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Coronavirus: an email to my family
- gentleman11 7y agoIs Juliana Grant a noteworthy expert or something?
- tessierashpool 7y agoFor those of you who don’t know me well, I am a preventive medicine physician and infectious disease epidemiologist. I graduated from the CDC’s Epidemic Intelligence Service and have over 17 years of experience in the field, most of that with CDC.
- tasuki 7y agoI have no idea whether she's "noteworthy", but yes, she's an epidemiologist. That, and her advice makes sense.
- nostromo 7y agoThis seems to be overstating things. > COVID-19 seems to be most severe in older adults. The median age of deaths is 75. I guess that’s technically “older adults” but I think “elderly” would be a better description. https://www.nytimes.com/2020/01/23/world/asia/coronavirus-victims-wuhan.html https://www.nytimes.com/2020/01/23/world/asia/coronavirus-vi... > there are a number of indications that it will be very much like the 1918 Flu Pandemic The New England Journal of Medicine has a different take: https://www.nejm.org/doi/full/10.1056/NEJMe2002387 https://www.nejm.org/doi/full/10.1056/NEJMe2002387 It sounds increasingly likely that the fatality rate is less than 1%, potentially a lot less, as were now hearing that 80% of people don’t even get sick enough to seek medical attention, and many have no signs of illness at all — which means the denominator in the death rate is likely much higher than is accounted for in the common 2% metric from the first data. > Expect people you know to die. Aside from this likely being inaccurate, is this language even remotely helpful?
- gamegoblin 7y agoWhat puts it in more relatable terms for me is if the death rate for elderly is 1 in 10, and the virus spreads into "basically everyone will get it" territory, statistically that will be several funerals for elderly family and friends I will attend this year. And while that isn't society-ending apocalypse, it's still impactful on a personal level.
- fiblye 7y agoThat statistic still only takes into account known and confirmed infections. Most reported deaths are from people who have other major health issues. With reports of people being infected in nursing homes, there's a possibility that even the elderly are being silently infected and symptoms aren't severe enough for them to seek treatment. It seems like there's some unknown factor that makes some people extremely sensitive to it, while others feel nothing at all.
- notacoward 7y ago> Most reported deaths are from people who have other major health issues. The percentage of people 70+ who have "other major health issues" is higher than you seem to think. People who are themselves in their 40s or 50s are likely to know several. Maybe that's not as true for people in their 20s, especially those who live within a closed social circle of mostly their FAANG/startup coworkers, but it's a bit insensitive (at best) to act as though that's true for everyone.
- fiblye 7y agoThanks for the completely inaccurate personal attack. :) News articles regarding this have been very explicit about saying the victims have notable health problems and not simply age. e.g., A long history of lung problems, cancer, etc. Plenty of old people are recovering fine, and I'm sure the reason health issues are mentioned is because those people have exceptionally bad health in some way. I don't think anyone really doesn't know that old people are less healthy overall. It's bizarre that some people think they need to explain that fact in a condescending manner.
- ganafagol 7y ago> COVID-19 seems to be most severe in older adults. Children and young adults generally have mild infections. We are grateful for this. I'm sorry to ask this .. why are we grateful for this?
- allendoerfer 7y agoWould it be worse for you if your 80 year old mother were to die or your 4 year old daughter? Which would surprise and shock you more? Which would be the thing you are more prepared for, because you already had the thought in your head that this would happen at some time? Which would possibly be so devastating it could also end your relationship to your partner, redefine you as a person and totally change your life?
- jackpirate 7y agoIf we have to choose between having a 75 year old and a 5 year old die, most people would choose the 75 year old. They would be dying relatively soon anyways.
- ganafagol 7y agoI love both. The "if you had to choose" argument is a horribly utilitaristic one and I'm happy I'm neither related nor acquainted with anybody seriously bringing it up.
- ggm 7y agohorribly utilitaristic invites 'one man's meat is another man's poison.' Lots of people think utility is a higher goal.
- nostromo 7y agoIt's based on the egalitarian notion that every human deserves a long and healthy life. If an older person's life ends a bit earlier than it should have, it's sad. But a child's life ending premature, before they've had much of a life at all, is worse, by most peoples' calculus.
- 7y ago
- m0zg 7y ago>> It’s possible that COVID-19 will be similar to a bad flu year but there are a number of indications that it will be very much like the 1918 Flu Pandemic. This, right here, is horseshit. There is no way whatsoever it will be like the 1918 Flu Pandemic, unless we've utterly failed as a society and did not invent anything in the last 102 years. In 1918 we didn't yet have _penicillin_, let alone antiviral drugs. More accurate prediction: this will be only slightly worse than the seasonal flu we endure every year. In fact, it's quite possible that this year in the US more people will die of the complications of the flu, than of COVID19.
- mlvljr 7y agoAlready the case, per what I read on HN last week.
- cycrutchfield 7y ago5-10x more deadly than influenza is “only slightly worse”?
- m0zg 7y agoNobody knows if it's 5-10x more deadly because nobody knows the denominator - the _total_ number of cases, including the cases which are mild (which most of them are), and for which people are unlikely to seek treatment. Also, even allowing hypothetically that it's 5x as deadly in China, that doesn't mean its CFR is the same in the developed world.
- chapelierfou 7y agoSo nobody knows, but somehow you know better?
