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R0 value is roughly 4-7. Upwards of 5% of the cases require the ICU, 15% require support breathing. Medical personnel are coming down with it frequently, and It

R0 value is roughly 4-7. Upwards of 5% of the cases require the ICU, 15% require support breathing. Medical personnel are coming down with it frequently, and Italy is trying to bring in newly graduated nurses and retired nurses to fill the gap. This is NOT hysteria. While it isn't a death sentence for most, it is imperative to slow this thing down.

zaroth 7y ago
Please understand that every single one of those percentages is wrong as you have stated them. You forgot the most important qualifier, which is that the denominator is some fraction (potentially small fraction) of the total number infected. So when you say “upwards” of 5% of cases require the ICU, this is potentially very misleading. Stating that upwards of 5% of hospital cases require the ICU may be true, but now you must not try to extrapolate that value any further until you can tell me definitively what percentage of infections result in hospitalization? 1 in 5? 1 in 20? I won’t get into debating R0 values because they are nearly impossible not to misuse. For example, COVID-19 does not have just one R0 value. R0 changes radically based on actual conditions on the ground, often day to day. The R0 value of COVID in a cult church in South Korea may be actually 1,000 while the R0 globally over the entire course of this news cycle might be 1.2.
- jacquesm 7y ago
  > Please understand that every single one of those percentages is wrong as you have stated them. No, they are accurate as far as I know and I've been following this thing with some dedication since before it was discussed in the media because of relatively close ties to China. > You forgot the most important qualifier, which is that the denominator is some fraction (potentially small fraction) of the total number infected. You are misrepresenting the OP's words. He said 'of cases', that is the denominator right there. That we don't know all cases is something that everybody takes as a given. But just like we don't know all cases we also don't know all of the dead. The same happened with the swine flu, with SARS and with every other epidemic so far. Only afterwards, sometimes more than a year later do we have all the numbers. And sometimes those end up substantially higher than the original estimate both for the number of infected people as well as for the number of people that end up dead. > So when you say “upwards” of 5% of cases require the ICU, this is potentially very misleading. Upwards of 5% of the known cases. But that's assumed, if we don't know someone is infected then they by definition won't require ICU level care. > Stating that upwards of 5% of hospital cases require the ICU may be true, but now you must not try to extrapolate that value any further until you can tell me definitively what percentage of infections result in hospitalization? 1 in 5? 1 in 20? They don't need to tell you anything 'definitely' to be allowed to speak their mind. And as far as I'm informed that 5% rate is on the money. So, instead, the onus is on you to prove that less than 5% of the people infected that require care require ICU care. I don't think you are able to do that but I will happily take good news at this point if properly sourced. > I won’t get into debating R0 values because they are nearly impossible not to misuse. Agreed. > For example, COVID-19 does not have just one R0 value. R0 changes radically based on actual conditions on the ground, often day to day. > The R0 value of COVID in a cult church in South Korea may be actually 1,000 while the R0 globally over the entire course of this news cycle might be 1.2. True, but there are averages and even the WHO seems to place the number at > 3 at this point in time. That is already a pretty high number, even when taking all the care in the world to ensure it doesn't spread. Of course the criminals in Korea that hope to bring about the end times in some kind of warped self fulfilling religious prophesy are going to skew that number upwards. But in Iran and Italy there was no such cult, and their numbers are very much in line with the development in Korea. And since we're mentioning Iran now, there are lots of informal reports that the situation there is much worse then officially reported, with the number of high officials there infected this - unfortunately - isn't hard to believe at all.
  - zaroth 7y ago
    I think it’s very important to be precise if you’re speaking of potential worldwide calamity. I think you may be giving OP too much credit with their use of “cases” implying hospital cases (which is the 5% ICU number, it is not 5% of infections require the ICU) I’m happy if we are agreeing and will leave it at that. > Upwards of 5% of the known cases. But that's assumed, if we don't know someone is infected then they by definition won't require ICU level care. You are still making too strong of a statement. In the study last week from NEJM of 1099 hospital patients around China that found that 90% plus were diagnosed with pneumonia, and 5% were admitted to the ICU. Case fatality rate was 1.4%. [1] It is absolutely not 5% of “known” cases. China turned anybody not seriously ill from the hospitals back home. So we actually do know there are a large number of uncounted mild (and even asymptomatic) cases. It is 5% of serious hospital cases going on to the ICU. This is not my claim, this is straight from the latest issue of the NEJM. Also, I didn’t say anyone couldn’t speak their mind. But I said if you do try extrapolating a sub-population percentage and multiplying by world population, it would be a serious miscalculation. That’s why I think it’s important (crucial) to clearly identify the sub-population when you state the percentage. Calling a sub-population dealing with hospital admittances the “known” cases is not clearly stating identifying the patient population. I don’t think HN commentators should play epidemiologist while making predictions of catastrophe. https://www.nejm.org/doi/full/10.1056/NEJMoa2002032 https://www.nejm.org/doi/full/10.1056/NEJMoa2002032
    - jacquesm 7y ago
      > But if you extrapolating a sub-population percentage and multiplying by world population Where did that happen? In this thread or elsewhere?
      - deleted 7y ago
        [deleted]
      - zaroth 7y ago
        I did not say that anyone did try to extrapolate numbers using these percentages in this thread. I said, and am saying, that it’s important not to try to do that. Because it leads to fear-mongering. For example, downthread, here; https://news.ycombinator.com/item?id=22461804 https://news.ycombinator.com/item?id=22461804
- pergadad 7y ago
  If you really want to doubt the numbers you can doubt them also very well the other way: there are incentives at various levels of Chinese government to understate the issue.
pergadad 7y ago
Also >80% of the world population does not have access to great quality healthcare....

