7 ms·

Around 99% of the patients developed a high temperature, while more than half experienced fatigue and a dry cough. About a third also experienced muscle pain an

by gzer0 7y ago

Around 99% of the patients developed a high temperature, while more than half experienced fatigue and a dry cough. About a third also experienced muscle pain and difficulty breathing. Research from the Chinese Center for Disease Control suggests that around 80% of coronavirus cases are mild. Around 15% of patients have gotten severe cases, and 5% have become critically ill. Here's how symptoms progress among typical patients: - Day 1: Patients run a fever. They may also experience fatigue, muscle pain, and a dry cough. A small minority of them may have had diarrhea or nausea one to two days before. - Day 5: Patients may have difficulty breathing — especially if they are older or have a preexisting health condition. - Day 7: This is how long it takes, on average, before patients are admitted to a hospital, according to the Wuhan University study. - Day 8: At this point, patients with severe cases (15%, according to the Chinese CDC) develop acute respiratory distress syndrome (ARDS), an illness that occurs when fluid builds up the lungs. ARDS is often fatal. - Day 10: If patients have worsening symptoms, this is the time in the disease's progression when they're most likely to be admitted to the ICU. These patients probably have more abdominal pain and appetite loss than patients with milder cases. Only a small fraction die: The current fatality rate hovers around 2%. - Day 17: On average, people who recover from the virus are discharged from the hospital after two-and-a-half weeks. ---- [1] https://jamanetwork.com/journals/jama/fullarticle/2761044 https://jamanetwork.com/journals/jama/fullarticle/2761044 [2] https://www.businessinsider.com/coronavirus-covid19-day-by-day-symptoms-patients-2020-2 https://www.businessinsider.com/coronavirus-covid19-day-by-d... Not allowed to do this and not sure how long this will be up; the entire UpToDate reprint on the latest we know about COVID-19 (Coronavirus) [3] https://www.scribd.com/document/448592904/COVID-19 https://www.scribd.com/document/448592904/COVID-19 ---- Stay vigilant, stay careful, but most importantly, do not spread false information.

