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Comment by goalieca | Hacker News Reader

The spanish flu killed working age people. The case fatality rate for Italian health care workers (frequently tested so should be a good proxy for IFR) is sitting around 0,35%. When you adjust for age (those under 60) you end up with <0.1%. When you look at data based on cfr, serology, etc it all paints a picture of stratified risks based on age. The best gift my age group can give is build herd immunity.

Given most deaths in Canada are in long term care homes (up to 80% in Quebec), this gives us a clear target to improve.

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It's strange that engineers are giving in to this biased and non-rational mental model, treating this situation as linear and robust.

It is non-linear and non-robust system. The main problem is that mortality rate even among young people would become much higher as soon as hospitals become overwhelmed.

So you can not make any predictive conclusions based on current stats. Please look at any of the numerous models available online which account for all factors, and you will see how badly herd immunity idea would end for all age groups.

>is that mortality rate even among young people would become much higher as soon as hospitals become overwhelmed.

I don't see how this follows. The point the parent was making is that young people don't seem to need hospital care. Why would they suddenly start dying just because 'hospitals are overwhelmed'? They still won't need them...

Original comment is talking about deaths, there are many, many more hospitalizations.

The ggp made no mention at all of hospitalization rates, only fatality rates.

Not true, the point of the parent is that young people don't seem to die. For 0.1% dying, how many are going to the hospital? Let's say it's 10% (completely random number), if you increase the population then 10% completely overcrowds the hospitals, quality of care plummets and 0.1% becomes 5% (once again, completely random number).

Not taking any position nor bringing data in this debate, just pointing out the logic

> The point the parent was making is that young people don't seem to need hospital care.

Low risk doesn't mean no risk, and we see plenty of younger people in hospital, and in intensive care, because of covid-19.

ICNARC has a report that they update over time using data from UK intensive care units. https://www.icnarc.org/Our-Audit/Audits/Cmp/Reports

https://www.icnarc.org/DataServices/Attachments/Download/c5a...

Age at admission (years), number of people discharged alive (%), number of people died (%)

  16-39     240 (78.4)     66 (21.6)
  40-49     350 (73.2)    128 (26.8)
  50-59     568 (57.0)    429 (43.0)
  60-69     503 (41.8)    701 (58.2)
  70-79     293 (32.2)    617 (67.8)
     80+     57 (31.3)    125 (68.7)

Once admitted to ICU people aged 16-39 have a 21.6% chance of dying vs a 78.4% chance of being discharged alive.

bad use of statistics. if gp is to be believed, once in ICU you are already in the 0.x %. the question then is, are you in the 0.1 or 99.9.

> Why would they suddenly start dying just because 'hospitals are overwhelmed'? They still won't need them...

Also, when hospitals are overwhelmed they stop all treatment. That young person who gets shot; has a road traffic accident; has a drug or alcohol overdose; has a problematic pregnancy and birth; has cancer -- all of these treatments become harder to provide.

You seem to be focused on a scenario where we allow the virus to spread among all groups, but that was not GP's suggestion. GP's point is that we can pinpoint who is at high risk and who is not, but that was not the case for the Spanish flu. (You talk of age as if it's the only risk factor, but it's clearly not.)

Hospitals would only become overwhelmed if the virus were to spread rapidly among high risk groups. Not many low risk individuals will wind up needing hospitalization.

Lastly, it would be more constructive to the debate to link to data instead of asserting that data exist somewhere out there which support your point.

Where can I find these models which account for all factors? I've never seen a model including e.g. long-term economic consequences.

> It's strange that engineers are giving in to this biased and non-rational mental model, treating this situation as linear and robust.

It's exactly what the model giving us 2.2M deaths in the US with strict quarantine was doing. Extrapolating the cruise ship case of 1% death to 80% of the US. Parent math is actually more reasonable.

But they probably have “flatten them curve” in mind, where you maintain some social distancing to reduce the speed of spread.

But some jurisdictions are so locked down that there is virtually no spread at all, leaving the population highly vulnerable to a second wave.

There’s lot of data from New York and elsewhere showing young people do not have nearly the same hospitalization rates as older people. Yes, we need to manage But engineers should also not find themselves governed by panic and fear.

The Spanish flu killed working age people.

When it returned the following year. It mutated to become much more dangerous to younger people.

The same year. What started as a bad flu in Kansas in the Spring of 1918 morphed into a super-killer by the Fall of the same year.[0]

[0]https://www.history.com/news/spanish-flu-second-wave-resurge...

yes - the first wave appeared to use young people as a transmission vector but didn't harm them compared to the second and third waves where they were hammered as hard as the young and old.

> The best gift my age group can give is build herd immunity.

Careful with that. There have been a number of deaths in younger age groups, statistically not as significant as those in older and at risk groups, but the risk is there.

Also reports of damage in nervous system, permanent lung damage, etc.

Statistically not as significant? Or statistically not significant?

Thanks, I updated my comment to be a little more clear that it is statistically not as significant. Didn’t realize that was ambiguous at first.

There's no current evidence that those who have been previously infected are immune.

If that was true, vaccines would be useless and lockdowns would be futile. There is no reason to believe this virus us somehow different from every other viruswe have ever seen and magically cannot be immunized against.

There are hundreds, if not thousands of viruses we can't be immunized against. They either mutate too quickly, rendering any antibodies we develop moot, or they kill us too quickly. We don't have a great track record in developing vaccines for viruses either.

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