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Comment by snapetom | Hacker News Reader

As flawed as this is, it's in line with other studies around the world. You can nitpick and critique each one for something, but we now have a whole body of evidence using different techniques and different methods that are all stating the number of cases is vastly undercounted, and the IFR is under 1%.

Scotland: https://www.medrxiv.org/content/10.1101/2020.04.13.20060467v...

NYC Pregnant Women: https://www.nejm.org/doi/full/10.1056/NEJMc2009316?query=C19...

Finland: https://thl.fi/en/web/thlfi-en/-/number-of-people-with-coron...

Germany: https://www.land.nrw/sites/default/files/asset/document/zwis...

Chelsea, Mass.: https://www.bostonglobe.com/2020/04/17/business/nearly-third...

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There's a world of difference between an IFR of "under 1%" and a claimed IFR of 0.1%.

It's been clear since the Diamond Princess that IFR would end up, very roughly, around 0.5%. But 0.1% is further outside the reasonable range than even 1%, because 0.1% has already been entirely excluded by the number of confirmed COVID-19 deaths in NYC.

I'm curious how all of these people claiming that Covid is at 0.1% or something close reconcile the fact that it has been the leading cause of death in the United States for multiple days ... and that's without most parts of the country having reached their peak.

I think NYC skews it. NYC, which has a loose definition of COVID-19 deaths, is responsible for half of the US deaths. There's also really no other metro area in the US which rivals NYC in population density. After all of this, I think we're going to find the IFR for NYC to be closer to 1% while the rest of the country is under 0.5%

The critique is the same for all papers and systematically impacts all estimates, so seeing more consistent results doesn't invalidate the criticism.

That said, it's quite possible the number of cases is undercounted! Someone should do a meta-analysis to obtain a better estimate, given the testing uncertainty.

No professional was ever under the delusion that the IFR was >= 1%. Perhaps you meant CFR[1], which by definition does not reflect total number of infections. See, e.g., https://en.wikipedia.org/wiki/Case_fatality_rate

[1] Where 'C' means "case" or "confirmed", which in the context of medical terminology and despite some ambiguity categorically is not synonymous with infected.

Specifically, the Imperial College model with the "two million deaths" conclusion assumed an IFR of 0.9% (adjusted for age distribution) in every scenario. Maybe not quite a delusion, but the only IFR number they modeled is starting to look pretty close to one.

As best I can tell, the Imperial College report (https://www.imperial.ac.uk/media/imperial-college/medicine/s...) got its numbers from this study: https://www.medrxiv.org/content/10.1101/2020.03.09.20033357v...

The derived IFR is still <1% (0.66%), but I'll admit it seems unjustifiably high given the inconsistent reporting out of China. It would have been better characterized, at least qualitatively, as somewhat pessimistic, given all the assumptions.

Ah right, the 0.9% is after adjusting for the age distribution of Great Britain:

> These estimates were corrected for non-uniform attack rates by age and when applied to the GB population result in an IFR of 0.9% with 4.4% of infections hospitalised (Table 1).

Anthony Fauci has stated multiple times in the past that he thought the "fatality rate" of Covid-19 would end up "around 1%." He didn't make a distinction between CFR and IFR, but the general public's understanding of "fatality rate" is obviously that of IFR.

Yes, and the evidence isn't suggestive of anything close to 0.1%. If it's less than 1%, it is still quite high.

> but the general public's understanding of "fatality rate" is obviously that of IFR

Looking at my nextdoor group. I'm going to disagree with you on this. There's a lot of people screaming, "4.7% of people will die!" Even for a CFR, that's high.

What you're describing is consistent with the nextdoor group thinking there is a 4.7% IFR.

I believe the originally, WHO, albeit based on incomplete and confusing data out of China, said it was 3.something percent. It got cleared up pretty quickly as the situation cleared up.

However, the press keeps reporting the CFR as "death rate" without clarifying the definition nor the distinction between IFR. You then amplify that on social media, and it's become a shit show. "Dr. X [who's really a chiropractor] said on his YouTube video that 5% of people will die!" Even worse, this distinction is still not clear with politicians on all sides.

So I agree that professionals have basically agreed the worst case is the IFR is under 1%. However, if you go to non-HN sites, you'll find that you'll have to fight the terrible messaging that's out there.

A broken clock and stuff. The problem is that this study is polluting the info-sphere, the flaw is so obvious that it should never get any wider audience.

The fatality rate is below one percent. It's quite a bit higher for the old and sick, much lower for healthy people. The only rational and sustainable solution is to isolate the vulnerable and let the other people live their lives with the appropriate hygiene and safety measures as well as extensive testing.

"only rational"?

Based on what? It seems like there is always an intrinsic value judgement here because reopening for young people means more old people will die, even with isolation. That's maybe a necessary cost to pay, but don't elevate your moral judgements to the "rational" when they are anything but.

Please stop pointing out articles that question certain bias..

Anything that questions climate, overpopulation, our obvious pandemics must be accepted at full face value.

Now that we've established what is not ok to question, please accept the initial study from imperial college London unquestioningly..

Also, you missed one from Los Angeles: https://www.latimes.com/california/story/2020-04-20/coronavi...

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