doctorphys 7y ago
Thank you for this. The day by day symptoms are CRITICAL. We are seeing patients well beyond the day 5: difficulty breathing condition. Your last statement is imperative.
funklute 7y ago
Are you aware if there is any data yet on what proportion of recoveries will experience lasting lung/other damage? For example, is the permanent lung damage seen so far (which I've only anecdotally read about, I must admit) mostly related to ARDS?
- gzer0 7y ago
  From a quick glance through UpToDate: [1] https://www.ncbi.nlm.nih.gov/pubmed/?term=32053470 https://www.ncbi.nlm.nih.gov/pubmed/?term=32053470 Not allowed to do this and not sure how long this will be up; the entire UpToDate reprint on the latest we know about COVID-19 (Coronavirus) [2] https://www.scribd.com/document/448592904/COVID-19 https://www.scribd.com/document/448592904/COVID-19 Edit: adding the SCRIBD to the main post. It's free. All 18 pages if anyone is interested.
- qiqitori 7y ago
  (IANAD) I don't think it is possible to derive any reliable facts from the data right now. Even if the patients who recovered from COVID-19 still find that there is something wrong with them, that could still go away in a week or a month or a year. However, here is a tiny bit of information on the long-term effects of the 2003 SARS outbreak: https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/severe-acute-respiratory-syndrome-sars/ https://www.lung.org/lung-health-and-diseases/lung-disease-l... > A small percentage of patients had long-term effects from their illness, including depression or anxiety, cough, shortness of breath, chronic lung disease or kidney disease. However, most patients fully recovered.
  - funklute 7y ago
    Yes, I think you may be right. I did find this, on the long-term effects of ARDS, and the effects are frankly a bit scary. Whether you survive or not, ARDS is clearly something to be avoided. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5757654/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5757654/
_-___________-_ 7y ago
Is that "day 1" before, after or during the 14 day incubation period that I keep seeing repeated? Do you have some good sources about the length of incubation?
- goblin89 7y ago
  The day 1 in this case is the day symptoms begin. The 14 day figure is more of a recommendation for the duration of quarantine, intended to cover incubation period in excess. As a sample of a timeline that actually happened, you can check out the short paper about German cases reported in January[0]. It appears to have taken 3–6 days from infection until symptoms started, and subsequently 2–4 days until patients felt healthy again (no symptoms anymore, virus still detected in saliva). [0] https://www.nejm.org/doi/10.1056/NEJMc2001468 https://www.nejm.org/doi/10.1056/NEJMc2001468
  - _-___________-_ 7y ago
    Thanks! Based on that paper it seems likely that a vast number of people could have already been infected and simply have thought it was a "traditionally common" infection (common cold, for example).
    - goblin89 7y ago
      That’s what it appears to be. This might complicate the situation for older patients or patients with complications, who would have more difficulties dealing with this infection relative to common cold or flu, especially if they get admitted to a hospital late.
qiqitori 7y ago
While 2% is indeed the WHO's current official early estimate, it's still very early to give accurate numbers here. https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/ Using the "closed cases" figures on this page (currently: 27892 closed cases, 25265 recovered, 2627 deaths), we get a fatality rate closer to 9.4%, but I've been monitoring this page for a while, and the fatality rate based on this calculation has improved a lot. For example, on 2020-02-10, the figures were 4376 closed cases, 3466 recovered, 910 deaths, resulting in a fatality rate of 20.8%. (https://web.archive.org/web/20200210100748/https://www.worldometers.info/coronavirus/ https://web.archive.org/web/20200210100748/https://www.world... <3 archive.org)
- ic4l 7y ago
  I have been confused about this 2-3% figure since they started using it... I mean they are not factoring in the lag-time. It seems like they just are taking all the new patients, and not calculating it correctly. I expect this number to grow.
  - goblin89 7y ago
    This NIH representative assessed the fatality rate at more like 1% in an interview to PBS a few days ago: https://www.youtube.com/watch?v=a6-De7IAS1I https://www.youtube.com/watch?v=a6-De7IAS1I
  - theobeers 7y ago
    There are multiple forces at play. On the one hand, as you note, it takes time for people to die, which could initially bias the fatality rate downward. On the other hand, a lot of milder cases will be missed entirely, which would bias the rate upward. My understanding is that the latter factor is considered more significant in the early stages of an epidemic like this.
- JshWright 7y ago
  World-o-meter isn't the definitive source for that information. Does the big counter at the top include the large number of people who contracted the disease, but never progressed past a mild stage, and so never reported it to their doctor? The WHO number is based on more than just the known cases vs deaths tally.
ddeck 7y ago
For additional, evidence-based research along these lines, I'd recommend the coronavirus section of the Lancet: https://www.thelancet.com/coronavirus https://www.thelancet.com/coronavirus They are hosting preliminary research, case reports, commentary and discussion from qualified experts in the area, many of which are on the ground in affected areas.
- gzer0 7y ago
  I have uploaded the entire 18 page document available to UpToDate subscribers for free on SCRIBD for as long as they will allow it as well. Good source you mention as well.
roenxi 7y ago
