of the above may be too risky. But if it's kinda sorta like the flu, maybe somewhat worse but not 50x worse - then it may be prudent to consider measured response, given that for the flu we basically have no response at all and we're ok with that.
None of us know for sure, but isn't it plausible on the face of it that something 10x worse that could easily become 100x or 1000x worse warrants the lockdowns? I don't know if this is common sense, but in an alternate universe it could be.
At about 10 weeks into the H1N1 influenza pandemic, we had a CFR of between 0.1 and 5.1% depending on the country as compared to 0.07 to 14.93% for COVID. H1N1 ended up with an actual IFR of 0.02% or one fifth of the low end of the CFR range.
Honestly, it's probably a maximum of three times as bad as H1N1, especially when you consider Italy later admitted of its 13.22% CFR, 88% of that number was "people who happened to die while COVID positive" instead of "likely died of COVID". [1] Huge deltas in CFR are likely attributable to mess-ups along the way and how COVID deaths are counted.
10X as bad is likely on the very highest end as Sweden hasn't locked down anyone, suggesting common sense instead, and their new case rate flattened out right alongside the rest of the world. 1000X is totally out of proportion with the data. [2]
I suppose we don't know for sure but we do have two and a half million data points which is enough to make a pretty good guess.
It's kinda starting us in the face that it's kinda like a bad flu except worse for old people, who we should lock down and look after as we build herd immunity.
[1] https://www.cebm.net/covid-19/global-covid-19-case-fatality-...
[2] https://aatishb.com/covidtrends/?location=Canada&location=Sw...
That seems impossible. CDC estimates 61k flu deaths in 2017-2018 and 34k in 2019-2020: https://www.cdc.gov/flu/about/burden/index.html
That is nowhere near 1.3k per day.
If we assume that COVID is spreading like wildfire (it is), and that we're front-loading the cases (we probably are), and that immunity will be built up as one-off instead of like having the disease mutate substantially every year like the flu, over a few years, it could easily be better.
I'm not saying it is or isn't, just that there is a path.