4 ms·

This is way more serious than the flu in multiple ways. First of all, estimates show that the case fatality ratio (CFR) is around 2%, which is 20x higher than t

This is way more serious than the flu in multiple ways. First of all, estimates show that the case fatality ratio (CFR) is around 2%, which is 20x higher than the flu. This number is likely to rise when ICUs are becoming over-constrained and cannot take new patients. This is already happening in the north of Italy as we speak. Second, the transmissibility of the SARS-nCov-2019 (the virus causing COVID-19) is much higher than the seasonal flu. This means the period within which a demand will be made on healthcare services will be much shorter and much more intense. Third, there are reports showing lasting damage to kidney and lung tissue (sponge-like structures). Even when surviving COVID-19, previously healthy people might become chronically ill. Fourth, in order to prevent at least part of what I am describing, very stringent measures are required. These already have a historic impact on our worldwide economy and will hit developed countries the most (since they require a worldwide infrastructure). It is very likely that the impact will become unprecedented as various continents are considering and implementing large-scale quarantine measures. Concluding, comparing COVID-19 with the regular flu is both simplistic and dangerous. Prepare yourself and your loved ones for a bumpy ride.

edejong 7y ago
Care to explain the down-voting?
- Loughla 7y ago
  I'll take a stab at why you're being down-voted.: >case fatality ratio (CFR) is around 2%, which is 20x higher than the flu. [Citation needed] >This number is likely to rise when ICUs are becoming over-constrained and cannot take new patients. This is already happening in the north of Italy as we speak. [Citation Needed] I can find citations for crowded hospitals in popular media, but nothing about the death rate increasing. >Third, there are reports showing lasting damage to kidney and lung tissue (sponge-like structures). Even when surviving COVID-19, previously healthy people might become chronically ill. [Major Citation Needed] >very stringent measures are required [Citation Needed] That's probably why. There are 4 claims you've made that need to be backed up with facts.
  - edejong 7y ago
    HN is not Wikipedia. I am more than happy to provide evidence for my claims, but I'd be downvoting almost every single comment on HN if those were the requirements. The CFR is easy to find with a Google search. There are multiple studies currently providing strong lower and upper bounds on CFR. My second statement has the word 'likely' in it. W.r.t. Italy, I am talking about an Italian media article describing over-constrained hospitals and the provisioning of military field hospitals. Third statement has some evidence in other parts of the thread. Fourth statement: many, many experts are warning that we are doing too little to late. The need for a response is logical given the high R0, CFR and needed hospitalization. If needed, I can provide some links, but going to my next meeting right now.
    - Loughla 7y ago
      HN is not wikipedia, correct. But there is a baseline for expectation, from what I can tell. If you're going to make claims of fact, especially for something controversial, you need to support with facts. That's your job as the person making the claim. Otherwise, you need to put a sentence in there that all of these things are just your opinion. And your response to me is just more hand-waving "i'm right i'm right" with zero content. You're still doing it.
chii 7y ago
> Third, there are reports showing lasting damage to kidney and lung tissue (sponge-like structures). Even when surviving COVID-19, previously healthy people might become chronically ill. you can't say that and not point to a source.
- edejong 7y ago
  Well, this [1] is an article describing extensive GGO [2] and subpleural parenchymal bands in recovered patients. I have read other reports from Wuhan doctors describing these effects, but some search terms seems to be censored these days. I am not a specialist, but it was described as lasting damage. [1] https://pubs.rsna.org/doi/10.1148/radiol.2020200370 https://pubs.rsna.org/doi/10.1148/radiol.2020200370 [2] https://en.wikipedia.org/wiki/Ground-glass_opacity https://en.wikipedia.org/wiki/Ground-glass_opacity
- simonh 7y ago
  Here's an article from the Lancet describing patients with high rates of organ function damage. It's not as useful as the one linked by edejong because it's a very early study. It shows that quite a few patients already had damage on admission, more than those that subsequently died so clearly many patients survived with organ damage, but it doesn't follow up on how many more may have suffered such damage after admission. So it's evidence, but not as strong. https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(20)30211-7.pdf https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736...
AnthonyMouse 7y ago
> First of all, estimates show that the case fatality ratio (CFR) is around 2%, which is 20x higher than the flu. These estimates are mostly from China. Obviously likely to be higher for a respiratory condition in a place with some of the worst air quality in the world. There is also some question about whether the less serious cases are even being identified -- if your sample is only of the people with severe symptoms, you get the wrong number for the percentage of people with severe symptoms. > Second, the transmissibility of the SARS-nCov-2019 (the virus causing COVID-19) is much higher than the seasonal flu. This means the period within which a demand will be made on healthcare services will be much shorter and much more intense. Fortunately flu season is coming to an end, so there will be less contention for resources there and the same reasons people get the flu less often in April than January will help to mitigate this. > Third, there are reports showing lasting damage to kidney and lung tissue (sponge-like structures). Even when surviving COVID-19, previously healthy people might become chronically ill. That can also be true of the flu, isn't it? > Fourth, in order to prevent at least part of what I am describing, very stringent measures are required. These already have a historic impact on our worldwide economy and will hit developed countries the most (since they require a worldwide infrastructure). This is probably just not going to happen. They'll try to contain it using strong measures when the number of cases is small enough that there is some hope of that actually happening, but strong measures aren't that problematic when they're only applied to a small number of people. If they fail in the early stages and millions of people become infected, the strong measures can't be justified at a large scale because once it's that widespread they won't be effective anyway. The point of the strong measures is to prevent that from happening. They aren't worth continuing after you've already lost.
- edejong 7y ago
  The estimates seem to be reflected by international numbers to a certain degree, ranging from 1%-3%. With the disease in exponential growth, dividing #death/#cases is not the right calculation to make, as it might take 3-5 weeks before a patient dies from the disease. The Princess Diamond ship is currently at 1.2% iirc. Your factor of under-representation of cases seems to cancel out the delayed onset of mortality at the moment. The end of the flu season is incomparable with the demands on the health-care system due to COVID-19 since flu-demand is at least 1-2 orders of magnitude smaller. The advantage of the end of the flu season is that we can identify cases quicker. W.r.t. lesions caused by COVID-19 comparable to the flu. Yes, both cause permanent damage. However, COVID-19 seems to attack more of the lungs and in general, both lungs, whereas influenza often is isolated to one lung. I am not a specialist, but I have read scary descriptions of COVID-19 lungs from specialists. The stringent measures are already happening and the effects are already being felt. The stock market has responded by evaporating 4000 billion in value. Given the past lackadaisical response of government, it is likely we will see further effects either way: response or not. If nothing is done and millions of people will get infected (think: 2 billion people) in a short amount of time (1 year), we will see widescale breakdown of services, global turmoil and panic. Hopefully, we will be able to slow the spread, develop a vaccine and 500 million people will get infected instead.