> Stay vigilant, stay careful, but most importantly, do not spread mass hysteria and panic. In the last month almost 1% of the current population of the earth quarantined in China [0]. What exactly worries you about mass hysteria and panic? Why would that be worse than what is likely to happen as Covid-19 spreads outside of China? I'm all in favor of not overselling the danger; but this virus is a real concern. I mean, unless someone has a very good argument why Hubei are somehow special and it can't happen again elsewhere everyone should be stocking up on supplies in case they are caught in a serious quarantine. The actions taken don't seem to be stopping exponential growth of this virus; if anything all that seems to be actively measured is how good countries are at producing testing kits. > Only a small fraction die: The current fatality rate hovers around 2%. If 2% of the people I know died this year, that would be the worst disaster in my country in my lifetime. [0] https://en.wikipedia.org/wiki/2020_Wuhan_lockdown https://en.wikipedia.org/wiki/2020_Wuhan_lockdown
- simonh 7y ago
  >What exactly worries you about mass hysteria and panic? Why would that be worse than what is likely to happen as Covid-19 spreads outside of China? Because then in addition to the damage caused by the outbreak, we will also have the additional often useless and counterproductive damage caused by hysteria and panic.
  - af0GRLoH 7y ago
    That is just understood as the hypothesis and the framing of the question. What is the nature of the useless and counterproductive damage caused by hysteria and panic? (I could speculate that it changes economic flows that upsets long term planning and so on, but I would like to hear the opinion of experts on the matter anyway).
    - marcinzm 7y ago
      >What is the nature of the useless and counterproductive damage caused by hysteria and panic? Of the top of my head. Hoarding of supplies causing shortages and harming people who actually need them right now. Progressing to health professionals lacking supplies (masks, etc.) due to shortages (and diverting of dedicated supplies). Unnecessary ER visits which stress the health system thus making it less able to react to an actual problem (as health professionals are tired and burned out). Stress and unnecessary interventions/ER visits increasing people's risk and exposure to existing diseases. edit: That's not counting real panic which involves mobs with metaphorical pitchforks and the military in streets enforcing some semblance of order (with bullets).
radicalbyte 7y ago
There's a flu going around in The Netherlands right now, it progresses like this: - Day 1: Fever, fatigue and muscle pain with a dry itchy cough. - Day 2+: Nausea and diarrhea can be experienced as well as the first day symptoms. It takes about a week for the worst of the symptoms to die down however the stomach ache, cough and light tiredness last weeks. My entire family and most of my son's class at school has had it and they're all still recovering. My wife is, after 3 weeks, still really ill. Probably because she's working full time and breastfeeding. This is what makes the Corona-virus hard: at the start the symptoms are extremely similar to existing flu. Unless the case is extremely severe most people won't see a doctor let alone a hospital. I don't see how it can be stopped.
- nilsocket 7y ago
  Why are you letting your wife work, when she is not in good condition. You take up the work and let her take rest, and also make sure that she eats and sleeps well. Give some good fruits and cook proper vegetarian dish.
  - tjr225 7y ago
    This seems like an incredibly naive thing to say to someone. Not everyone has the privilege of choosing not to work. Welcome to global capitalism.
    - ryanlol 7y ago
      I would bet that there are far fewer people like that in NL than there are people who would work out of some twisted sense of not being “sick enough”.
- tqkxzugoaupvwqr 7y ago
  > My wife is, after 3 weeks, still really ill. Probably because she's working full time In my opinion it’s high time to call in sick. She is neither helping herself nor her coworkers by going to work.
usrusr 7y ago
Regarding an uncontrolled outbreak (we can't just quarantine everyone, everywhere without secondary effects from economic collapse getting more deadly than the disease itself), the number I find myself speculating about most is how many would be dead or permanently harmed in absence of intensive care? Because no health system in the world would have the capacity to put more than about one in thousand people in intensive care. Even Hubei is still below 0.2% total known infections, surely in large parts thanks to measures that would be impossible to scale globally.
- jacquesm 7y ago
  > Because no health system in the world would have the capacity to put more than about one in thousand people in intensive care. Try one in ten thousand. And that's in the most developed countries with the best healthcare.
  - Retric 7y ago
    On the other hand diseases don’t reach 100% of the population on the same day. Quarantine has been surprisingly effective in China, though at significant economic cost. That seems to be a much larger concern than the capacity of heathcare systems. If this becomes a true epidemic it’s going to be bad, but societies have been dealing with epidemics for a long time.
    - jacquesm 7y ago
