9 ms·

It's worth reflecting on how many novel pandemics a 40 year old person has experienced in their lifetime. HIV, SARS, MERS, Ebola, Zika, COVID-19... For some r

It's worth reflecting on how many novel pandemics a 40 year old person has experienced in their lifetime. HIV, SARS, MERS, Ebola, Zika, COVID-19... For some reason it feels like a "only in the history books" event -- and yet it's actually quite common. The average-aged American (38) has lived through multiple epidemics -- including one that has killed 30 million people (HIV) -- and yet we barely talk about it.

lisper 7y ago
Seasonal flu kills hundreds of thousands of people every year and we barely talk about that.
- samastur 7y ago
  Yes, because it infects so many millions. Covid-19 right now looks a magnitude more deadly with significant long term health consequences for many who survive.
  - _-___________-_ 7y ago
    > a magnitude more deadly Probably not. Case fatality rates don't accurately show the "deadliness" since many people have likely been infected but been asymptomatic or had mild illness that didn't cause them to seek medical advice. > significant long term health consequences for many who survive There is no evidence for that, and it doesn't make sense given the available data. Some number of people have long-term health consequences, and if you only compare that number to the number of people who went to hospital with serious illness, you might see a high percentage, but that's a huge distortion of reality.
    - djmips 7y ago
      > Probably not. Case fatality rates don't accurately show the "deadliness" since many people have likely been infected but been asymptomatic or had mild illness that didn't cause them to seek medical advice. I agree with this point but would also like to point out the possibility that way more people get infected by SARS-CoV-2 than the flu. I also want to note that the flu also has the same asymptomatic or mild illness factor and that the deadliness would be only comparing people who sought medical treatment.
    - mrb 7y ago
      Yes, it is a magnitude deadlier than the flu. We now have 4 independent estimates that place the Infection Fatality Ratio at about 0.5% to 1.7% which is between 5x and 17x deadlier than the flu (0.1%): https://twitter.com/zorinaq/status/1230977769795776512 https://twitter.com/zorinaq/status/1230977769795776512 Incidentally, this makes COVID19 comparable to the 1918 Spanish Flu (IFR ~2%) according to experts (see link above). And keep in mind the IFR, unlike the CFR, is the metric that takes into account undetected mild or asymptomatic cases. «There is no evidence for that» There is, see https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30305-6/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... : In those who survive intensive care, [...] aberrant and excessive immune responses lead to long-term lung damage and fibrosis, causing functional disability and reduced quality of life.
    - samastur 7y ago
      I agree that exact rates are difficult to determine, will change over time and one should not overreact, but there is plenty of evidence for what I said. If this virus would be just like flu, then Wuhan wouldn't have much problem coping.
      - _-___________-_ 7y ago
        If it was a brand new flu, to which people had no immunity, which was initially covered up and then largely "responded to" by crowding everyone who might possibly have been infected into overcrowded, shared quarantine centres where they are now virtually guaranteed to get it, I bet they would have the same problem coping.
    - cm2187 7y ago
      Agree, I hate to quote Trump, but there seems to be many “doomers” among us, who seem to take some kind of pleasure in entertaining the idea that we are in the middle of some big disaster. For the moment the numbers I see (mentioned in my other post [1]) seem to support something slightly worse than the common flu, but nothing that should be really concerning. Also the comparison to the Spanish flu often ignores the fact that we are way better equipped to deal with the symptoms than in 1918. [1] https://news.ycombinator.com/item?id=22421649 https://news.ycombinator.com/item?id=22421649
  - deleted 7y ago
    [deleted]
- watwut 7y ago
  Mortality of flu is over 0.1%, with coronavirus it is over 2%. And flu has shorter incubation time. That is massive difference.
  - baq 7y ago
    2% may be still too high, it might even be high sub 1% (e.g. .7%), but the big problem is how many of cases require hospitalization and especially intensive care. if number of ICU patients grows 10x in one month, we're all in trouble and that's seemingly what happened in China.
    - trengorilla 7y ago
      I don't understand how this figure keeps getting quoted. Out of cases that have been fully resolved we're now at an 8% mortality rate. 2% is counting ongoing cases, that's not the figure you should be looking at.
      - bart_spoon 7y ago
        Because the 8% mortality rate is based on resolved cases, and it generally takes people longer to fully recover than it does to die, so it is skewed upwards. A couple of weeks ago, the same mortality figure was near 30%, because most people with the disease who were not going to die hadn't had time to recover yet. Things are still early enough that the 8% figure will continue to go down. Additionally, it is widely acknowledged that the actual number of cases is undercounted, with the mildest cases less likely to have been tested and included in those numbers, again resulting in overly high numbers. And finally, it would appear that Wuhan in particular is skewing the numbers higher, as being the site of the outbreak it was caught off guard and has struggled to manage the number of cases. Elsewhere in both China and the world, the death rate is far lower. The estimate of 8% is unquestionably much too high. Exactly what the mortality rate is will still take more time to discover.
        trengorilla 7y ago
        Thanks.
- pengaru 7y ago
  Or mosquitoes and the malaria they spread... Malaria was responsible 405,000 deaths globally in 2018 according to [0]. [0] https://www.who.int/news-room/feature-stories/detail/world-malaria-report-2019 https://www.who.int/news-room/feature-stories/detail/world-m...
  - djmips 7y ago
    How many people do you know with malaria? It's a tropical region disease. In a pandemic of Covid-19, it is going to affect people all over the world in every region.
    - pengaru 7y ago
      The parent mentioned Zika, any such list including Zika would be incomplete without Malaria as well. I agree that covid-19 seems to have a larger potential breadth, and didn't intend to downplay its significance.
    - ggm 7y ago
