5 ms·

To be clear, at this time we only the “CFR” - known case fatality rate. Likewise, we only know the known case hospitalization rate. What we do not know, and ca

by zaroth 7y ago

To be clear, at this time we only the “CFR” - known case fatality rate. Likewise, we only know the known case hospitalization rate. What we do not know, and can only estimate, is the “IFR” or the overall infection fatality rate, and the overall infection hospitalization rate. Imagine the flu was a brand new virus which we didn’t have any test for. In 3 months we would see 100,000 hospitalizations and 10,000 deaths from this new virus. Only after testing became inexpensive and widespread would we come to realize that actually 32 million people were infected with this virus, but only 200,000 per year went to the hospital, about 20,000 of which end up dying. My point is, we do not know the infection hospitalization rate, nor the infection fatality rate of COVID-19, but its upper bound is the CFR and it’s reasonable to suspect the actual value is at least an order of magnitude lower than the current CFR data might indicate. It’s not reasonable to state anything definitively about the overall hospitalization rate of COVID at this time without the qualifier that it’s based on only known cases and therefore overstated by some unknown amount. You may find this letter (written March 4th) from doctors specializing in Emergency Medicine more compelling than my own summary: https://www.bmj.com/content/368/bmj.m606/rr-5 https://www.bmj.com/content/368/bmj.m606/rr-5

jacobolus 7y ago
Edit: I was basing my comment on a 2018 newspaper story, but thanks for tracking down a peer-reviewed model estimate. I deleted my comment as it didn’t make a grounded comparison. We can only wait and see how many people die from ncov-19 in Italy or anywhere else.
- zaroth 7y ago
  > “We estimated excess deaths of 7,027, 20,259, 15,801 and 24,981 attributable to influenza epidemics in the 2013/14, 2014/15, 2015/16 and 2016/17, respectively, using the Goldstein index. The average annual mortality excess rate per 100,000 ranged from 11.6 to 41.2 with most of the influenza-associated deaths per year registered among the elderly.” > “In the winter seasons from 2013/14 to 2016/17, an estimated average of 5,290,000 ILI cases occurred in Italy, corresponding to an incidence of 9%. More than 68,000 deaths attributable to flu epidemics were estimated in the study period.” (Edited) The wording here is confusing. It’s an average of 5.2 million cases per year for 4 years resulting in a total of 68,000 deaths over 4 years. Meaning an average of 0.325% IFR due to Flu (ILI - “influenza-like illness” in Italy. That’s a high confidence IFR based on a well established surveillance network and widespread testing. Meaning it is likely not being overstated. Versus COVID’s know case fatality rate, which is an upper bound on the IFR and known to be missing a significant number of mild cases in the general population from the denominator. I agree that it remains to be seen how bad this will be in Italy and elsewhere, but putting it in perspective to the flu (which we do not generally “fear”) is useful. [1] - https://www.sciencedirect.com/science/article/pii/S1201971219303285 https://www.sciencedirect.com/science/article/pii/S120197121...
  - jacobolus 7y ago
    Consider the chain of reasoning in https://threadreaderapp.com/thread/1236095180459003909.html https://threadreaderapp.com/thread/1236095180459003909.html
    - zaroth 7y ago
      This is just dark fiction, not science. If any of this were true, China would already be totally overrun. Instead they are reported fewer than 150 new cases per day and closing their temporary hospitals. My prediction is that we will see the same thing happening in Italy and South Korea in two/three weeks time.
      - jacobolus 7y ago
        The counter-prediction is irresponsible wishful thinking. China just did the most extreme and largest-scale social shutdown in modern history. I sincerely hope you are right though.

by zaroth 7y ago

jacobolus 7y ago

Edit: I was basing my comment on a 2018 newspaper story, but thanks for tracking down a peer-reviewed model estimate. I deleted my comment as it didn’t make a grounded comparison. We can only wait and see how many people die from ncov-19 in Italy or anywhere else.

zaroth 7y ago
> “We estimated excess deaths of 7,027, 20,259, 15,801 and 24,981 attributable to influenza epidemics in the 2013/14, 2014/15, 2015/16 and 2016/17, respectively, using the Goldstein index. The average annual mortality excess rate per 100,000 ranged from 11.6 to 41.2 with most of the influenza-associated deaths per year registered among the elderly.” > “In the winter seasons from 2013/14 to 2016/17, an estimated average of 5,290,000 ILI cases occurred in Italy, corresponding to an incidence of 9%. More than 68,000 deaths attributable to flu epidemics were estimated in the study period.” (Edited) The wording here is confusing. It’s an average of 5.2 million cases per year for 4 years resulting in a total of 68,000 deaths over 4 years. Meaning an average of 0.325% IFR due to Flu (ILI - “influenza-like illness” in Italy. That’s a high confidence IFR based on a well established surveillance network and widespread testing. Meaning it is likely not being overstated. Versus COVID’s know case fatality rate, which is an upper bound on the IFR and known to be missing a significant number of mild cases in the general population from the denominator. I agree that it remains to be seen how bad this will be in Italy and elsewhere, but putting it in perspective to the flu (which we do not generally “fear”) is useful. [1] - https://www.sciencedirect.com/science/article/pii/S1201971219303285 https://www.sciencedirect.com/science/article/pii/S120197121...
- jacobolus 7y ago
  Consider the chain of reasoning in https://threadreaderapp.com/thread/1236095180459003909.html https://threadreaderapp.com/thread/1236095180459003909.html
  - zaroth 7y ago
    This is just dark fiction, not science. If any of this were true, China would already be totally overrun. Instead they are reported fewer than 150 new cases per day and closing their temporary hospitals. My prediction is that we will see the same thing happening in Italy and South Korea in two/three weeks time.
    - jacobolus 7y ago
      The counter-prediction is irresponsible wishful thinking. China just did the most extreme and largest-scale social shutdown in modern history. I sincerely hope you are right though.