      > On the other hand diseases don’t reach 100% of the population on the same day. That's absolutely true, even in Wuhan the %age of infected people on the total population is relatively small, but much larger than the # of ICU beds that existed. And the virus had a long time to spread around there before any countermeasures were taken. Even so, ventilators and ICU beds are not normally all available either. > Quarantine has been surprisingly effective in China, though at significant economic cost. It would have been a lot more effective if they had done it sooner. > That seems to be a much larger concern than the capacity of heathcare systems. Yes, and I'm sure that at some level that's the right trade-off, I'm just not sure what that level is and whether or not we are already past it. > If this becomes a true epidemic it’s going to be bad, but societies have been dealing with epidemics for a long time. In Italy they went from 0 dead and a handful of cases to 7 dead and > 200 cases. Most of them are old people and people that were already ill. Historically the way we deal with epidemics is by developing medication. That takes time and in the meantime the damage could be substantial.
taurath 7y ago
In the US, a 2 week stay in the hospital will cost you upwards of $50,000. Even if you have insurance, understand it will be a significant cost to you. If you’re uninsured like 20 million Americans or underinsured like 80 million, going to the hospital means automatic bankruptcy. Every day our broken healthcare system will force many people to choose between all their families assets and getting care. This should not be a consideration, but often is. If you are traveling to the US, please make sure you get as much travelers health insurance as possible.
- jumbopapa 7y ago
  It is my understand that it is highly unlikely an uninsured person would ever pay anything close to the billed "price." Same is true for insurance companies. Edit: Some are telling me this isn't true, but what does a hospital have to gain from someone filing bankruptcy? Why would they charge such high prices that no one can afford? I would think that some money is better than no money.
  - taurath 7y ago
    Unfortunately that isn’t much of a factor in reality, and I have the receipts in my filing cabinet to prove it. Insurance/“cash” can “negotiate” but at the end of the day the average hospital stay is near $4000/day.
    - MandieD 7y ago
      Good God. I had a small surgery in Germany about 10 years ago that is usually outpatient, but I passed out afterwards, so the doctor had me admitted for overnight observation. Total bill for surgery, lab and the stay in a room with another American lady who was on bedrest with triplets (!!!): 1400 EUR, which my American insurer paid with absolutely no arguments. This was the full retail, premium “private patient” rate - most Germans wouldn’t have even seen a bill that size. A friend in the US had the same procedure outpatient, and it was $6000, $1200 of which she was responsible for. On the upside, they gave her 30 Vicodin for the post-op pain and no follow-up about said opioids, where I only got a week's worth of Tramadol (much less potent) and a follow-up with my regular doc who wanted to know at what rate I was taking them. My friend was slightly tempted to sell her leftovers...
Theboda 7y ago
Third link in one picture https://ibb.co/S79Tyz9 https://ibb.co/S79Tyz9
49para 7y ago
The 2% mortality rate is for the whole population, if you end up in the hospital with acute pneumonia the mortality rate is around 61% https://www.scribd.com/document/448385523/s-2213260020300795#from_embed https://www.scribd.com/document/448385523/s-2213260020300795...
- aldoushuxley001 7y ago
  That number is still only for extremely at risk segments of the population, and the study has such a small sample size that it should be taken with large grains of salt.
  - koheripbal 7y ago
    I wouldn't dismiss the entire elderly population of Earth "extremely at risk" population. They are our mothers/fathers/grandparents...
    - aldoushuxley001 7y ago
      I’m saying that’s what that study accounted for: extremely at risk populations. So yeah elderly, people with preexisting conditions, etc. It’s not a dismissal to acknowledge the limitations of your linked study; to do otherwise would be fearmongering in my opinion.
    - everybodyknows 7y ago
      >Please respond to the strongest plausible interpretation of what someone says, not a weaker one that's easier to criticize. Assume good faith. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
- koheripbal 7y ago
  ...also important to remember that those who recover from severe symptoms (~10%) have permanently damaged lung function due to lesions that formed during infection.
surge 7y ago
Of closed cases (people that have recovered or died) the fatality rate is more like 10%. It's only 2% of total that have it, meaning a lot of people have neither recovered or died as it spreads and they're waiting to find out if they fall in the 10% or the other 90%. Edit: https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/ Looks like its now only 9%, it was 10% a day or two ago.
- magneticnorth 7y ago
  Yes, the closed cases has been steadily dropping but remains well above 2% - however, we expect that number to be higher than the actual mortality rate while the infection is still spreading/growing, as recovering from the disease takes longer than dying from it. What I find more concerning is that the current ratio of deaths to cases is 3%, which I would expect to be an underestimate. Hopefully this is due to under-reporting of the mild cases, but it does imply either a major under-reporting of active cases or a significantly higher mortality rate than has been estimated so far (most likely the former).
- Nuzzerino 7y ago
  I would take that number with a grain of salt too, as there is a lot of asymmetry with how and when that data is reported. There may be a large number of "recovering" cases that are not completely closed yet but have essentially zero chance of death in the future. The definition of recovered seems open to interpretation while death is not, and so the deaths would have a more immediate reporting period, as well as a shorter average interval of time since infection started.
AnimalMuppet 7y ago
Minor nit: If day 7 is when they are admitted, then day 17 is not when they are released. Day 24 is.

