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You asked for an extrapolation example, I gave that one. OK, so we agree people are extrapolating with these numbers. Now, you want to keep playing that game.

• jacquesm 7y ago
  > Now, you want to keep playing that game. I am not playing games. This stuff is far too serious to play games over. > To extrapolate over the general population with the 1.4% case fatality of serious hospital cases, would be wrong and would be fear mongering. The general population does not have a infection rate of 100% nor a case fatality rate of 1.4%. No, but the Spanish Flu for instance had an infection rate of about 25%, and the general infected population could very well be above that 1.4% (in fact, there is every indication so far that it will end up somewhere between 2 and 3%). > So the premise is wrong, the assumptions are wrong, and the result are wrong. The premises isn't nearly as faulty as you make it out to be, it might be off by a factor of four, hopefully much less than that. But so far - taking Wuhan as our baseline - unchecked this thing will spread very fast and kill lots of people. The only reason the onslaught was halted is because the Chinese took a bunch of draconian counter measures, the likes of which very few countries in the world will be able to copy. > Qualifying a statement ending with ”means 2 million deaths in that single bracket alone.” with a qualifier that is false is what I would call fearmongering. That's fine by me. But it isn't. As a whole it isn't and in the details it isn't either. We actually have precedent for this whole situation, it is the 1918 pandemic and the world apparently hasn't learned its lesson fully. Which may mean we are about to re-learn it the hard way. Maybe this time it will stick. But then - as now - there were plenty of people like you who were willfully - given the way this conversation is progressing I am assuming you are doing this on purpose - ignoring the cold hard facts. And that made the pandemic much worse than it had to be. Large events were not called off and led to the disease spreading much further than it had to. Absent an effective anti-dote to this virus and with an overwhelmed health care system (note the qualifiers!) we might as well be in 1918. > No, it’s not an “implied assumption” it’s faulty epidemiology. Not as far as I can see. People talk about hypotheticals all the time. You can't really come out like this against a pretty clear comment and at the same time make up stuff you rail against that never happened in the first place. Fix your own issues first. > First, it is faulty to assume that everyone who is exposed will be infected. Agreed, so let's divide the number by 4 and call it a day. That's the worst this could possibly get. Right? Or do you think that given a sample of '1' the 1918 flu might not be the best guideline for precision and that it might be better or worse? We don't actually know the answer to that. > Second, it is faulty to apply the 1.4% case fatality rate of serious hospital infections to the entire US population. That's true. But for all the same money we end up with a higher case fatality rate. So that may end up affecting the equation in a negative way. But assuming 10% of the country becomes infected and 5% of those end up with symptoms serious enough to warrant ICU care there is a serious problem. And that 10% could very well be low. So as far as I'm concerned you should start taking this a bit more serious instead of trying to shout down the discussion. Stay dispassionate and try to argue your case with actual numbers rather than nay-saying. That way you can contribute rather than just irritate. Think of it as an opportunity to educate, and you just might learn a thing or two yourself.
  • zaroth 7y ago
    Look, I appreciate the discussion, and I’m about to sign off. I just want to say, it’s easy to take the wrong numbers, multiply together, and see 100 ways that millions of people die. That’s fear mongering. What I believe is that it’s incumbent on anyone who wants to participant in predictive discussions to do so responsibly and using only the best numbers that we have on hand. Anything could happen. And this is always true, whether it’s the Ebola discussion from a while back, or SARS, or MERS, or COVID today. You still seem to insist on claiming that we could see pervasive worldwide infection, 5% ICU admits, and 1.4%+ general population fatality. I hope you will soon realize that is not actually representative of what we are facing, where in fact, the vast majority of cases are mild or even asymptomatic. I expect this will be clear even to the most avid doomers by mid-April. Lastly, I don’t want to go back and forth on little things, but this; > at the same time make up stuff you rail against that never happened in the first place. Fix your own issues first. I think you need to re-read what I originally wrote. I never strawmaned. I said the numbers were all wrong as they were stated due to lack of proper context. I could have used the word “useless” or “misleading” instead of “wrong” and that might have been better. I then followed up by saying it’s imperative not to try to use those numbers to extrapolate in the general population. I could have said “one must not”. I was not accusing Op of doing this. I was trying to say that the danger of not properly qualifying the context of a percentage like case fatality is that people will misuse it by improperly extrapolating. Then we found an example down thread which does exactly that... and you defend it anyway. Which is fine, but I stand my ground on the argument (same as the NEJM doctors) that it’s improper to extrapolate the hospital case fatality to the general population. If one “assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%.” (NEJM)
    • jacquesm 7y ago
      > using only the best numbers that we have on hand. But you yourself are not doing that. You quote data that has been long ago overrun by the reality on the ground. > You still seem to insist on claiming that we could see pervasive worldwide infection, 5% ICU admits, and 1.4%+ general population fatality. We could. We also could not. Let's hope for the best and plan for the worst. That way we can all laugh at this a year from now. > I hope you will soon realize that is not actually representative of what we are facing, where in fact, the vast majority of cases are mild or even asymptomatic. I do not doubt that at all. But that does not rule out that the numbers could still be quite bad. 10% infected and 1.4% CFR would be very bad news. > I expect this will be clear even to the most avid doomers by mid-April. Maybe those 'avid doomers' aren't the doomers. The doomers are the cultists and the 'we're all going to die' people. We're not all going to die. But unless we take substantial countermeasures a lot more people will die than need to. Look at Iran for a taste of that. And that's the message that should go out: reduce the opportunity for the virus to spread so that we get to R0 < 1 as soon as possible and then mop up from there. Anything less and it will just get worse and worse.