      How many people do you know with malaria? It's a tropical region disease. No. The name is Italian. It predates Italian colonies in the tropics. It's a disease which was endemic in marshlands believed to be caused by bad air Mal aria and was in Scotland amongst other places. Malaria is not exclusively tropical. Nor is dengue or mosquito borne encephalitis. Tropical wet regions sustain mosquitos. So do cooler climates.
    - adventured 7y ago
      > How many people do you know with malaria? It's a tropical region disease. Malaria is not inherently a tropical region disease. It routinely plagued Europe until the 1950s. Russia for one example had a huge Malaria outbreak in the early 1920s as did Eastern Europe broadly. "Gustavo Pittaluga (1876-1956) estimated that in 1923, 18 million people suffered from malaria in Russia, and that sixty thousand deaths occurred out of a total population of about 110 million (Anigstein, Pittaluga, 1925). Similar observations were made throughout the whole of eastern and south-eastern Europe and the former Ottoman Empire." http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-59702011000200009 http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104...
- rixrax 7y ago
  Yes it does. After we have vaccinated vast amounts of global population with flu vaccines that mostly work. Try flu without vaccination and potentially 10x mortality rate: CoVid-19.
  - lisper 7y ago
    Maybe. We don't actually know how many mild or asymptomatic cases of covid are out there, and so we don't know what the mortality rate is. 2% is an upper bound, but almost certainly not the true mortality rate. I'm not saying that we should not take covid very seriously. I'm just saying that before we allow it to shut down the global economy we ought to maintain some perspective on the magnitude of the risks society already faces year-in and year-out.
- DanBC 7y ago
  I don't know about you but I'm bombarded every year with campaigns to get people immunised, and the meetings I go to talk about availability of the vaccine for the public, and for healthcare professionals, and how many professionals have been vaccinated so far and how we can ethically increase that number, and on top of that every year for the past however long in the English NHS there's been a lot of talk about winter pressure.
  - lisper 7y ago
    Fair enough, but there is nonetheless a lot more hand-wringing about covid-19 than there is about seasonal flu despite the fact that the total number of covid cases is still less than the number of annual flu deaths. Covid is very serious and we should not be complacent about it. But I think it's important to keep some perspective, especially since we seem to be on the brink of shutting down the entire global economy.
netheril96 7y ago
COVID-19 is unlike anything before (in modern times). Especially HIV. You don't catch HIV by boarding the subway, eating in a restaurant, or running a marathon. For most people, avoiding unsafe sex is enough to avoid HIV. But if COVID-19 spreads to their country, people's daily lives will be significantly disrupted. SARS, MERS, Ebola, Zika are a little more like COVID-19, except they never propagate that far.
- bamboozled 7y ago
  Do you really think getting HIV is even slightly comparable to having HIV though? Sure you can catch COVID-19 more easily, but it seems like having HIV is a far worse outcome.
  - netheril96 7y ago
    And having Ebola is a even worse outcome. But few in developed countries worry about Ebola at all. Why? Because it is not easy for them to catch Ebola at all.
    - bitreality 7y ago
      This is a disease with a high spread rate, medium fatality rate. That's far more of a public threat than low spread rate, high fatality rate. Spread rate is far more relevant than death rate, and to top it off someone can be spreading it for weeks with no symptoms.
  - ck425 7y ago
    HIV is an incredibly manageable disease these days. The day to day effects are on a similar scale to Diabetes ie take regular medication and watch for specific symptoms that could imply it worsening. Otherwise there relatively little day to day impact other than the stigma. I should caveat that I'm referring to countries with a modern and available health system.
    - deleted 7y ago
      [deleted]
deleted 7y ago
[deleted]
shas3 7y ago
70 year olds too have their own virus stories outside the 40 year period you mention. Especially 1957 and 1968 (indian context). Biowarfare paranoia aside, I don’t think there is anything special about the modern era when it comes to the genesis of new viruses.
tanilama 7y ago
COVID-19 is much more powerful than any of these you mentioned before. It is SARS+, less fatal but much more infectious. In a way, it is a very successful virus (in a nightmare scenario), that aspiring to become the next flu. The Chinese scientists had admitted that, we might have to live with this virus from this time forward. It won't go away like SARS-v1. Also to note, fatality rate might seem low, but 20% of ALL patients will develop severe lung issue, that is what makes this virus pretty damn dangerous to us.
- lotsofpulp 7y ago
  >Also to note, fatality rate might seem low, but 20% of ALL patients will develop severe lung issue, that is what makes this virus pretty damn dangerous to us. Source?
  - yulaow 7y ago
    - 13.8% are severe, developing severe diseases including pneumonia and shortness of breath. - 4.7% as critical and can include: respiratory failure, septic shock, and multi-organ failure. https://www.worldometers.info/coronavirus/coronavirus-symptoms/ https://www.worldometers.info/coronavirus/coronavirus-sympto...
    - lotsofpulp 7y ago
      I don’t know how reputable that website is, the company that owns that website has less than 10 employees and was founded in 2016. I’d rather get the info from CDC/WHO/other reputable organizations for info. Lots of grand claims on this website too, makes it seem sketchy: https://dadax.cn/en/about-dadax/ https://dadax.cn/en/about-dadax/
  - hellofunk 7y ago
    It’s been widely reported by health officials all over the world that 80% of cases have only mild illness, but the remaining 20% have very serious illness.
swebs 7y ago
And diseases like this must have been forming and quickly dying off throughout history. It wasn't until the advent of globalization and intercontinental travel that they've become pandemics.
socialdemocrat 7y ago
Oh I remember we were scared as hell about HIV back in the 80s.
billfruit 7y ago
Actually I find that the HIV epidemic rarely discussed when the press is discussing the current epidemic. US didn't reply crown themselves with glory in handling the HIV situation, iirc more than 4000 people had died before the President Regan started to act anything about it.
billfruit 7y ago
Also the 1994 plague epidemic in India, centered at Surat.
monkeynotes 7y ago
> killed 30 million people (HIV) Over decades. Airborne viruses have the potential to large numbers of people in a matter of months.