by gzer0 7y ago

doctorphys 7y ago

Thank you for this. The day by day symptoms are CRITICAL. We are seeing patients well beyond the day 5: difficulty breathing condition. Your last statement is imperative.

funklute 7y ago

Are you aware if there is any data yet on what proportion of recoveries will experience lasting lung/other damage? For example, is the permanent lung damage seen so far (which I've only anecdotally read about, I must admit) mostly related to ARDS?

gzer0 7y ago
From a quick glance through UpToDate: [1] https://www.ncbi.nlm.nih.gov/pubmed/?term=32053470 https://www.ncbi.nlm.nih.gov/pubmed/?term=32053470 Not allowed to do this and not sure how long this will be up; the entire UpToDate reprint on the latest we know about COVID-19 (Coronavirus) [2] https://www.scribd.com/document/448592904/COVID-19 https://www.scribd.com/document/448592904/COVID-19 Edit: adding the SCRIBD to the main post. It's free. All 18 pages if anyone is interested.
qiqitori 7y ago
(IANAD) I don't think it is possible to derive any reliable facts from the data right now. Even if the patients who recovered from COVID-19 still find that there is something wrong with them, that could still go away in a week or a month or a year. However, here is a tiny bit of information on the long-term effects of the 2003 SARS outbreak: https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/severe-acute-respiratory-syndrome-sars/ https://www.lung.org/lung-health-and-diseases/lung-disease-l... > A small percentage of patients had long-term effects from their illness, including depression or anxiety, cough, shortness of breath, chronic lung disease or kidney disease. However, most patients fully recovered.
- funklute 7y ago
  Yes, I think you may be right. I did find this, on the long-term effects of ARDS, and the effects are frankly a bit scary. Whether you survive or not, ARDS is clearly something to be avoided. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5757654/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5757654/

_-___________-_ 7y ago

Is that "day 1" before, after or during the 14 day incubation period that I keep seeing repeated? Do you have some good sources about the length of incubation?

goblin89 7y ago
The day 1 in this case is the day symptoms begin. The 14 day figure is more of a recommendation for the duration of quarantine, intended to cover incubation period in excess. As a sample of a timeline that actually happened, you can check out the short paper about German cases reported in January[0]. It appears to have taken 3–6 days from infection until symptoms started, and subsequently 2–4 days until patients felt healthy again (no symptoms anymore, virus still detected in saliva). [0] https://www.nejm.org/doi/10.1056/NEJMc2001468 https://www.nejm.org/doi/10.1056/NEJMc2001468
- _-___________-_ 7y ago
  Thanks! Based on that paper it seems likely that a vast number of people could have already been infected and simply have thought it was a "traditionally common" infection (common cold, for example).
  - goblin89 7y ago
    That’s what it appears to be. This might complicate the situation for older patients or patients with complications, who would have more difficulties dealing with this infection relative to common cold or flu, especially if they get admitted to a hospital late.