edejong 7y ago

Care to explain the down-voting?

Loughla 7y ago
I'll take a stab at why you're being down-voted.: >case fatality ratio (CFR) is around 2%, which is 20x higher than the flu. [Citation needed] >This number is likely to rise when ICUs are becoming over-constrained and cannot take new patients. This is already happening in the north of Italy as we speak. [Citation Needed] I can find citations for crowded hospitals in popular media, but nothing about the death rate increasing. >Third, there are reports showing lasting damage to kidney and lung tissue (sponge-like structures). Even when surviving COVID-19, previously healthy people might become chronically ill. [Major Citation Needed] >very stringent measures are required [Citation Needed] That's probably why. There are 4 claims you've made that need to be backed up with facts.
- edejong 7y ago
  HN is not Wikipedia. I am more than happy to provide evidence for my claims, but I'd be downvoting almost every single comment on HN if those were the requirements. The CFR is easy to find with a Google search. There are multiple studies currently providing strong lower and upper bounds on CFR. My second statement has the word 'likely' in it. W.r.t. Italy, I am talking about an Italian media article describing over-constrained hospitals and the provisioning of military field hospitals. Third statement has some evidence in other parts of the thread. Fourth statement: many, many experts are warning that we are doing too little to late. The need for a response is logical given the high R0, CFR and needed hospitalization. If needed, I can provide some links, but going to my next meeting right now.
  - Loughla 7y ago
    HN is not wikipedia, correct. But there is a baseline for expectation, from what I can tell. If you're going to make claims of fact, especially for something controversial, you need to support with facts. That's your job as the person making the claim. Otherwise, you need to put a sentence in there that all of these things are just your opinion. And your response to me is just more hand-waving "i'm right i'm right" with zero content. You're still doing it.