lisper 7y ago

Seasonal flu kills hundreds of thousands of people every year and we barely talk about that.

samastur 7y ago
Yes, because it infects so many millions. Covid-19 right now looks a magnitude more deadly with significant long term health consequences for many who survive.
- _-___________-_ 7y ago
  > a magnitude more deadly Probably not. Case fatality rates don't accurately show the "deadliness" since many people have likely been infected but been asymptomatic or had mild illness that didn't cause them to seek medical advice. > significant long term health consequences for many who survive There is no evidence for that, and it doesn't make sense given the available data. Some number of people have long-term health consequences, and if you only compare that number to the number of people who went to hospital with serious illness, you might see a high percentage, but that's a huge distortion of reality.
  - djmips 7y ago
    > Probably not. Case fatality rates don't accurately show the "deadliness" since many people have likely been infected but been asymptomatic or had mild illness that didn't cause them to seek medical advice. I agree with this point but would also like to point out the possibility that way more people get infected by SARS-CoV-2 than the flu. I also want to note that the flu also has the same asymptomatic or mild illness factor and that the deadliness would be only comparing people who sought medical treatment.
  - mrb 7y ago
    Yes, it is a magnitude deadlier than the flu. We now have 4 independent estimates that place the Infection Fatality Ratio at about 0.5% to 1.7% which is between 5x and 17x deadlier than the flu (0.1%): https://twitter.com/zorinaq/status/1230977769795776512 https://twitter.com/zorinaq/status/1230977769795776512 Incidentally, this makes COVID19 comparable to the 1918 Spanish Flu (IFR ~2%) according to experts (see link above). And keep in mind the IFR, unlike the CFR, is the metric that takes into account undetected mild or asymptomatic cases. «There is no evidence for that» There is, see https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30305-6/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... : In those who survive intensive care, [...] aberrant and excessive immune responses lead to long-term lung damage and fibrosis, causing functional disability and reduced quality of life.
  - samastur 7y ago
    I agree that exact rates are difficult to determine, will change over time and one should not overreact, but there is plenty of evidence for what I said. If this virus would be just like flu, then Wuhan wouldn't have much problem coping.
    - _-___________-_ 7y ago
      If it was a brand new flu, to which people had no immunity, which was initially covered up and then largely "responded to" by crowding everyone who might possibly have been infected into overcrowded, shared quarantine centres where they are now virtually guaranteed to get it, I bet they would have the same problem coping.
  - cm2187 7y ago
    Agree, I hate to quote Trump, but there seems to be many “doomers” among us, who seem to take some kind of pleasure in entertaining the idea that we are in the middle of some big disaster. For the moment the numbers I see (mentioned in my other post [1]) seem to support something slightly worse than the common flu, but nothing that should be really concerning. Also the comparison to the Spanish flu often ignores the fact that we are way better equipped to deal with the symptoms than in 1918. [1] https://news.ycombinator.com/item?id=22421649 https://news.ycombinator.com/item?id=22421649
- deleted 7y ago
  [deleted]
watwut 7y ago
Mortality of flu is over 0.1%, with coronavirus it is over 2%. And flu has shorter incubation time. That is massive difference.
- baq 7y ago
  2% may be still too high, it might even be high sub 1% (e.g. .7%), but the big problem is how many of cases require hospitalization and especially intensive care. if number of ICU patients grows 10x in one month, we're all in trouble and that's seemingly what happened in China.
  - trengorilla 7y ago
    I don't understand how this figure keeps getting quoted. Out of cases that have been fully resolved we're now at an 8% mortality rate. 2% is counting ongoing cases, that's not the figure you should be looking at.
    - bart_spoon 7y ago