zaroth 7y ago

Please understand that every single one of those percentages is wrong as you have stated them. You forgot the most important qualifier, which is that the denominator is some fraction (potentially small fraction) of the total number infected. So when you say “upwards” of 5% of cases require the ICU, this is potentially very misleading. Stating that upwards of 5% of hospital cases require the ICU may be true, but now you must not try to extrapolate that value any further until you can tell me definitively what percentage of infections result in hospitalization? 1 in 5? 1 in 20? I won’t get into debating R0 values because they are nearly impossible not to misuse. For example, COVID-19 does not have just one R0 value. R0 changes radically based on actual conditions on the ground, often day to day. The R0 value of COVID in a cult church in South Korea may be actually 1,000 while the R0 globally over the entire course of this news cycle might be 1.2.

jacquesm 7y ago
> Please understand that every single one of those percentages is wrong as you have stated them. No, they are accurate as far as I know and I've been following this thing with some dedication since before it was discussed in the media because of relatively close ties to China. > You forgot the most important qualifier, which is that the denominator is some fraction (potentially small fraction) of the total number infected. You are misrepresenting the OP's words. He said 'of cases', that is the denominator right there. That we don't know all cases is something that everybody takes as a given. But just like we don't know all cases we also don't know all of the dead. The same happened with the swine flu, with SARS and with every other epidemic so far. Only afterwards, sometimes more than a year later do we have all the numbers. And sometimes those end up substantially higher than the original estimate both for the number of infected people as well as for the number of people that end up dead. > So when you say “upwards” of 5% of cases require the ICU, this is potentially very misleading. Upwards of 5% of the known cases. But that's assumed, if we don't know someone is infected then they by definition won't require ICU level care. > Stating that upwards of 5% of hospital cases require the ICU may be true, but now you must not try to extrapolate that value any further until you can tell me definitively what percentage of infections result in hospitalization? 1 in 5? 1 in 20? They don't need to tell you anything 'definitely' to be allowed to speak their mind. And as far as I'm informed that 5% rate is on the money. So, instead, the onus is on you to prove that less than 5% of the people infected that require care require ICU care. I don't think you are able to do that but I will happily take good news at this point if properly sourced. > I won’t get into debating R0 values because they are nearly impossible not to misuse. Agreed. > For example, COVID-19 does not have just one R0 value. R0 changes radically based on actual conditions on the ground, often day to day. > The R0 value of COVID in a cult church in South Korea may be actually 1,000 while the R0 globally over the entire course of this news cycle might be 1.2. True, but there are averages and even the WHO seems to place the number at > 3 at this point in time. That is already a pretty high number, even when taking all the care in the world to ensure it doesn't spread. Of course the criminals in Korea that hope to bring about the end times in some kind of warped self fulfilling religious prophesy are going to skew that number upwards. But in Iran and Italy there was no such cult, and their numbers are very much in line with the development in Korea. And since we're mentioning Iran now, there are lots of informal reports that the situation there is much worse then officially reported, with the number of high officials there infected this - unfortunately - isn't hard to believe at all.
- zaroth 7y ago
  I think it’s very important to be precise if you’re speaking of potential worldwide calamity. I think you may be giving OP too much credit with their use of “cases” implying hospital cases (which is the 5% ICU number, it is not 5% of infections require the ICU) I’m happy if we are agreeing and will leave it at that. > Upwards of 5% of the known cases. But that's assumed, if we don't know someone is infected then they by definition won't require ICU level care. You are still making too strong of a statement. In the study last week from NEJM of 1099 hospital patients around China that found that 90% plus were diagnosed with pneumonia, and 5% were admitted to the ICU. Case fatality rate was 1.4%. [1] It is absolutely not 5% of “known” cases. China turned anybody not seriously ill from the hospitals back home. So we actually do know there are a large number of uncounted mild (and even asymptomatic) cases. It is 5% of serious hospital cases going on to the ICU. This is not my claim, this is straight from the latest issue of the NEJM. Also, I didn’t say anyone couldn’t speak their mind. But I said if you do try extrapolating a sub-population percentage and multiplying by world population, it would be a serious miscalculation. That’s why I think it’s important (crucial) to clearly identify the sub-population when you state the percentage. Calling a sub-population dealing with hospital admittances the “known” cases is not clearly stating identifying the patient population. I don’t think HN commentators should play epidemiologist while making predictions of catastrophe. https://www.nejm.org/doi/full/10.1056/NEJMoa2002032 https://www.nejm.org/doi/full/10.1056/NEJMoa2002032
  - jacquesm 7y ago
    > But if you extrapolating a sub-population percentage and multiplying by world population Where did that happen? In this thread or elsewhere?
    - deleted 7y ago
      [deleted]
    - zaroth 7y ago
      I did not say that anyone did try to extrapolate numbers using these percentages in this thread. I said, and am saying, that it’s important not to try to do that. Because it leads to fear-mongering. For example, downthread, here; https://news.ycombinator.com/item?id=22461804 https://news.ycombinator.com/item?id=22461804
pergadad 7y ago
If you really want to doubt the numbers you can doubt them also very well the other way: there are incentives at various levels of Chinese government to understate the issue.

pergadad 7y ago

Also >80% of the world population does not have access to great quality healthcare....