chii 7y ago

> Third, there are reports showing lasting damage to kidney and lung tissue (sponge-like structures). Even when surviving COVID-19, previously healthy people might become chronically ill. you can't say that and not point to a source.

edejong 7y ago
Well, this [1] is an article describing extensive GGO [2] and subpleural parenchymal bands in recovered patients. I have read other reports from Wuhan doctors describing these effects, but some search terms seems to be censored these days. I am not a specialist, but it was described as lasting damage. [1] https://pubs.rsna.org/doi/10.1148/radiol.2020200370 https://pubs.rsna.org/doi/10.1148/radiol.2020200370 [2] https://en.wikipedia.org/wiki/Ground-glass_opacity https://en.wikipedia.org/wiki/Ground-glass_opacity
simonh 7y ago
Here's an article from the Lancet describing patients with high rates of organ function damage. It's not as useful as the one linked by edejong because it's a very early study. It shows that quite a few patients already had damage on admission, more than those that subsequently died so clearly many patients survived with organ damage, but it doesn't follow up on how many more may have suffered such damage after admission. So it's evidence, but not as strong. https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(20)30211-7.pdf https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736...

AnthonyMouse 7y ago

> First of all, estimates show that the case fatality ratio (CFR) is around 2%, which is 20x higher than the flu. These estimates are mostly from China. Obviously likely to be higher for a respiratory condition in a place with some of the worst air quality in the world. There is also some question about whether the less serious cases are even being identified -- if your sample is only of the people with severe symptoms, you get the wrong number for the percentage of people with severe symptoms. > Second, the transmissibility of the SARS-nCov-2019 (the virus causing COVID-19) is much higher than the seasonal flu. This means the period within which a demand will be made on healthcare services will be much shorter and much more intense. Fortunately flu season is coming to an end, so there will be less contention for resources there and the same reasons people get the flu less often in April than January will help to mitigate this. > Third, there are reports showing lasting damage to kidney and lung tissue (sponge-like structures). Even when surviving COVID-19, previously healthy people might become chronically ill. That can also be true of the flu, isn't it? > Fourth, in order to prevent at least part of what I am describing, very stringent measures are required. These already have a historic impact on our worldwide economy and will hit developed countries the most (since they require a worldwide infrastructure). This is probably just not going to happen. They'll try to contain it using strong measures when the number of cases is small enough that there is some hope of that actually happening, but strong measures aren't that problematic when they're only applied to a small number of people. If they fail in the early stages and millions of people become infected, the strong measures can't be justified at a large scale because once it's that widespread they won't be effective anyway. The point of the strong measures is to prevent that from happening. They aren't worth continuing after you've already lost.

edejong 7y ago
The estimates seem to be reflected by international numbers to a certain degree, ranging from 1%-3%. With the disease in exponential growth, dividing #death/#cases is not the right calculation to make, as it might take 3-5 weeks before a patient dies from the disease. The Princess Diamond ship is currently at 1.2% iirc. Your factor of under-representation of cases seems to cancel out the delayed onset of mortality at the moment. The end of the flu season is incomparable with the demands on the health-care system due to COVID-19 since flu-demand is at least 1-2 orders of magnitude smaller. The advantage of the end of the flu season is that we can identify cases quicker. W.r.t. lesions caused by COVID-19 comparable to the flu. Yes, both cause permanent damage. However, COVID-19 seems to attack more of the lungs and in general, both lungs, whereas influenza often is isolated to one lung. I am not a specialist, but I have read scary descriptions of COVID-19 lungs from specialists. The stringent measures are already happening and the effects are already being felt. The stock market has responded by evaporating 4000 billion in value. Given the past lackadaisical response of government, it is likely we will see further effects either way: response or not. If nothing is done and millions of people will get infected (think: 2 billion people) in a short amount of time (1 year), we will see widescale breakdown of services, global turmoil and panic. Hopefully, we will be able to slow the spread, develop a vaccine and 500 million people will get infected instead.