      Because the 8% mortality rate is based on resolved cases, and it generally takes people longer to fully recover than it does to die, so it is skewed upwards. A couple of weeks ago, the same mortality figure was near 30%, because most people with the disease who were not going to die hadn't had time to recover yet. Things are still early enough that the 8% figure will continue to go down. Additionally, it is widely acknowledged that the actual number of cases is undercounted, with the mildest cases less likely to have been tested and included in those numbers, again resulting in overly high numbers. And finally, it would appear that Wuhan in particular is skewing the numbers higher, as being the site of the outbreak it was caught off guard and has struggled to manage the number of cases. Elsewhere in both China and the world, the death rate is far lower. The estimate of 8% is unquestionably much too high. Exactly what the mortality rate is will still take more time to discover.
      - trengorilla 7y ago
        Thanks.
pengaru 7y ago
Or mosquitoes and the malaria they spread... Malaria was responsible 405,000 deaths globally in 2018 according to [0]. [0] https://www.who.int/news-room/feature-stories/detail/world-malaria-report-2019 https://www.who.int/news-room/feature-stories/detail/world-m...
- djmips 7y ago
  How many people do you know with malaria? It's a tropical region disease. In a pandemic of Covid-19, it is going to affect people all over the world in every region.
  - pengaru 7y ago
    The parent mentioned Zika, any such list including Zika would be incomplete without Malaria as well. I agree that covid-19 seems to have a larger potential breadth, and didn't intend to downplay its significance.
  - ggm 7y ago
    How many people do you know with malaria? It's a tropical region disease. No. The name is Italian. It predates Italian colonies in the tropics. It's a disease which was endemic in marshlands believed to be caused by bad air Mal aria and was in Scotland amongst other places. Malaria is not exclusively tropical. Nor is dengue or mosquito borne encephalitis. Tropical wet regions sustain mosquitos. So do cooler climates.
  - adventured 7y ago
    > How many people do you know with malaria? It's a tropical region disease. Malaria is not inherently a tropical region disease. It routinely plagued Europe until the 1950s. Russia for one example had a huge Malaria outbreak in the early 1920s as did Eastern Europe broadly. "Gustavo Pittaluga (1876-1956) estimated that in 1923, 18 million people suffered from malaria in Russia, and that sixty thousand deaths occurred out of a total population of about 110 million (Anigstein, Pittaluga, 1925). Similar observations were made throughout the whole of eastern and south-eastern Europe and the former Ottoman Empire." http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-59702011000200009 http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104...
rixrax 7y ago
Yes it does. After we have vaccinated vast amounts of global population with flu vaccines that mostly work. Try flu without vaccination and potentially 10x mortality rate: CoVid-19.
- lisper 7y ago
  Maybe. We don't actually know how many mild or asymptomatic cases of covid are out there, and so we don't know what the mortality rate is. 2% is an upper bound, but almost certainly not the true mortality rate. I'm not saying that we should not take covid very seriously. I'm just saying that before we allow it to shut down the global economy we ought to maintain some perspective on the magnitude of the risks society already faces year-in and year-out.
DanBC 7y ago
I don't know about you but I'm bombarded every year with campaigns to get people immunised, and the meetings I go to talk about availability of the vaccine for the public, and for healthcare professionals, and how many professionals have been vaccinated so far and how we can ethically increase that number, and on top of that every year for the past however long in the English NHS there's been a lot of talk about winter pressure.
- lisper 7y ago
  Fair enough, but there is nonetheless a lot more hand-wringing about covid-19 than there is about seasonal flu despite the fact that the total number of covid cases is still less than the number of annual flu deaths. Covid is very serious and we should not be complacent about it. But I think it's important to keep some perspective, especially since we seem to be on the brink of shutting down the entire global economy.