qiqitori 7y ago

While 2% is indeed the WHO's current official early estimate, it's still very early to give accurate numbers here. https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/ Using the "closed cases" figures on this page (currently: 27892 closed cases, 25265 recovered, 2627 deaths), we get a fatality rate closer to 9.4%, but I've been monitoring this page for a while, and the fatality rate based on this calculation has improved a lot. For example, on 2020-02-10, the figures were 4376 closed cases, 3466 recovered, 910 deaths, resulting in a fatality rate of 20.8%. (https://web.archive.org/web/20200210100748/https://www.worldometers.info/coronavirus/ https://web.archive.org/web/20200210100748/https://www.world... <3 archive.org)

ic4l 7y ago
I have been confused about this 2-3% figure since they started using it... I mean they are not factoring in the lag-time. It seems like they just are taking all the new patients, and not calculating it correctly. I expect this number to grow.
- goblin89 7y ago
  This NIH representative assessed the fatality rate at more like 1% in an interview to PBS a few days ago: https://www.youtube.com/watch?v=a6-De7IAS1I https://www.youtube.com/watch?v=a6-De7IAS1I
- theobeers 7y ago
  There are multiple forces at play. On the one hand, as you note, it takes time for people to die, which could initially bias the fatality rate downward. On the other hand, a lot of milder cases will be missed entirely, which would bias the rate upward. My understanding is that the latter factor is considered more significant in the early stages of an epidemic like this.
JshWright 7y ago
World-o-meter isn't the definitive source for that information. Does the big counter at the top include the large number of people who contracted the disease, but never progressed past a mild stage, and so never reported it to their doctor? The WHO number is based on more than just the known cases vs deaths tally.

ddeck 7y ago

For additional, evidence-based research along these lines, I'd recommend the coronavirus section of the Lancet: https://www.thelancet.com/coronavirus https://www.thelancet.com/coronavirus They are hosting preliminary research, case reports, commentary and discussion from qualified experts in the area, many of which are on the ground in affected areas.

gzer0 7y ago
I have uploaded the entire 18 page document available to UpToDate subscribers for free on SCRIBD for as long as they will allow it as well. Good source you mention as well.

roenxi 7y ago

> Stay vigilant, stay careful, but most importantly, do not spread mass hysteria and panic. In the last month almost 1% of the current population of the earth quarantined in China [0]. What exactly worries you about mass hysteria and panic? Why would that be worse than what is likely to happen as Covid-19 spreads outside of China? I'm all in favor of not overselling the danger; but this virus is a real concern. I mean, unless someone has a very good argument why Hubei are somehow special and it can't happen again elsewhere everyone should be stocking up on supplies in case they are caught in a serious quarantine. The actions taken don't seem to be stopping exponential growth of this virus; if anything all that seems to be actively measured is how good countries are at producing testing kits. > Only a small fraction die: The current fatality rate hovers around 2%. If 2% of the people I know died this year, that would be the worst disaster in my country in my lifetime. [0] https://en.wikipedia.org/wiki/2020_Wuhan_lockdown https://en.wikipedia.org/wiki/2020_Wuhan_lockdown

simonh 7y ago
>What exactly worries you about mass hysteria and panic? Why would that be worse than what is likely to happen as Covid-19 spreads outside of China? Because then in addition to the damage caused by the outbreak, we will also have the additional often useless and counterproductive damage caused by hysteria and panic.
- af0GRLoH 7y ago
  That is just understood as the hypothesis and the framing of the question. What is the nature of the useless and counterproductive damage caused by hysteria and panic? (I could speculate that it changes economic flows that upsets long term planning and so on, but I would like to hear the opinion of experts on the matter anyway).
  - marcinzm 7y ago
    >What is the nature of the useless and counterproductive damage caused by hysteria and panic? Of the top of my head. Hoarding of supplies causing shortages and harming people who actually need them right now. Progressing to health professionals lacking supplies (masks, etc.) due to shortages (and diverting of dedicated supplies). Unnecessary ER visits which stress the health system thus making it less able to react to an actual problem (as health professionals are tired and burned out). Stress and unnecessary interventions/ER visits increasing people's risk and exposure to existing diseases. edit: That's not counting real panic which involves mobs with metaphorical pitchforks and the military in streets enforcing some semblance of order (with bullets).