- mrb 7y agoThe denominator was estimated by multiple teams: https://news.ycombinator.com/item?id=22405204 https://news.ycombinator.com/item?id=22405204 That's why we are fairly confident in the approximative CFR range of 0.5%-1.6% See more details in all the studies I link to in my post at: https://blog.zorinaq.com/case-fatality-ratio-ncov/#updates--validation https://blog.zorinaq.com/case-fatality-ratio-ncov/#updates--...
- enchiridion 7y agoI am seeing some harsh comments here out of fear. I dealt with the same reaction from family members. The U.S. is doing very little to prevent this. A lot of people, especially elderly people, will likely die. It will also likely have a severe impact on the market. The sooner we can all accept this and prepare the better.
- pbourke 7y ago> It will also likely have a severe impact on the market. Not just the market - the real economy.
- dosethree 7y ago"The U.S. is doing very little to prevent this. A lot of people, especially elderly people, will likely die." At this point, what realistically could the US do to prevent this? It will continue to spread in other countries, and there's nothing the US can do about that. We can implement more severe travel restrictions, but that has its own issues and it's not recommended by the WHO. That will only be effective for a period of time in the beginning of the virus spread, and they are basically doing that afaik Im no expert, but besides providing financial or medical aid to to the countries fighting the virus, and helping developing a vaccine/cure, I'm not sure what the US should be doing prevention wise
- cheeseomlit 7y agoMuch more stringent travel restrictions beginning a month ago would've helped
- koheripbal 7y agoThere is considerable value in SLOWING the virus. 1. You smooth out the cases that end up in hospitals and ICUs 2. You give more time for a vaccine to be developed and deployed. 3. You reduce the economic impact.
- enchiridion 7y agoExactly #1. From what I've seen, in a best case scenario we have 30k extra ventilators. Reportedly, 6% of cases require ventilation. Some quick math shows that only .16% of the population needs to be infected at the same time for our ventilator supply to runs out.
- remarkEon 7y ago> For those of you who don’t know me well, I am a preventive medicine physician and infectious disease epidemiologist. I graduated from the CDC’s Epidemic Intelligence Service and have over 17 years of experience in the field, most of that with CDC. For those here expressing skepticism of the author's (admittedly dire) predictions, what set of credentials should someone have before you take what they say seriously? Not trying to be snarky. Perhaps I simply wish to understand more of what people find convincing in situations like this and why.
- miked85 7y agoI am not sure there is any set of credentials which would make me trust someone's predictions.
- koheripbal 7y agoReally? That doesn't seem rational. If a doctor diagnosed you with pancreatic cancer and told you that you had 6 months to live - you would not trust his prediction?
- miked85 7y agoI would get a second and third opinion, and then decide. I guess my point was that I am not going to trust any one individual based off of their credentials.
- samvher 7y agoI think a lot of the comments in this discussion risk understating the potential impact of the virus. Yes, there are many unknowns, and we might not encounter the worst-case scenario. But many experts have basis for being worried, e.g. listen to these interviews [1,2]. It will take a while before the virus really spreads in the US/Europe but it seems pretty clear that it's not contained anymore. Remarks about the fatality rate cut both ways: if it's lower than reported it means that the virus is spreading faster than we think (more mild cases), if it's higher than reported there are going to be many more fatalities still. There are arguments to be made for both (lower: many mild cases go undetected, higher: reported fatality rates often seem to be calculated from active cases, not complete cases). Either way it's clear that in China the rate of infection was well beyond what hospitals could handle which seems to indicate that we might encounter similar issues. Let's just be careful and be prepared, there really seems to be too little info to get comfortable with this at this point. [1] https://www.stitcher.com/podcast/deep-background-with-noah-feldman/e/67663436 https://www.stitcher.com/podcast/deep-background-with-noah-f... [2] https://www.nytimes.com/2020/02/27/podcasts/the-daily/coronavirus.html https://www.nytimes.com/2020/02/27/podcasts/the-daily/corona...
- remarkEon 7y ago>Either way it's clear that in China the rate of infection was well beyond what hospitals could handle which seems to indicate that we might encounter similar issues. What's more concerning about what happened in China is that it overwhelmed their healthcare infrastructure even after they implemented what would otherwise be called martial law throughout the country for a period of time.
- clumsysmurf 7y agoJust FYI: Reddit /r/coronavirus is having an AMA with a panel of experts from WebMD on Wednesday, March 4 at 12pm EST /r/covid19 is an interesting scientific discussion of the topic.
- pbourke 7y agoWhat is wrong with this god-damned site? Seriously, this post was #25 on the front page, I check again and it's buried 4 pages deep literally 10 minutes later. Some people in this community are in really deep denial and do not understand the concept of asymmetric risk. This is a clearly written piece that can be shared widely with your network, especially for people who may not be clued in to the situation. Please share this.
- samvher 7y agoI don't get this either - the front page has many posts with fewer points over a longer period. Maybe downvotes are treated differently from upvotes in the sorting algorithm?
- koheripbal 7y agoI think it's more likely they don't understand the concept of exponential growth. China had to literally shut down their entire economy just to slow the virus. Our only hope is warm weather and some way to speed vaccine development.
- demosito666 7y agoHonest question: how one can ditinguish coronavirus from other "pandemics" of recent years like svine flu or bird flu or whatnot? Those happened primarily on TV news, and the informational background was about the same: apocalyptic pictures of empty airport, packed hospitals, etc. Why should an average Joe care more this time?
- koheripbal 7y agoI don't believe any of those had packed hospitals nor piles of bodies, as we've seen for this one. There are some major differences.
- gmoore 7y agoMuch conjecture, not supporting data. Much of what he predicts is not supported by the CDC which he starts off saying you should listen to first....