netheril96 7y ago

COVID-19 is unlike anything before (in modern times). Especially HIV. You don't catch HIV by boarding the subway, eating in a restaurant, or running a marathon. For most people, avoiding unsafe sex is enough to avoid HIV. But if COVID-19 spreads to their country, people's daily lives will be significantly disrupted. SARS, MERS, Ebola, Zika are a little more like COVID-19, except they never propagate that far.

bamboozled 7y ago
Do you really think getting HIV is even slightly comparable to having HIV though? Sure you can catch COVID-19 more easily, but it seems like having HIV is a far worse outcome.
- netheril96 7y ago
  And having Ebola is a even worse outcome. But few in developed countries worry about Ebola at all. Why? Because it is not easy for them to catch Ebola at all.
  - bitreality 7y ago
    This is a disease with a high spread rate, medium fatality rate. That's far more of a public threat than low spread rate, high fatality rate. Spread rate is far more relevant than death rate, and to top it off someone can be spreading it for weeks with no symptoms.
- ck425 7y ago
  HIV is an incredibly manageable disease these days. The day to day effects are on a similar scale to Diabetes ie take regular medication and watch for specific symptoms that could imply it worsening. Otherwise there relatively little day to day impact other than the stigma. I should caveat that I'm referring to countries with a modern and available health system.
  - deleted 7y ago
    [deleted]

deleted 7y ago

[deleted]

shas3 7y ago

70 year olds too have their own virus stories outside the 40 year period you mention. Especially 1957 and 1968 (indian context). Biowarfare paranoia aside, I don’t think there is anything special about the modern era when it comes to the genesis of new viruses.

tanilama 7y ago

COVID-19 is much more powerful than any of these you mentioned before. It is SARS+, less fatal but much more infectious. In a way, it is a very successful virus (in a nightmare scenario), that aspiring to become the next flu. The Chinese scientists had admitted that, we might have to live with this virus from this time forward. It won't go away like SARS-v1. Also to note, fatality rate might seem low, but 20% of ALL patients will develop severe lung issue, that is what makes this virus pretty damn dangerous to us.

lotsofpulp 7y ago
>Also to note, fatality rate might seem low, but 20% of ALL patients will develop severe lung issue, that is what makes this virus pretty damn dangerous to us. Source?
- yulaow 7y ago
  - 13.8% are severe, developing severe diseases including pneumonia and shortness of breath. - 4.7% as critical and can include: respiratory failure, septic shock, and multi-organ failure. https://www.worldometers.info/coronavirus/coronavirus-symptoms/ https://www.worldometers.info/coronavirus/coronavirus-sympto...
  - lotsofpulp 7y ago
    I don’t know how reputable that website is, the company that owns that website has less than 10 employees and was founded in 2016. I’d rather get the info from CDC/WHO/other reputable organizations for info. Lots of grand claims on this website too, makes it seem sketchy: https://dadax.cn/en/about-dadax/ https://dadax.cn/en/about-dadax/
- hellofunk 7y ago
  It’s been widely reported by health officials all over the world that 80% of cases have only mild illness, but the remaining 20% have very serious illness.

swebs 7y ago

And diseases like this must have been forming and quickly dying off throughout history. It wasn't until the advent of globalization and intercontinental travel that they've become pandemics.

socialdemocrat 7y ago

Oh I remember we were scared as hell about HIV back in the 80s.

billfruit 7y ago

Actually I find that the HIV epidemic rarely discussed when the press is discussing the current epidemic. US didn't reply crown themselves with glory in handling the HIV situation, iirc more than 4000 people had died before the President Regan started to act anything about it.

billfruit 7y ago

Also the 1994 plague epidemic in India, centered at Surat.

monkeynotes 7y ago

> killed 30 million people (HIV) Over decades. Airborne viruses have the potential to large numbers of people in a matter of months.