radicalbyte 7y ago

There's a flu going around in The Netherlands right now, it progresses like this: - Day 1: Fever, fatigue and muscle pain with a dry itchy cough. - Day 2+: Nausea and diarrhea can be experienced as well as the first day symptoms. It takes about a week for the worst of the symptoms to die down however the stomach ache, cough and light tiredness last weeks. My entire family and most of my son's class at school has had it and they're all still recovering. My wife is, after 3 weeks, still really ill. Probably because she's working full time and breastfeeding. This is what makes the Corona-virus hard: at the start the symptoms are extremely similar to existing flu. Unless the case is extremely severe most people won't see a doctor let alone a hospital. I don't see how it can be stopped.

nilsocket 7y ago
Why are you letting your wife work, when she is not in good condition. You take up the work and let her take rest, and also make sure that she eats and sleeps well. Give some good fruits and cook proper vegetarian dish.
- tjr225 7y ago
  This seems like an incredibly naive thing to say to someone. Not everyone has the privilege of choosing not to work. Welcome to global capitalism.
  - ryanlol 7y ago
    I would bet that there are far fewer people like that in NL than there are people who would work out of some twisted sense of not being “sick enough”.
tqkxzugoaupvwqr 7y ago
> My wife is, after 3 weeks, still really ill. Probably because she's working full time In my opinion it’s high time to call in sick. She is neither helping herself nor her coworkers by going to work.

usrusr 7y ago

Regarding an uncontrolled outbreak (we can't just quarantine everyone, everywhere without secondary effects from economic collapse getting more deadly than the disease itself), the number I find myself speculating about most is how many would be dead or permanently harmed in absence of intensive care? Because no health system in the world would have the capacity to put more than about one in thousand people in intensive care. Even Hubei is still below 0.2% total known infections, surely in large parts thanks to measures that would be impossible to scale globally.

jacquesm 7y ago
> Because no health system in the world would have the capacity to put more than about one in thousand people in intensive care. Try one in ten thousand. And that's in the most developed countries with the best healthcare.
- Retric 7y ago
  On the other hand diseases don’t reach 100% of the population on the same day. Quarantine has been surprisingly effective in China, though at significant economic cost. That seems to be a much larger concern than the capacity of heathcare systems. If this becomes a true epidemic it’s going to be bad, but societies have been dealing with epidemics for a long time.
  - jacquesm 7y ago
    > On the other hand diseases don’t reach 100% of the population on the same day. That's absolutely true, even in Wuhan the %age of infected people on the total population is relatively small, but much larger than the # of ICU beds that existed. And the virus had a long time to spread around there before any countermeasures were taken. Even so, ventilators and ICU beds are not normally all available either. > Quarantine has been surprisingly effective in China, though at significant economic cost. It would have been a lot more effective if they had done it sooner. > That seems to be a much larger concern than the capacity of heathcare systems. Yes, and I'm sure that at some level that's the right trade-off, I'm just not sure what that level is and whether or not we are already past it. > If this becomes a true epidemic it’s going to be bad, but societies have been dealing with epidemics for a long time. In Italy they went from 0 dead and a handful of cases to 7 dead and > 200 cases. Most of them are old people and people that were already ill. Historically the way we deal with epidemics is by developing medication. That takes time and in the meantime the damage could be substantial.

taurath 7y ago

In the US, a 2 week stay in the hospital will cost you upwards of $50,000. Even if you have insurance, understand it will be a significant cost to you. If you’re uninsured like 20 million Americans or underinsured like 80 million, going to the hospital means automatic bankruptcy. Every day our broken healthcare system will force many people to choose between all their families assets and getting care. This should not be a consideration, but often is. If you are traveling to the US, please make sure you get as much travelers health insurance as possible.

jumbopapa 7y ago
It is my understand that it is highly unlikely an uninsured person would ever pay anything close to the billed "price." Same is true for insurance companies. Edit: Some are telling me this isn't true, but what does a hospital have to gain from someone filing bankruptcy? Why would they charge such high prices that no one can afford? I would think that some money is better than no money.
- taurath 7y ago
  Unfortunately that isn’t much of a factor in reality, and I have the receipts in my filing cabinet to prove it. Insurance/“cash” can “negotiate” but at the end of the day the average hospital stay is near $4000/day.
  - MandieD 7y ago
    Good God. I had a small surgery in Germany about 10 years ago that is usually outpatient, but I passed out afterwards, so the doctor had me admitted for overnight observation. Total bill for surgery, lab and the stay in a room with another American lady who was on bedrest with triplets (!!!): 1400 EUR, which my American insurer paid with absolutely no arguments. This was the full retail, premium “private patient” rate - most Germans wouldn’t have even seen a bill that size. A friend in the US had the same procedure outpatient, and it was $6000, $1200 of which she was responsible for. On the upside, they gave her 30 Vicodin for the post-op pain and no follow-up about said opioids, where I only got a week's worth of Tramadol (much less potent) and a follow-up with my regular doc who wanted to know at what rate I was taking them. My friend was slightly tempted to sell her leftovers...

Theboda 7y ago

Third link in one picture https://ibb.co/S79Tyz9 https://ibb.co/S79Tyz9

49para 7y ago

The 2% mortality rate is for the whole population, if you end up in the hospital with acute pneumonia the mortality rate is around 61% https://www.scribd.com/document/448385523/s-2213260020300795#from_embed https://www.scribd.com/document/448385523/s-2213260020300795...

aldoushuxley001 7y ago
That number is still only for extremely at risk segments of the population, and the study has such a small sample size that it should be taken with large grains of salt.
- koheripbal 7y ago
  I wouldn't dismiss the entire elderly population of Earth "extremely at risk" population. They are our mothers/fathers/grandparents...
  - aldoushuxley001 7y ago
    I’m saying that’s what that study accounted for: extremely at risk populations. So yeah elderly, people with preexisting conditions, etc. It’s not a dismissal to acknowledge the limitations of your linked study; to do otherwise would be fearmongering in my opinion.
  - everybodyknows 7y ago
    >Please respond to the strongest plausible interpretation of what someone says, not a weaker one that's easier to criticize. Assume good faith. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
koheripbal 7y ago
...also important to remember that those who recover from severe symptoms (~10%) have permanently damaged lung function due to lesions that formed during infection.

surge 7y ago

Of closed cases (people that have recovered or died) the fatality rate is more like 10%. It's only 2% of total that have it, meaning a lot of people have neither recovered or died as it spreads and they're waiting to find out if they fall in the 10% or the other 90%. Edit: https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/ Looks like its now only 9%, it was 10% a day or two ago.

magneticnorth 7y ago
Yes, the closed cases has been steadily dropping but remains well above 2% - however, we expect that number to be higher than the actual mortality rate while the infection is still spreading/growing, as recovering from the disease takes longer than dying from it. What I find more concerning is that the current ratio of deaths to cases is 3%, which I would expect to be an underestimate. Hopefully this is due to under-reporting of the mild cases, but it does imply either a major under-reporting of active cases or a significantly higher mortality rate than has been estimated so far (most likely the former).
Nuzzerino 7y ago
I would take that number with a grain of salt too, as there is a lot of asymmetry with how and when that data is reported. There may be a large number of "recovering" cases that are not completely closed yet but have essentially zero chance of death in the future. The definition of recovered seems open to interpretation while death is not, and so the deaths would have a more immediate reporting period, as well as a shorter average interval of time since infection started.

AnimalMuppet 7y ago

Minor nit: If day 7 is when they are admitted, then day 17 is not when they are released. Day 24 is.